荧光染色法与KOH法在皮肤真菌检查中的效果比较

目的探讨真菌荧光法在皮肤浅部真菌筛查的敏感性。方法收集皮肤科门诊疑似真菌感染的患者标本,同时用KOH湿片法和真菌荧光染色法进行检测,并对检验结果进行对比。结果 1 209例患者中真菌荧光染色法阳性的阳性率为42.76%,KOH湿片法的阳性率为24.81%,结果差异有统计学意义(χ^2=87.094,P<0.05)。荧光染色法和KOH法在患者不同部位的阳性率:头面部为55.59%、7.90%,体股部为46.93%、30.06%,手足部为27.37%、26.25%,外阴部为31.85%、14.07%,指甲(趾甲)部为51.64%、48.36%;在不同疾病中的阳性率:马拉色毛囊炎为77.00%、8.50%,手足癣为48.04%、46.08%,体癣为50.31%、33.44%,甲癣为51.64%、48.36%,花斑癣为66.67%、48.00%,湿疹为10.24%、5.42%,皮炎为48.11%、9.43%。结论荧光染色法是一种简单、快速、准确的真菌镜检方法,值得在临床上推广使用。其总体的阳性率比KOH湿片法高,毛囊虫、疥疮等真菌荧光染色法在镜下更容易辨认。头面部、外阴等油脂分泌旺盛的部位以及马拉色毛囊炎、湿疹和皮炎等疾病推荐使用荧光染色法来排除是否有真菌的感染。

Effect comparison between fluorescent staining and KOH method in detection of skin fungi

Objective To explore the sensitivity of fluorescence in superficial fungal screening. Methods The specimens collected from 1,209 cases of suspected fungal infection in dermatology clinic were tested using KOH method and fluorescence method respectively, and the results were compared. Results The positive rate of fungal fluorescence staining was 42.76%, and that of KOH method was 24.81%(χ^2=87.094, P<0.05). The positive rates of fluorescent staining vs KOH method in detection of different body parts were as follows: head and face(55.59% vs 7.90%), body and thigh(46.93% vs 30.06%), hand and foot(27.37% vs 26.25%), genitalia(31.85 vs 14.07%), toenail and nail(51.64% vs 48.36%);The positive rates in detection of different diseases were as follows: malasseh folliculitis(77.00% vs 8.50%), tinea of feet and hands(48.04% vs 46.08%), tinea corporis(50.31% vs 33.44%), mycosis ungualis(51.64% vs 48.36%), chromophytosis(66.67% vs 48.00%), eczema(10.24% vs 5.42%) and dermatitis(48.11% vs 9.43%). Conclusion Fluorescence is a simple, rapid and accurate microscopy method, the overall positive rate of which was higher than that of KOH method. Fungi such as follicles and scabies are easier to recognize with naked eye by fluorescence staining. For head, face, genitalia and other body parts with strong secretion of oil, as well as malasseh folliculitis, eczema and dermatitis and other diseases, fluorescence staining is recommended for exclusion of fungal infections.