皮肤型孢子丝菌病585例临床分析

目的 对近3年吉林地区585例皮肤型孢子丝菌病病例进行总结，分析其临床和流行病学特征。方法 对2007-2009年我院皮肤科确诊的孢子丝菌病病例进行回顾性分析。结果 585例患者中男女比1 ∶ 1.35，平均年龄40.5岁，发病年龄以51 ～ 60岁最多见（22.05%）；平均病程6.78个月；冬春季节发病者所占百分比最高；居住于农村者551例（94.19%），有外伤史者占25.47%。临床表现以固定型最常见（56.58%），其次为淋巴管型（39.66%），皮肤播散型和不确定型各占1.88%。受累部位以四肢（50.94%）及面部（43.76%）最多。治疗采用10%碘化钾溶液、伊曲康唑、特比萘芬或联合治疗。失访250例，余335例已治愈289例，平均疗程2.09个月，其余46例仍在治疗随访中。结论 孢子丝菌病近年来仍然是吉林地区的多发病，其临床及流行病学特点与以往报道相似，但中老年患者所占比例及皮损不典型病例增加，碘化钾、伊曲康唑和特比萘芬是治疗孢子丝菌病安全有效的药物。

Clinical analysis of 585 cases of cutaneous sporotrichosis

Objective To summarize and analyze the clinical and epidemiological characteristics of 585 cases of cutaneous sporotrichosis collected in Jilin province in the last 3 years. Methods A retrospective study was conducted on sporotrichosis cases diagnosed at the Department of Dermatology in the hospital from 2007 to 2009. Results Totally, 585 cases were included in this study. Among these patients, the male/female ratio was 1:1.35 with an average age of 40.5 years and average duration of symptoms of 6.78 months.The age at onset was mainly between 51 and 60 years (22.05%). Sporotrichosis seemed more frequently to occur in winter and spring. The majority (94.19%) of the patients were rural habitants, and 149 (25.47%) patients recalled history of trauma. Fixed form was the most common clinical presentation (56.58%), followed by lymphocutaneous form (39.66%), cutaneous disseminated form ( 1.88% ) and undefined form ( 1.88% ). The predilection sites of sporotrichosis were extremities (50.94%) and face (43.76%). The treatment of sporotrichosis included a 10% solution of potassium iodide, itraconazole and terbinafine alone or in combination. Two hundred and fifty patients were lost to follow up. Of the remaining 335 patients, 289 were cured with an average treatment duration of 2.09 months, 46 were still under follow-up or treatment. Conclusions The case load of sporotrichosis in Jilin province has remained high in recent years. The clinical and epidemic features of sporotrichosis cases in this report are similar to those in previous reports, but the proportion of middle-aged patients and atypical cases increases. Potassium iodide solution, itraconazole and terbinafine are effective and safe for the treatment of sporotrichosis.