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題名 | Cutaneous Leishmaniasis: A Case Confirmed by Both Histopathologic Examination and Polymerase Chain Reaction=皮膚萊什曼原蟲病:同時藉由組織病理檢查及聚合酶連鎖反應確定診斷的病例 |
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作者 | 葉明雄; 何美瑾; 吳育弘; 胡淑玲; | 書刊名 | 中華皮膚科醫學雜誌 |
卷期 | 24:1 民95.03 |
頁次 | 頁58-62 |
分類號 | 415.725 |
關鍵詞 | 萊什曼原蟲病; 皮膚; 丘疹; Cutaneous leishmaniasis; Polymerase chain reaction; |
語文 | 英文(English) |
中文摘要 | 萊什曼原蟲病是由胞內寄生的萊什曼原蟲所引起,經由雌性白蛉叮咬而傳染。臨床上可分為皮膚、廣泛性皮膚、黏膜皮膚、及內臟四型。我們報告一例境外移入的皮膚萊什曼原蟲病。一位50歲男性國際建築商人曾在布吉納法索工作,離開該國一個月後在右上臂出現兩處紅色丘疹,並在三個月內逐漸進展成中央有潰瘍的紅腫結節。接著又在右前臂出現另一紅色丘疹。切片病理檢查在巨噬細胞內發現許多萊什曼原蟲的無鞭毛體,並進一步由切片組織的聚合酶連鎖反應確定診斷。投予itraconazole二星期後,並無明顯的臨床進步,因此在病患要求下,將這三處病灶全部切除。經八個月後的追蹤並無復發。 |
英文摘要 | Leishmaniasis is caused by intracellular protozoa of the genus Leishmania and transmitted by the bite of female sandflies. Clinically, it is classified into cutaneous, diffuse cutaneous, mucocutaneous, and visceral forms. We report an imported case of cutaneous leishmaniasis. A 50-year-old male international constructor who had worked in Burkina Faso developed two red papules on right upper arm one month after he left Burkina Faso. The cutaneous lesions gradually progressed into erythematous plaques with central ulceration in three months. Another erythematous papule ensued on his right forearm. Histopathologic examination of the biopsy specimen revealed numerous Leishmania amastigotes in macrophages. Polymerase chain reaction of the biopsy specimen further confirmed the diagnosis. Itraconazole was given for 2 weeks, and then all the three lesions were excised due to the absence of obvious clinical response and the patient's request. No recurrence was noted after an eight-month period of follow up. |
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