- 中国皮肤病性病图鉴(第3版)
- 朱学骏
- 684字
- 2021-12-13 16:19:49
念珠菌病 Candidiasis
是由念珠菌属的真菌(白念珠菌为主)引起的皮肤、黏膜及内脏器官的急性或慢性感染。
诊断要点:
临床表现多样。
口腔念珠菌病又称鹅口疮,为口腔黏膜上出现白色假膜,基底有红色糜烂、渗出。念珠菌性阴道炎好发于糖尿病及妊娠妇女,阴道黏膜红肿、表面有白色薄膜附着,有凝乳状分泌物,自觉剧烈瘙痒。
念珠菌性龟头包皮炎在龟头及冠状沟和包皮内侧有针头大的丘疱疹,表面附着较多白色乳酪状伪膜。
念珠菌性间擦疹发生于间擦部位,包括指趾间浸渍、红斑、糜烂性损害。
丘疹性皮肤念珠菌病好发于夏季,多见于颈、肩、躯干、四肢和会阴等处,皮损为2~3mm大小的扁平丘疹及丘疱疹,暗红色,表面有圈状脱屑。
念珠菌性甲沟炎的甲沟红肿,挤之有少许分泌物,但很少化脓。
慢性黏膜皮肤念珠菌病(CMCC)是因天然免疫缺陷而引起的一种顽固的皮肤黏膜感染,黏膜表现同口腔念珠菌病,皮肤表现为疣状或结节状损害,表面结痂,病程为慢性经过。
治疗要点:
局部治疗主要针对局限于皮肤、黏膜部位的念珠菌病。如口含克霉唑、制霉菌素片治疗口腔念珠菌病,阴道念珠菌病患者每晚用3%碳酸氢钠溶液清洗外阴后在阴道内放入制霉菌素、克霉唑和咪康唑栓剂等。系统治疗主要适用于系统性感染,但对于顽固的、反复发作的局部感染也可应用,常选用氟康唑、伊曲康唑等,长期应用应注意监测耐药发生。
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-1_12900.jpg?sign=1739109257-fhqSQqhLhav07wuXMwy74xrVveBaOhY3-0-9eee4f01e11e71a0570e1fb9ed367752)
图4-9-1 鹅口疮
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-2_12901.jpg?sign=1739109257-hdLjZ2zbg4eWxNKgKwzHP4GNotA4fDyr-0-0c26a568b45a5a88d3f2cfbfd50857d6)
图4-9-2 鹅口疮
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-3_12899.jpg?sign=1739109257-epxwLb1rXX9XRP6iClKciIjJHpRjjX9W-0-6429df6acf130bfd2fa2b7bc7e852608)
图4-9-3 念珠菌性龟头炎及尿道炎
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-4_12902.jpg?sign=1739109257-XfWrW7CeVIzcDHLTRQSGZnrZmi74LWSR-0-00ae83adfa17f8f063cc7f226480d124)
图4-9-4 念珠菌性龟头炎
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-5_12904.jpg?sign=1739109257-JLG1oFTPEGeFM0dAVWG4q6DT0u5Bp8oa-0-dcf481fa3947391222c74153de39103b)
图4-9-5 念珠菌性间擦疹
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-6_12905.jpg?sign=1739109257-vwqEcggVVPQdb9t1MO44LV0gY943r1oH-0-92cef6010ec4a1ff1bea44b533367abb)
图4-9-6 念珠菌性间擦疹
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-7_12907.jpg?sign=1739109257-4jkoonZfCtAttA62gC4Y01y8z3poTZ4B-0-2b67795d3ee1129ee8707fe2fcab27f7)
图4-9-7 念珠菌性间擦疹
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-8_12908.jpg?sign=1739109257-FjXG75Y3uoj9MNEd1xwhGg0FusZQBAph-0-50b193fd4ef3051b74ae55b82fc61a3e)
图4-9-8 念珠菌性甲沟炎
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-9_12909.jpg?sign=1739109257-0WLZxYNtClfWq1OOKE7XvG5SHJpfL8jD-0-96a68291ed197d6e2f5c5f06ba0fc512)
图4-9-9 慢性黏膜皮肤念珠菌病
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-10_12912.jpg?sign=1739109257-1EIX52HUQGYF3pHBy52nxlmQiWeYVwDh-0-474e6b3a775e50c46d5ee05fbc1d77d5)
图4-9-10 慢性黏膜皮肤念珠菌病
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-11_12913.jpg?sign=1739109257-H2Tund3hU43AYor3KpgJb3HVSIvQa6kq-0-410a6a3f5f7255cad80f0bd765dd8fb3)
图4-9-11 慢性黏膜皮肤念珠菌病
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-12_12914.jpg?sign=1739109257-XMDd10JxqGEYyVxmCkYEMBMCgTX5jMGx-0-d7b50e46d79709798c641c0445024736)
图4-9-12 慢性黏膜皮肤念珠菌病
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-13_12915.jpg?sign=1739109257-EWFxfkPFRfZqmyDeDbniIvlmzsdGUvLu-0-f0f3a73030ff8b12f096476381373394)
图4-9-13 慢性黏膜皮肤念珠菌病
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-14_12917.jpg?sign=1739109257-Jd8Hk9RYwCxrgAdArkvcR5YrVPYUGC8M-0-47df330fc9b0301f351309d38175c9ef)
图4-9-14 慢性黏膜皮肤念珠菌病