CAJ | 학술논문

目的分析恙虫病皮肤损害的临床特征.方法分析17例住院恙虫病患者的皮肤损害及临床特征.结果恙虫病有88.2%(15/17)的患者出现皮肤焦痂及溃疡,有64.7%(11/17)的患者伴有皮肤出疹.焦痂出现在发热后4～10 d,其发生部位不一,数量为1个,平均直径1.2 cm(0.5～3.0 cm),表面干燥呈黑色,周边绕以环形红晕,不伴疼痛及瘙痒,于出现后5～9 d焦痂脱落形成浅溃疡.出现焦痂者中有80.0%的患者伴有焦痂附近浅表淋巴结肿大.66.7%的患者首诊时未发现焦痂.伴有皮肤出疹者为充血性丘疹(45.5%)和斑丘疹(54.5%),不伴瘙痒,于出疹后2～5 d消退.结论恙虫病的皮肤损害包括皮肤焦痂和皮疹.皮肤焦痂是本病的重要特征,为临床诊断的主要依据.
목적 분석양충병피부손해적림상특정.방법 분석17례주원양충병환자적피부손해급림상특정.결과 양충병유88.2%(15/17)적환자출현피부초가급궤양,유64.7%(11/17)적환자반유피부출진.초가출현재발열후4～10 d,기발생부위불일,수량위1개,평균직경1.2 cm(0.5～3.0 cm),표면간조정흑색,주변요이배형홍훈,불반동통급소양,우출현후5～9 d초가탈락형성천궤양.출현초가자중유80.0%적환자반유초가부근천표림파결종대.66.7%적환자수진시미발현초가.반유피부출진자위충혈성구진(45.5%)화반구진(54.5%),불반소양,우출진후2～5 d소퇴.결론 양충병적피부손해포괄피부초가화피진.피부초가시본병적중요특정,위림상진단적주요의거.
Objective To investigate the clinical characteristics of skin lesions of tsutsugamushi disease.Methods The skin lesions and clinical characteristics of 17 hospitalized patients with tsutsugamushi disease were analyzed. Results Of the patients, 88.2% (15/17) developed eschar and skin ulcer, 64.7% (11/17) had skin rashes. The patients often developed solitary, painless and nonpruritic eschar 4 to 10 days after the occurrence of fever, with indefinite locations and average diameter of 1.2 cm (range: 0.5 - 3.0 cm). The eschar was covered with a black and dry surface and surrounded by a ring-shaped erythematous halo, and usually shedded 5 to 9 days after the appearance with the formation of shallow ulcer. Superficial lymphadenectasis was observed near the eschar in 80% of the patients with eschar, and no eschar was observed at the first visit in 66.7% of the patients. Skin rashes mainly included nonpruritic congestive papules (45.5%) and maculopapular rashes (54.5%), and often subsided 2 to 5 days after emergence. Conclusions The skin lesions of tsutsugamushi disease include eschar and skin rashes. Eschar is an important characteristic and highly suggestive of this entity.