中华皮肤科杂志
中華皮膚科雜誌
중화피부과잡지
Chinese Journal of Dermatology
2012年
10期
739-741
,共3页
占城%夏玉坤%吕雪莲%陈晶%赵文%王玲%彭琳琳%马洁浩%崔红艳%王学军%景东云
佔城%夏玉坤%呂雪蓮%陳晶%趙文%王玲%彭琳琳%馬潔浩%崔紅豔%王學軍%景東雲
점성%하옥곤%려설련%진정%조문%왕령%팽림림%마길호%최홍염%왕학군%경동운
例1女,40岁,右手及前臂结节斑块2个月,否认外伤史,但从事热带鱼销售.体检示右手手指、腕、肘关节旁暗红色结节斑块,右上肢多发串珠样皮下结节.例2女,48岁,左手及前臂结节斑块2个月.发病前有清洗热带鱼鱼缸及过滤网外伤史.体检示左手、腕、前臂及上臂散在暗紫红色斑块及无痛性皮下结节.例3男,39岁,双手指散在结节3个月.否认外伤史但爱好热带鱼养殖.体检双手指间关节伸侧散在暗红色黄豆大结节.实验室检查:3例皮损组织反复真菌学检查均为阴性.组织病理提示混合炎症细胞浸润的感染性肉芽肿改变.结核菌素纯蛋白衍生物(PPD)试验均为阳性.例1和例2活检组织分离出海分枝杆菌,例3分枝杆菌培养阴性.3例均诊断为游泳池肉芽肿.分别给予利福平和克拉霉素为主的抗非典型分枝杆菌治疗,1～3个月后皮损完全消退,总疗程2～5个月不等.停药后随访3～12个月均无复发.
例1女,40歲,右手及前臂結節斑塊2箇月,否認外傷史,但從事熱帶魚銷售.體檢示右手手指、腕、肘關節徬暗紅色結節斑塊,右上肢多髮串珠樣皮下結節.例2女,48歲,左手及前臂結節斑塊2箇月.髮病前有清洗熱帶魚魚缸及過濾網外傷史.體檢示左手、腕、前臂及上臂散在暗紫紅色斑塊及無痛性皮下結節.例3男,39歲,雙手指散在結節3箇月.否認外傷史但愛好熱帶魚養殖.體檢雙手指間關節伸側散在暗紅色黃豆大結節.實驗室檢查:3例皮損組織反複真菌學檢查均為陰性.組織病理提示混閤炎癥細胞浸潤的感染性肉芽腫改變.結覈菌素純蛋白衍生物(PPD)試驗均為暘性.例1和例2活檢組織分離齣海分枝桿菌,例3分枝桿菌培養陰性.3例均診斷為遊泳池肉芽腫.分彆給予利福平和剋拉黴素為主的抗非典型分枝桿菌治療,1～3箇月後皮損完全消退,總療程2～5箇月不等.停藥後隨訪3～12箇月均無複髮.
례1녀,40세,우수급전비결절반괴2개월,부인외상사,단종사열대어소수.체검시우수수지、완、주관절방암홍색결절반괴,우상지다발천주양피하결절.례2녀,48세,좌수급전비결절반괴2개월.발병전유청세열대어어항급과려망외상사.체검시좌수、완、전비급상비산재암자홍색반괴급무통성피하결절.례3남,39세,쌍수지산재결절3개월.부인외상사단애호열대어양식.체검쌍수지간관절신측산재암홍색황두대결절.실험실검사:3례피손조직반복진균학검사균위음성.조직병리제시혼합염증세포침윤적감염성육아종개변.결핵균소순단백연생물(PPD)시험균위양성.례1화례2활검조직분리출해분지간균,례3분지간균배양음성.3례균진단위유영지육아종.분별급여리복평화극랍매소위주적항비전형분지간균치료,1～3개월후피손완전소퇴,총료정2～5개월불등.정약후수방3～12개월균무복발.
Three cases of swimming pool granuloma are reported.Case 1:a 40-year-old female presented with a 2-month history of nodules and plaques on the right hand and forearm.She was a tropical fish salesperson but denied trauma history.Skin examination revealed multiple irregularly sized,dark-red nodules and plaques on the joints of right fingers,wrist,and elbow,as well as multiple subcutaneous nodules simulating strings of beads on the right upper limb.Case 2:a 48-year-old female presented with a 2-month history of nodules and plaques on the left hand and forearm.There was a history of trauma due to tropical fish tank and filter cleaning.Physical examination showed multiple deep purple plaques and painless subcutaneous nodules scattered on the left hand,wrist,and upper limb.Case 3:a 39-year-old male presented with a 3-month history of nodules on the fingers of both hands.There was no history of trauma,but he was a tropical aquarist.Skin examination revealed multiple soybean-sized dark-red nodules on the extensor aspect of interphalangeal joints of both hands.Fungal examinations yielded negative results in the 3 cases,while histopathology revealed infectious granuloma with a mixed inflammatory cell infiltrate.All of the cases showed positive results in purified protein derivative (PPD)skin test.Mycobacterium marinum was isolated from the lesional tissue of Case 1 and 2,but not from Case 3.All the patients were diagnosed with swimming pool granuloma,and given anti-atypical mycobacterial therapy including oral rifampin and clarithromycin.The lesions disappeared after 1 to 3 months of treatment,with the treatment course varying from 2 to 5 months.No recurrence was observed during a 3- to 12-month follow-up.
