脓癣的发病情况和病原菌变迁:上海地区19年的回顾性研究

目的了解近19年间上海地区脓癣的发病情况、病原菌及其变迁。方法选取头皮屑及头发真菌直接镜检阳性和(或)真菌培养为皮肤癣菌者,记录其临床表现、感染方式及动物接触史等。结果头癣患者1 009例,其中男性437例,女性572例;年龄20 d～93岁,平均10.44岁;脓癣114例(11.30%),其中男性44例,女性70例。年龄20 d～68岁,平均10.60岁,5～10岁最多见(45.61%),其次为5岁以下儿童(31.58%)。感染方式:发内型48例,发外型66例。真菌培养阳性的脓癣95例,其中犬小孢子菌29例(30.53%)、紫色毛癣菌21例(22.11%)、须癣毛癣菌19例(20.00%)、红色毛癣菌15例(15.79%)、断发毛癣菌7例(7.37%)、石膏样小孢子菌4例(4.21%)。脓癣的发病呈上升趋势,须癣毛癣菌脓癣尤为显著。结论上海地区脓癣主要发生于10岁以内儿童,犬小孢子菌是最常见的致病菌,发外型感染较发内型多见。

Incidence and pathogen changes of kerion in Shanghai: a 19-year retrospective study

Objective To find out incidence and pathogens of kerion in Shanghai in the last 19 years. Methods Retrospective analysis was used. Diagnosis of tinea eapitis was confirmed by direct microscopic examination and （or） fungal culture. The identification of fungi was based on the macroscop!c and microscopic characteristics of the colonies. Clinical features, hair invasion patterns and pet contact history were recorded for each patient. Results Total 1 009 tinea capitis cases were in the servey. Kerion was seen in 114 cases： 44 males and 70 females. Their age was from 20 days to 68 years old with an average of 10.60 years. Kerion was most often seen in children between 5 and 10 years of age,followed by children younger than 5 years old. Ectothrix （66 casts） was more than endothrix （48 cases） on the patterns of invasion in kerion patients. Ninety-five kerlon cases were positive cultured. Microsporum canis （30.53%） was the most common pathogen, followed by Trichophyton violaceum （22.11%）, T. mentagrophytes （20.00%）, T. rubrum （ 15.79% ）, T. tousurans （7.37%） and M. gypseum （4.21%）. Incidence of kerion was rising especially caused by T. mentagrophytes. Conclusions Kerion was common seen in children younger than 10 years old. M. canis was the most common pathogen and ectothrix was the main invasion pattern of kerion in Shanghai.