中国麻风皮肤病杂志 ›› 2022, Vol. 38 ›› Issue (9): 621-625.doi: 10.12144/zgmfskin202209621

• 临床研究 • 上一篇    下一篇

湖北省输入性皮肤利什曼病一例并文献复习

王萌1,高利昆2,童永清2,江珊2   

  1. 1潜江市中心医院皮肤科，潜江，433100；
    2武汉大学人民医院，武汉，430060
  • 出版日期:2022-09-15 发布日期:2022-07-13

Imported cutaneous leishmaniasis in Hubei: a case report and literature review

WANG Meng1, GAO Likun2, TONG Yongqing2, JIANG Shan2   

  1. 1 Department of Dermatology, Central Hospital of Qianjiang, Qianjiang 433100, China; 2 Renmin Hospital of Wuhan University, Wuhan 430060, China
  • Online:2022-09-15 Published:2022-07-13

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摘要： 患者，男，37岁。左下肢皮疹4周，伴轻压痛。无发热等全身症状。患者曾在伊拉克援外工作。皮肤科专科检查：左小腿屈侧见3个暗红色斑块，中央见浅溃疡面，上覆淡黄色分泌物。皮损组织病理学检查：皮肤溃疡形成及散在小灶状微脓肿形成，伴淋巴细胞、组织细胞浸润，组织细胞内可见直径2~4 μm嗜碱性圆形小体。Giemsa染色（+）。皮损组织PCR检测提示硕大利什曼原虫。特比萘芬片口服6周治疗无效后，改为氟康唑胶囊口服，8周后皮损基本痊愈。治疗期间未出现严重不良反应。

关键词: 皮肤利什曼病, 硕大利什曼原虫, 氟康唑

Abstract: A 37-year-old man presented with rashes on the left lower limb with mild tenderness for 4 weeks. There were no systemic symptoms such as fever. The patient had worked as an aid worker in Iraq. Phyical examination showed 3 dark red plaques on the left leg, with a shallow ulcerated surface covered with pale yellow secretions in the center. Histological examination of lesions showed ulceration and scattered focal microabscesses with infiltration of lymphocytic cells and histiocytes, basophilic round bodies with diameters of 2-4 μm in histiocytes. Giemsa stain was positive. PCR analysis of the skin tissue indicated the L. major. Terbinafine was ineffective after 6 weeks of oral treatment, then fluconazole capsules were taken orally for 8 weeks and the lesions were cured. There were no serious adverse reactions during the treatment.

Key words: cutaneous leishmaniasis, L. major, fluconazole