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NEJM：叠瓦癣-案例报道

2016-12-08 xing.T MedSci原创

叠瓦癣
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这些皮肤表现的鉴别诊断包括匐行性回状红斑、副肿瘤性现象。患者用灰黄霉素清除活动性感染和局部浸泡稀醋防止叠瓦癣复发。不幸的是，由于该患者居住较远，无法进行后续的随访。

患者为18岁斐济女性，因在其肩部出现同心鳞片皮疹史3年而就诊；同时在她的躯干、手臂、腿部皮肤（未提供图片）均出现了这样的皮疹。皮疹瘙痒并逐步蔓延涉及约70%的体表面积，她的哥哥也有类似的皮肤改变。以往口服灰黄霉素、特比萘芬可以导致皮疹暂时性好转。该患者的临床诊断为叠瓦癣。 

叠瓦癣是一种罕见的、由同心性毛癣菌引起的浅部真菌感染，在美国中部和南部和南太平洋地区流行。这些病变往往为瘙痒，最常见的部位是在躯干和四肢，但可以在身体的任何部分出现。感染往往遵循一个慢性或再次出现和复发的过程，虽然它是无侵袭性的。 

这些皮肤表现的鉴别诊断包括匐行性回状红斑、副肿瘤性现象。患者用灰黄霉素清除活动性感染和局部浸泡稀醋防止叠瓦癣复发。不幸的是，由于该患者居住较远，无法进行后续的随访。 

原始出处： 

Carrick Burns,et al. Tinea Imbricata.N Engl J Med 2016; 375:2272December 8, 2016DOI: 10.1056/NEJMicm1516757 

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  1. [GetPortalCommentsPageByObjectIdResponse(id=183782, encodeId=db1f183e822b, content=这种病例很少，很难看到图片。谢谢上传病例。, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Mar 30 12:25:11 CST 2017, time=2017-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=165815, encodeId=0c99165815ae, content=学习了，很典型！, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon Dec 26 15:09:50 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162748, encodeId=741d162e4834, content=讲的好，学习了，分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Dec 14 12:44:30 CST 2016, time=2016-12-14, status=1, ipAttribution=)]
    2017-03-30 虈亣靌

    这种病例很少，很难看到图片。谢谢上传病例。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=183782, encodeId=db1f183e822b, content=这种病例很少，很难看到图片。谢谢上传病例。, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Mar 30 12:25:11 CST 2017, time=2017-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=165815, encodeId=0c99165815ae, content=学习了，很典型！, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon Dec 26 15:09:50 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162748, encodeId=741d162e4834, content=讲的好，学习了，分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Dec 14 12:44:30 CST 2016, time=2016-12-14, status=1, ipAttribution=)]
    2016-12-26 laoli

    学习了，很典型！

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=183782, encodeId=db1f183e822b, content=这种病例很少，很难看到图片。谢谢上传病例。, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Mar 30 12:25:11 CST 2017, time=2017-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=165815, encodeId=0c99165815ae, content=学习了，很典型！, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon Dec 26 15:09:50 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162748, encodeId=741d162e4834, content=讲的好，学习了，分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Dec 14 12:44:30 CST 2016, time=2016-12-14, status=1, ipAttribution=)]
    2016-12-14 虈亣靌

    讲的好，学习了，分享了

    0