浅部真菌感染和变态反应性皮肤病相关性研究

摘要

目的 通过比较合并与未合并浅部真菌感染的变态反应性皮肤病对常用变应原的敏感性,综合从皮肤或指(趾)甲中分离出的菌种情况,评估浅部真菌感染在变态反应性皮肤病的病因学中的作用.方法 受试者包括353例慢性荨麻疹、湿疹及特应性皮炎患者.通过真菌直接镜检法将受试者分为两组.实验组:变态反应性皮肤病合并浅部真菌感染组(n =173)；对照组:变态反应性皮肤病无浅部真菌感染组(n=180).对所有实验组及对照组受试者进行9种真菌变应原和9种非真菌变应原皮内试验.实验组患者进一步进行真菌培养以鉴定菌种.结果 慢性荨麻疹患者实验组须发癣菌、新月弯孢霉,特异青霉、烟曲霉变应原阳性率显著高于对照组(P＜0.05),慢性湿疹患者实验组须发癣菌变应原阳性率显著高于对照组(P ＜0.001).慢性湿疹、荨麻疹患者其他真菌变应原及粉尘螨、屋尘螨等非真菌变应原阳性率比较差异均无统计学意义(P＞0.05).134例患者皮肤或指(趾)甲分离鉴定主要为红色毛癣菌(52.86％)、须癣毛癣菌(14.18％)、絮状表皮癣菌(5.22％)、白念珠菌(6.72％),实验组须发癣菌变应原阳性率及皮肤分离皮肤癣菌阳性率比较差异无统计学意义(P＞0.05).结论 实验结果表明,须发癣菌变应原阳性的慢性荨麻疹、湿疹患者往往合并皮肤癣菌感染,皮肤癣菌感染可能在部分慢性荨麻疹、湿疹的病因学中起重要作用.%Objective To investigate superficial fungal infection in the etiology of allergic dermatitis by comparing the sensitivities of fungal allergens and unfungal allergens among allergic dermatitis patients with or without tinea, and the identification of pathogens. Methods Totally 353 patients with chronic urticaria, eczema or atopic dermatitis were divided into two groups classified by direct microscopic examination; the group with superficial fungal infection ( n =173) and the contra! Group without superficial fungal infection ( n - 180). Skin prick tests were performed in all subjects, but fungal culture were administered only in the patients with superficial fungal infection. Results Positive rates to Trichophyton,Specific Penicillium,Curvularia lunata and Aspergillus fumigatus in experiment group were higher than those in control group ( P ＜ 0. 05). Positive rate to Trichophyton in experiment group was higher than that in control group ( P ＜0.001). There were no statistically significant differences among other fungal allergens and unfungal allergens ( P ＞0.05). T. rubrum (52. 86% ) , T. mentagrophytes (14.18% ) , Epidermophyton floccosum (5. 22% ) and Candida (6. 72% ) were cultured in 134 cases of skin allergic diseases with superficial fungal infection. The positive rates were not statistically significant between Trichophyton and dermatophytes ( P ＞0.05). Conclusions Patients with chronic urticaria or eczema who present immediate hypersensitivity to Trichophyton always have dermatophyte infection. Superficial fungal infections seem to be an important factort in the subjects with chronic urticaria or eczema.