NEJM:化脓性汗腺炎-病例报道

2017-12-21 xing.T MedSci原创

该患者接受了2周的全身抗生素治疗,并开始了一个包括戒烟在内的改善生活方式的计划。他的状况没有改善。医务人员建议患者去擅长于化脓性汗腺炎诊治的皮肤科转诊中心就诊。最后,患者失去了随访。

患者一名27岁的男性,在研究者所在医院的热带病中心接受了2年的痤疮治疗,并在生殖器和会阴部有多处疼痛病灶。该患者既往接受过多种抗生素药物治疗和手术治疗(多次尝试切除和引流)也无法治愈。

体格检查发现在生殖腹股沟区(如图A所示)、腋窝(如图B所示)以及臀部和耳后有炎症性和非炎症性结节和疤痕组织。临床诊断为化脓性汗腺炎(Hurley II期,I-III级,分期较高表明脓肿更多和影响区域更大)。



化脓性汗腺炎是一种毛囊的慢性、炎症性、复发性皮肤病。化脓性汗腺炎的病因尚不清楚,涉及多种因素,如遗传和环境因素。它通常发生在青春期之后,在身体具有顶泌腺的区域(通常是腋窝、腹股沟和肛门生殖器区域),伴有疼痛性、深部的、炎症性病变。延误诊断较为常见,因为病变最初常被误认为是简单的感染。病变可能愈合缓慢,并可能导致窦道和疤痕。治疗包括手术以及局部和全身使用抗生素(通常为强力霉素或利福平联合克林霉素);在严重的情况下,可考虑全身性免疫抑制剂。

该患者接受了2周的全身抗生素治疗,并开始了一个包括戒烟在内的改善生活方式的计划。他的状况没有改善。医务人员建议患者去擅长于化脓性汗腺炎诊治的皮肤科转诊中心就诊。最后,患者失去了随访。

原始出处:

Anna Beltrame,et al. Clinical Diagnosis of Hidradenitis Suppurativa.N Engl J Med 2017; http://www.nejm.org/doi/full/10.1056/NEJMicm1707912

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1748169, encodeId=a9931e48169eb, content=<a href='/topic/show?id=129533595e9' target=_blank style='color:#2F92EE;'>#化脓性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33595, encryptionId=129533595e9, topicName=化脓性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=443536086917, createdName=hb2020ye, createdTime=Sun Apr 22 21:12:00 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271233, encodeId=1e802e12330e, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Thu Dec 21 13:06:38 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271175, encodeId=b2e52e1175fb, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Dec 21 10:01:46 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271164, encodeId=aec32e116490, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Dec 21 09:38:16 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271154, encodeId=09e02e115458, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Dec 21 09:22:55 CST 2017, time=2017-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=271128, encodeId=35b92e1128cc, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Thu Dec 21 08:19:23 CST 2017, time=2017-12-21, status=1, ipAttribution=)]
    2017-12-21 天涯183

    非常好的文章.学习了

    0

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    2017-12-21 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0

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    2017-12-21 龙胆草

    学习谢谢分享

    0

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    2017-12-21 Y—xianghai

    学习了新知识

    0

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