Prevalencia de especies de Malassezia asociadas a lesiones de dermatitis seborreica en pacientes de Argentina

BackgroundSeborrheic dermatitis (SD) is considered the second most frequently dermatosis associated with the genus Malassezia but little is the knowledge about the epidemiology of this association.AimsTo determinate the prevalence of Malassezia species associated with SD and to analyse their distribution according to the location of the lesion on the body.MethodsThis study was performed in Resistencia city, located in a subtropical area in northeast Argentina. In this study, 226 skin samples from patients with lesions compatible with SD were studied. Age, gender and body sites lesion were recorded. Strains were identified by PCR-RFLP.ResultsOne hundred and thirty-one positive cultures were obtained. Association of 2 species was detected in 10 cases; therefore, 141 strains were isolated. Malasezzia globosa (43.3%) was the most frequent species isolated, followed by Malasezzia furfur (20.6%), Malasezzia sympodialis (17%) and Malasezzia restricta (16.3%). Three isolates of Malasezzia slooffiae (2.1%) and one of Malasezzia pachydermatis (0.7%) were obtained. Statistical significance (P < 0.05) was found between M. globosa and scalp. Malasezzia restricta was isolated only in head areas.ConclusionsThis study suggests M. globosa is the most related species to SD. The prevalence of other species is different from that reported by other authors. Only M. globosa and M. restricta presented a pattern of relationship with the body sites of the lesions. It is noteworthy is the isolation of the zoophylic species M. pachydermatis. The Malassezia genus ecology and the pathogenic role of its species are still under study. This work is a contribution to this knowledge.     

皮肤镜诊断脂溢性角化病与基底细胞癌的准确性及结果分析

目的:探讨皮肤镜诊断脂溢性角化病与基底细胞癌的准确性,参照现有诊断标准对结果进行分析。方法:收集临床诊断为脂溢性角化病和基底细胞癌的病例,参照目前的皮肤镜诊断标准对其作出诊断,并与组织病理结果相比较,分析皮肤镜诊断脂溢性角化病与基底细胞癌的价值,并分析脂溢性角化病和基底细胞癌的皮肤镜特征。结果:应用皮肤镜诊断脂溢性角化病的准确性为94.6%,灵敏度为95.8%,漏诊率为4.2%,特异性为90.0%,误诊率为10.0%,阳性预测值为97.2%,阴性预测值为85.7%。Kappa值为0.843,皮肤镜诊断与病理诊断有极佳的一致性(u=8.901,P0.001)。脂溢性角化病患者中出现频次较高的皮肤镜特征分别为乳黄色角栓或多发性粟丘疹样囊性结构(66.7%)、粉刺样开口(56.5%),其次是沟壑样结构(脑回样外观)(42.0%)。应用皮肤镜诊断基底细胞癌的准确性为83.3%,灵敏度为84.6%,漏诊率为15.4%,特异性为80.0%,误诊率为20.0%,阳性预测值为91.7%,阴性预测值为66.7%。Kappa值为0.609,皮肤镜诊断与病理诊断有高度的一致性(u=3.684,P0.001)。基底细胞癌患者中出现频次较高的皮肤镜特征分别为大的蓝灰色卵圆形巢(81.8%)、多发性蓝灰色小球(59.1%),然后是分支状毛细血管扩张(45.5%)。结论:皮肤镜是一种无创的可以显著提高脂溢性角化病与基底细胞癌确诊率的检查办法,但现有诊断标准还需不断改良和细化。     

对SK、AK、cSCC临床及病理特征的差异性分析

摘要 目的：探讨SK、AK、cSCC临床及病理特征的差异。方法：收集2010年1月-2020年12月期间经皮肤科病理确诊为SK（484例）、AK（68例）和cSCC（152例）患者的临床及病理资料,分析患者发病性别、年龄、皮损部位、病理分型及误诊疾病的构成等特点。结果：1. SK好发于46-60岁和61-75岁,在31-45岁年龄段好发于非暴露部位;AK好发于61-75岁和≥76岁年龄段,无论在哪个年龄段均好发于暴露部位,且随年龄增长患病率增高;cSCC好发于61-75岁和≥76岁年龄段,在46-60岁年龄段,好发于非暴露部位,在≥76岁年龄段,cSCC好发于暴露部位。2. SK及cSCC可发生于任何部位;AK可发生于除外阴以外的其他部位,好发于头面颈部。3. SK发病男女无差异,AK发病女多于男,cSCC发病男多于女。4. SK以棘层肥厚型（52.9%）和角化过度型（38.2%）多见,AK以萎缩型（47.0%）和角化过度型（26.5%）多见。6.SK误诊率为29%,AK误诊率为63%。结论：SK、AK及cSCC发病性别、年龄、皮损部位等各有异同,临床表现多样,易误诊,临床需提高警惕。     

复方黄柏液联合派瑞松治疗脂溢性皮炎的临床研究

目的:探讨复方黄柏液联合派瑞松治疗脂溢性皮炎的临床疗效及其对患者血清白细胞介素-8(IL-8)、白细胞介素-2(IL-2)及白细胞介素-10(IL-10)水平的影响。方法:选择于我院就诊的脂溢性皮炎患者120例,随机分为实验组和对照组,每组各60例。对照组患者采用派瑞松进行治疗,实验组患者采用复方黄柏液联合派瑞松进行治疗。比较治疗前后两组患者血清白细胞介素-2(IL-2)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)水平,并比较治疗后脂溢性皮炎复发率、复发间隔天数及临床治疗效果。结果:治疗后,与对照组相比,实验组患者血清IL-10水平及复发率明显较低(P0.05);血清IL-2、IL-8水平及临床总有效率较高(P0.05);痊愈至复发的间隔时间较长(P0.05)。结论:复方黄柏液联合派瑞松能够明显提高脂溢性皮炎的临床治疗效果,降低临床复发率,可能与缓解机体的炎症反应有关。     

马拉色菌相关疾病研究现状

马拉色菌是一种存在于人体皮肤表面的真菌,容易诱发真菌感染性皮肤疾病,其中花斑癣的发病与该菌属存在着直接的相关性。目前研究表明脂溢性皮炎、特应性皮炎、马拉色菌毛囊炎、银屑病等相关疾病的发生和发展均与马拉色菌属的感染存在着一定的联系。在综合相关文献报道的基础上,对马拉色菌属在一些常见皮肤疾病中的发病机制进行了有关的概述。