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目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)并发泛发性紫色毛癣菌感染的特点和临床表现。方法选择2011年1月—2012年12月收治的系统性红斑狼疮对并发泛发性紫色毛癣菌感染患者11例,均进行系统检查、皮肤科检查、真菌学检查,针对SLE给予继续治疗。患者臀部、额部、颈部皮损采取外用特比萘酚乳膏治疗,2次/d;指、趾甲处皮损外搽甲癣酊,2次/d;墨点癣患者剃光头发,1次/周;每日热水洗头1次,将毛巾、梳子、枕套等生活用品进行消毒处理,同时,给予灰黄霉素口服,0.2 g/次,3次/d;硫黄软膏外搽头皮,2次/d。连续治疗42 d后观察效果。结果 11例患者系统检查未见异常,皮肤科检查结果提示2例患者头皮存在少许鳞状附着;11例患者额部、颈部均存在不同范围的弧形红斑,并伴有小片状白色鳞屑;5例患者臀部可见不规则状红斑和散在丘疹,边界清楚见有脱屑;9例患者指(趾)甲变黄、增厚。11例患者经毛发穿孔试验结果为阴性,尿素酶试验结果为阴性,临床鉴定为紫色毛癣菌。经临床治疗后,皮损完全消失者10例,治疗有效率为90.90%。结论系统性红斑狼疮患者常并发真菌感染,泛发性紫色毛癣菌是皮肤癣菌感染中的一种,以指、趾甲感染最为常见,临床治疗过程中合理使用糖皮质激素和免疫抑制剂,及时调整用量和使用期限能够有效减少紫色毛癣菌感染的风险。
Objective To investigate the characteristics and clinical manifestations of systemic lupus erythematosus (SLE) complicated with T. rubrum infection. Methods From January 2011 to December 2012, 11 patients with systemic lupus erythematosus (SLE) who were infected with generalized trichophyton rubrum were selected for systematic examination, dermatology examination and mycological examination, respectively, and the treatment of SLE was continued. Patient hip, forehead, neck and neck lesions treated with topical naphthol cream, 2 times / d; refers to the nail lesions at the outer coating of Onychomycosis tincture, 2 times / d; ink ringworm patients with shaved hair, 1 times / week; daily hot water shampoo 1 times, towels, combs, pillowcases and other daily necessities disinfection, at the same time, given griseofulvin orally, 0.2 g / time, 3 times / d; Scalp, 2 times / d. After 42 days of continuous treatment, the effect was observed. Results No abnormalities were found in 11 patients. Dermatological examination revealed slight squamous attachment of the scalp in 2 patients. Eleven patients had varying degrees of arcuate erythema on both the frontal and neck, accompanied by small white scales Five patients showed irregular erythema and scattered papules in the buttocks, with clear scaling on the border. Nine patients had yellowing and thickening of the nail. 11 cases of patients with hair perforation test results were negative, urease test results were negative, clinically identified as Trichophyton rubrum. After clinical treatment, skin lesions completely disappeared in 10 cases, the effective rate was 90.90%. Conclusion Patients with systemic lupus erythematosus often complicated by fungal infection, Trichophyton rubrum is a dermatophyte infection in order to refer to, nails infection is the most common, rational use of glucocorticoids and immunosuppressive agents during clinical treatment, Timely adjustment of dosage and shelf life can effectively reduce the risk of Trichophyton rubrum infection.