![中国皮肤病性病图鉴(第3版)](https://wfqqreader-1252317822.image.myqcloud.com/cover/336/41816336/b_41816336.jpg)
上QQ阅读APP看书,第一时间看更新
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=1739222163-N1kBkxnNFWNE1mYQtfkTRjxdwRodBEDt-0-af0ec6450f5ca5b39682bca0dee3c947)
图4-9-1 鹅口疮
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-2_12901.jpg?sign=1739222163-BMM6eJ59bgDOFruXFdtuw9l4bhk9c5ii-0-9e6bdaa8ef870325e8d83f1f0ed434b3)
图4-9-2 鹅口疮
![](https://epubservercos.yuewen.com/2D47EB/21846772801639806/epubprivate/OEBPS/Images/P4-9-3_12899.jpg?sign=1739222163-JCnSrfwLYOs9g7UCjdnl8YuwXEbrXA9E-0-5556a73c2fa3e380f2f4ac5877134739)
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=1739222163-yYbpjhxC8MK1EwwVmcHoe3a8XvQ6YbqW-0-6e1cd4bda5a2cf44177107f7c8c4e896)
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=1739222163-bdTvhWwqrjpJ0uqDhhwGyGKsE1BoCDqY-0-674bbbdb3fa5cfb966b05aeadc9a4580)
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=1739222163-0OFP7Me6wc09pTvu7w1n7wU8blI34tbD-0-593337b1b09ee91b6b5fcba7b79752b5)
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=1739222163-8DT4jUbqh8Rl5Al5NBpD05qT1HFWZLqP-0-f19ed52255480492117190e3049bc5c8)
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=1739222163-vJmf4siFhtEvrk5n1ivoZ3Wal9hw2uUJ-0-837628c57e63d0a05ff2258cf8f48212)
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=1739222163-0VIFx0mXKISGBjyG8AbNUHR5SqEALuMk-0-68ce58811781a4c95875b1af3daba1e3)
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=1739222163-nq32NjV9TrcMnW3ucZQYNoFN2BfOoBPn-0-75bddde6ac1bfcb5073bbf2e6b1835a0)
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=1739222163-uPLQryfJYplimxSEb3F9ajzfjDMQqXZE-0-4f686a82a13c366890644cad34d018d0)
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=1739222163-NsHRnTZEFZyx9hCKJxxKsS58zWj4qY2c-0-340b64cc01ce57a604be8077a8dd055a)
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=1739222163-ddIj8lr73cozooXBLBq1sOE7sd8fCFVS-0-f2ee0318913dd02c9625aa8a606e0f4f)
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=1739222163-10CsM9sxxkxh5ZRcc3IKh2YVVS9S2hGg-0-0b024aadd95d35c30f8f9f6773311f3e)
图4-9-14 慢性黏膜皮肤念珠菌病