克拉玛依地区90例皮肤利什曼病的临床分析

目的：研究克拉玛依地区皮肤利什曼病的临床类型及病理。方法：分析整理１９８８—１９９４年确诊的９０例皮肤利什曼病的临床及病理资料。结果：该病主要临床类型可分为丘疹、斑块、溃疡性结节和结节性痒疹型４种。丘疹及斑块型主要由利什曼原虫引起的巨噬细胞聚集和炎症反应；溃疡性结节型是皮肤组织坏死、液化及脱落，溃疡边缘的真皮层呈充血和水肿，并有中性粒细胞和淋巴细胞浸润，在浸润区内可查见原虫；结节性痒疹型主要是真皮层形成结核样结节，利什曼原虫很少。患者的血象正常，Ｂ超检查脾脏的大小与当地正常人无明显差异。结论：克拉玛依地区皮肤利什曼病有丘疹、斑块、溃疡性结节及结节性痒疹型４种临床类型，且各有病理特征。

CLINICOPATHOLOGIC ANALYSIS ON NINETY CASES OF CUTANEOUS LEISHMANIASIS IN KARAMAY REGION OF XINJIANG

AIM:To study the clinical forms of cutaneous leishmaniasis (CL) basing on pathological changes in Karamay of Xinjiang. METHOD:Analysis on clinical and pathological data in 90 parasitologically confirmed CL cases in Karamay from 1988 to 1994. RESULTS:Cutaneous lesions were divided into 4 forms: papule,plaque,ulcerous nodule and nodular prurigo.Dermal pathological changes showed that the papule form and plaque form mainly consisted of accumulated macrophages and inflammatory cells induced by Leishmania . The skin surrounding the ulcerous nodule form presented necrosis,liquifaction and desquamation with Leishmania detected in the lesion.Nodular prurigo form was chiefly composed of epithelial cells,fibroblasts,giant cells and lymphocytes;a few Leishmania were found in the dermis.Normal blood picture was revealed in all cases.The size of spleen examined by B mode ultrasonography did not show marked difference comparing with the normal control.CONCLUSION:There are four forms of CL with different histopathological changes in Karamay of Xinjiang.