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1 病例介绍 例1 患者男,15岁。因双眼眶、鼻孔、口腔、口周、双手掌、背、双跖部及肛周反复出现鳞屑性脱皮糜烂长达7～8年,双手握拳双足行走疼痛,食欲不振,于1996年2月3日来我院就诊。患者从小生过“鹅口疮”,时好时发未根治。至6～7岁时,病变皮损扩大。无长期腹泻史,家族中无类似发病史。体查:发育、营养中等、面部稍苍白,心肺肝脾无殊。神经、骨骼系统无异常。皮肤科检查:双眼睑、鼻周、口周、双手掌、双足跖、肛门周围均有大片脱屑性斑片,部分有糜烂,露出鲜红色真皮层,双手握拳困难。口腔粘膜、舌背、舌尖有大片不规则形乳白色斑,揭去后留下红色渗出性基底。指趾甲板及甲沟无异常。取手及口周皮损镜检:镜下见大量典型的假菌丝及芽生厚壁孢子。据病史、体征及实验室检查结果、诊断为“慢性皮肤粘膜念珠菌病”。
1 case introduction example 1 male patient, 15 years old. Due to double eyes, nostrils, mouth, mouth, palms, back, double plantar and perianal recurring scaly peeling peeling as long as 7 to 8 years, both hands fist walking pain, loss of appetite, in February 1996 3 days to our hospital. Patients from niche over “thrush”, when the time is not cure. To 6 to 7 years old, the lesion lesions enlarged. No history of long-term diarrhea, no similar family history of the disease. Physical examination: development, nutrition, moderate pale face, heart and lung spleen without special. Nerve, skeletal system no abnormalities. Dermatology examination: double eyelid, nasal week, perioral, double palms, both feet plantar, anus around the large pieces of desquamative patches, some erosion, exposing bright red dermis, hands making fist difficulties. Oral mucosa, tongue back, tongue has a large irregular white milky spots, leaving the red exudative base. Finger nail plate and a groove without exception. Fiduciary and periocular lesions microscopic examination: see a large number of typical hyphae and sprouting thick walled spores. According to history, signs and laboratory tests, diagnosis of “chronic cutaneous mucosal candidiasis.”