發(fā)布時間：2018-07-06 19:05

  本文選題：頭癬 + 皮膚鏡學　； 參考：《川北醫(yī)學院》2016年碩士論文

【摘要】：目的:觀察頭癬在治療前后皮膚鏡下征象及其變化,探討皮膚鏡在頭癬診斷及治療中的價值。方法:收集2015年6月至2016年1月到川北醫(yī)學院附屬醫(yī)院皮膚科初診的頭癬患者,所有病例收集完整的臨床資料、采集大體照片和皮膚鏡照片,觀察頭癬患者治療前后皮損各個部位(中央及邊緣)皮膚鏡下征象及其變化情況,并對其進行每2周一次的皮膚鏡追蹤觀察,共8周,對所收集的數據進行統(tǒng)計分析。結果:1.頭癬患者男女比例約為1.7:1,平均發(fā)病年齡為6歲,學齡前期兒童最多,占48.8%。41例頭癬患者中,白癬27例(65.9%)、黑點癬5例(12.2%)、膿癬9例(22.0%)、黃癬0例。真菌鏡檢陽性率為85.4%,真菌培養(yǎng)陽性率為87.8%。2.治療前頭癬患者皮膚鏡下征象出現(xiàn)率由高到低依次為斷發(fā)(97.6%)、黑點征(95.1%)、甘蔗樣發(fā)(63.4%)、勾狀發(fā)(51.2%)、Z型發(fā)(26.8%)、膿皰(22.0%)、逗號發(fā)(14.6%)、螺旋狀發(fā)(9.8%);對照組皮膚鏡下無甘蔗樣發(fā)、逗號發(fā)、螺旋狀發(fā)及Z型發(fā)。3.白癬中查見甘蔗樣發(fā)、Z型發(fā),黑點癬中查見逗號發(fā)、螺旋狀發(fā)及Z型發(fā),膿癬中查見甘蔗樣發(fā)、逗號發(fā)及Z型發(fā)。4.甘蔗樣發(fā)與菌絲陽性呈正相關關系(r值為0.036,P值0.05);逗號發(fā)、螺旋狀發(fā)與菌絲陽性呈負相關關系(r值分別為-0.518,-0.411,P值0.05);其余各征象與直接鏡檢結果的相關關系無統(tǒng)計學意義(P值均0.05)。5.頭癬治療后皮膚鏡下各征象逐漸減少,所有皮膚鏡下征象消失時真菌檢查陰性。結論:1.皮膚鏡可對頭癬進行診斷,頭癬在皮膚鏡下可查見特征性的甘蔗樣發(fā)、逗號發(fā)、螺旋狀發(fā)及Z型發(fā)。其中白癬可見甘蔗樣發(fā)和Z型發(fā),黑點癬可見逗號發(fā)、螺旋狀發(fā)及Z型發(fā),膿癬可見甘蔗樣發(fā)、逗號發(fā)及Z型發(fā)。2.皮膚鏡指導真菌鏡檢標本取材,有助于提高真菌鏡檢陽性率。3.皮膚鏡可以對頭癬患者進行療效判斷,較真菌鏡檢及培養(yǎng)方便。
[Abstract]:Objective: To observe the signs and changes of tinea capitis under the skin mirror before and after treatment, to explore the value of skin mirror in the diagnosis and treatment of tinea capitis. Methods: to collect tinea capitis patients in Department of Dermatology of Affiliated Hospital of Chuanbei Medical College from June 2015 to January 2016. The symptoms and changes of skin lesions under the skin lesions (central and edge) of the tinea capitis patients before and after treatment were observed and observed every 2 weeks. The data were analyzed for 8 weeks. The results showed that the proportion of men and women in 1. tinea patients was about 1.7:1, the average age was 6 years old, the most of the preschool children, accounting for 48.. Among 8%.41 cases, there were 27 cases of tinea capitis (65.9%), 5 cases of tinea ringworm (12.2%), 9 cases of psoriasis (22%) and 0 cases of tinea Macris. The positive rate of fungal microscopy was 85.4%. The positive rate of fungal culture was 87.8%.2. in the patients with tinea capitis from high to low (97.6%), black spot sign (95.1%), sugar cane like hair (63.4%), hook hair (51.2%), Z type hair. (26.8%) pustules (22%), comma hair (14.6%), spiral hair (9.8%); in the control group, no sugarcane like hair, comma hair, spiral hair, and Z type.3. tinea ringworm were found in the control group. The hair of sugarcane like hair, Z type hair, spiral hair and Z type hair were found in the black spot ringworm, and the tinea pedis and Z type.4. cane like hair and mycelium were found in the ringworm of the pus. Positive correlation (r value was 0.036, P value 0.05); comma hair, spiral hair and mycelium positive correlation (r value was -0.518, -0.411, P value 0.05 respectively); the correlation between the other signs and direct microscopic examination results was not statistically significant (P value was 0.05), each of the skin microscopic signs gradually decreased after the treatment of.5. tinea capitis, and all the skin microscopic signs disappeared. The fungal examination was negative. Conclusion: 1. skin mirrors can be used to diagnose tinea capitis. The tinea capitis can be found with characteristic sugarcane like hair, comma hair, spiral hair and Z type hair under the skin mirror. The tinea capitis can be seen from the sugarcane like hair and Z type hair, the black spot ringworm can be seen comma hair, spiral hair and Z type hair, the tinea pedis is visible, comma hair and Z type.2. skin mirror finger. The specimen obtained from microscopic examination of fungi helps to improve the positive rate of fungal microscopy..3. skin mirror can be used for the treatment of tinea pedis, and is more convenient than fungal microscopy and culture.
【學位授予單位】：川北醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R756.1

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