表现为红皮病的挪威疥一例

患者,女,53岁。双上肢红斑、丘疹伴瘙痒1年,泛发全身3个月,曾误诊为"过敏",予抗组胺药、糖皮质激素软膏治疗,皮损未见明显好转。皮肤活检及显微镜镜检发现疥螨,给予氧化锌硫软膏外用。     

挪威疥致红皮病1例

报告1例挪威疥的诊疗经过.患者女,65岁,全身红斑、丘疹、鳞屑伴痒1个月.既往有脑梗死、高血压病史,入院诊断为红皮病.镜检发现大量疥虫.诊断:挪威疥;红皮症.治疗上予以外用硫磺软膏、消毒等对症支持治疗后,皮疹好转.     

挪威疥1例

患者女,60岁。全身弥漫性红斑脱屑1个半月,皮肤科情况:躯干及四肢见弥漫性水肿性红斑,其上泛发针尖至米粒大红色丘疹及丘疱疹,手背及指间潮红、肿胀、肥厚,上覆鳞屑,散在分布淡黄色厚痂,有特殊臭味。镜检见疥虫的虫体及虫卵。诊断:挪威疥;红皮病。     

挪威疥误诊一例

患者女,72岁,因老年痴呆长期在某老年养护中心住院。因全身红斑、脱屑伴痒1年,加重伴掌跖及头皮角化厚痂3周,经常搔抓影响睡眠。初起皮疹时曾诊断为湿疹、真菌感染,予以抗组胺药及抗真菌治疗效果不佳,患者皮损进一步加重而请皮肤科会诊……     

误诊为湿疹的挪威疥一例

患者，男，24岁。全身皮肤起丘疹伴瘙痒1年余就诊。当地医院曾按“泛发性湿疹”予抗过敏治疗，皮损未见好转。取皮疹鳞屑镜检见疥螨。诊断：挪威疥。经治疗痊愈。     

挪威疥误诊1例

挪威疥又称结痂性疥疮或角化性疥疮，临床比较少见,但近年发病率亦有所增高，由于其临床表现不同于普通的疥疮，而与角化过度性湿疹、湿疹伴感染、银屑病等有一定的相似之处，极易误诊，并易造成传染。现将笔者诊治的1例挪威疥报道如下：     

挪威疥误诊2例

例1男,78岁。全身红斑、丘疹、鳞屑伴瘙痒40余天。曾在外院以"剥脱性皮炎"予糖皮质激素治疗,皮损短暂好转后又加重。例2男,80岁。全身丘疹、丘疱疹、细屑伴剧烈瘙痒20余天。在当地医院以"湿疹"予抗过敏治疗,皮损未见好转。刮取2例患者鳞屑做直接镜检,均发现典型的疥虫形态,诊断:挪威疥。经治疗痊愈。     

挪威疥误诊为药疹1例

患者男,20岁。入院时表现为全身皮肤弥漫性潮红、肿胀、脱屑、黏着性鳞屑,胸背部泛发粟粒大小的脓疱,双手黏着性黄厚痂,伴瘙痒、发热,诊断为药疹。取鳞屑镜检见大量疥虫和虫卵,确诊为挪威疥。外用硫磺软膏治愈。     

挪威疥误诊1例

报告1例挪威疥的误诊及治疗经过。患者男,75岁,躯干、四肢反复红斑、丘疹、脱屑伴瘙痒1年、手足肿胀1月。有类风湿性关节炎、高血压病病史,长期卧床,卫生护理条件差,在外院反复诊断为"湿疹""红皮病"。镜检发现大量疥虫。诊断:挪威疥。给予硫磺软膏外用,并辅以抗感染等治疗。临床医生应提高对该病的警惕和认识,结合病史、皮损特点及镜检等进行诊断,减少误诊,提高治愈率。     

挪威疥误诊为泛发性湿疹1例

<正>1病历摘要患者女,53岁。因躯干及四肢反复红斑、丘疹伴瘙痒9个月来我院皮肤科就诊。患者9个月前无明显诱因腹部、腰部出现散在红斑、丘疹,表面有少量脱屑,伴明显瘙痒,皮损逐渐扩展至躯干、面部、耳部及四肢,于外院就诊,诊断为泛发性湿疹。予硫代硫酸钠、炎琥宁等静脉滴注,复方甘草酸苷、左西替利嗪及枸地氯雷他定口服,糠酸莫米松、氧化锌硼酸软膏等外用,皮损好转,但反复发作。我院以泛发性湿疹收治入院。患者既往有高     

挪威疥合并单纯型大疱性表皮松解症及狼疮性肾炎一例

患者，女，39岁。全身红斑结痂伴痒半年，蛋白尿3周。既往背部四肢反复破溃28年。组织病理示：角化过度伴灶性角化不全，角层下见疥虫，棘层肥厚，皮屑镜检见疥虫。电子显微镜示：表皮细胞间细胞连接装置明显减少或缺如，细胞之间可见明显间隙，部分区域大疱形成。血红蛋白74 g/L，尿蛋白+++，ANA阳性，抗心磷脂抗体IgG 31.9 U。诊断：挪威疥；单纯型大疱性表皮松解症；狼疮性肾炎。     

挪威疥疮1例

报告挪威疥疮１例。患者男６５岁，头皮，颈肩、胸背、上肢、手背大片厚层痂子，不易刮落，阴囊部抓痕，散在结节。瘙痒不明显。痂皮外疥螨成虫、虫卵镜检（＋）。外用硫柳膏治愈。     

以红皮病为首发症状的艾滋病一例

患者,男,40岁。全身皮肤潮红、脱屑伴瘙痒1个月。患者既往无湿疹、银屑病病史。查体：全身弥漫性潮红,表面覆盖黄白色细碎鳞屑,口周、眼周可见裂隙伴渗出,双足背覆盖袜套样黄色、褐色样鳞屑,可见痂样结构。HIV抗体初筛及确诊试验阳性。诊断为艾滋病、红皮病。     

大疱性疥疮

报告1例大疱性疥疮。患者男,65岁。3个月前无明显诱因躯干、四肢出现散在红斑、水疱、糜烂、结痂,伴瘙痒。患者1个月前指缝间、阴囊处出现类似红斑、丘疹,瘙痒明显。皮肤科检查:躯干、四肢可见弥漫性红斑,部分红斑上可见紧张性水疱,疱壁紧张,疱液清亮,部分水疱破裂后糜烂,可见红色糜烂面,部分表面结痂;双手指缝间、阴囊散在红斑,苔藓样变,可见抓痕。皮损组织病理检查:(左股内侧皮损)角化不全,浆液渗出,可见表皮下疱,疱内可见浆液,大量嗜酸性粒细胞及红细胞,真皮浅层可见嗜酸性粒细胞及中性粒细胞浸润;直接免疫荧光:皮肤全层未见特异性荧光,间接免疫荧光:真皮与表皮交界处(-);镜检发现疥螨。诊断:大疱性疥疮。     

Crusted (Norwegian) scabies in a patient with dystrophic epidermolysis bullosa

A 13-year-old girl with severe non-mutilating recessive dystrophic epidermolysis bullosa (EB) was admitted to hospital because of a Staphyloccus aureussepsos, deterioration of her general condition and worsening of her skin disease, which itched severely. In addition to the blisters and erosions normally seen, she was covered from head to toe with scales and hyperkeratotic crusts. Despite intensive topical therapy, her skin condition did not improve significantly until scabies was detected and treated 1 week after admission. Because of the huge number of mites found and the crusted appearance, a diagnosis of crusted (Norwegian) scabies was made. She was successfully treated with two doses of ivermectin orally and one application of lindane ointment. Permethrin cream was not tolerated. In this patient crusted scabies may have developed because of: (i) a modified host response due to malnourishment; (ii) inability to scratch because of the absence of fingernails; and (iii) abnormal scratching behaviour because of the vulnerability of EB skin, or a combination of these factors. Limited isolation measures were taken on admission and full measures were taken immediately after the diagnosis of crusted scabies was made. Prophylactic treatment of ward personnel was not undertaken. Fortunately, there was not an outbreak of scabies in the hospital.     

Crusted (Norwegian) scabies in a patient with smoldering adult T-cell leukemia

Crusted (Norwegian) scabies is described in a patient with smoldering adult T-cell leukemia (ATL). The patient is an 84-year-old Japanese woman who presented with widespread scaling over the trunk and limbs and crusted lesions on the scalp and ears. Microscopical examination of scrapings from the scalp and ears showed extraordinarily large numbers of scabies mites. The white blood cell count was 5.1 x 10(9)/L with 6% abnormal lymphocytes with mature nuclei that showed convolution and lobulation. Anti-HTLV-I antibodies were positive. Southern blot analysis revealed that the cellular DNA extracted from this patient's peripheral blood cells, digested with Pst I, showed the same pattern of provirus genome as the DNA from ATL patients. A diagnosis of crusted scabies with smoldering ATL was made. It is possible that crusted scabies could be an opportunistic infection and a pre-diagnostic sign of ATL.