2000～2008年原发性皮肤隐球菌病回顾性分析

摘要

目的 了解2000-2008年间原发性皮肤隐球菌病(PCC)的流行病学及临床特征.方法 检索并回顾性分析2000-2008年文献报道的原发性皮肤隐球菌病病例资料,对比分析2000-2008年与1985-2000年报道的PCC病例及免疫正常与免疫受损PCC病例的特征是否存在差异.结果 共检索出2000-2008年间符合PCC诊断标准的病例28例.近8a来PCC仍好发于年龄较大者,但男性更多见;免疫正常或受损宿主均可发生PCC; HIV感染患者发生PCC几率更小;外伤可能为PCC重要的诱发因素;皮疹部位仍以四肢等暴露部位为主;皮疹性质由以前较特异的化脓性指头炎或蜂窝织炎为主变迁到以溃疡、结节、红斑、肿块等非特异性皮疹为主;治疗仍以抗真菌药物口服或与手术联合为主,氟康唑仍为一线药物;预后一般较好.结论 近年来PCC表现出一些新的特点.宿主的免疫状态可能不影响其发生PCC的机率或影响较小,而仅影响隐球菌感染后的转归.%Objective To study the epidemiology and clinical features of primary cutaneous cryptococcosis from 2000 to 2008.Methods Cases of primary cutaneous cryptococcosis from 2000 to 2008 were retrospectively analysed and the differences with those between 1985 and 2000 were compared.Results PCC occurred more commonly in the older and the male in the recent 8 years.There was no difference in the onset between immunocompetent and immunocompromised hosts, while HIV positive patients had the lower probability to get PCC,xternal injury might be the important causative factors,erythra still happened majorly in extremities or other exposure sites, the erythra had changed from whitlow or cellulitis to ulcer,nodus,erythema,and so on, the oral antifungal drugs combined with surgery were most acceptable treatment and fluconazole was still the first choice for PCC, and the prognosis was good.Conclusions In recent years, PCC obtained some new characteristics.We considered that the immune state affected less or had no effect on incidence of PCC ,while majorly affected the final outcome of Cryptococcus infection.