皮肤感染
皮肤感染(英语:Skin infection)是指人类或其他动物的皮肤受到感染。皮肤感染不仅会影响皮肤,它还会影响相关的软组织,例如蜂窝组织和黏膜。[來源請求]皮肤感染包括一类称为皮肤和皮肤结构感染(SSSI)(也称为皮肤和软组织感染(SSTI)[1]或急性细菌性SSSI(ABSSSI))的感染。[2]皮肤感染不同于皮炎(发生在皮肤的炎症),[3][4]虽然皮肤感染可能导致皮炎。[5]
成因
细菌
2013年,细菌性皮肤感染影响了约1.55亿人,而其中蜂窝组织炎约有6亿人感染。[6]常见的细菌性皮肤感染包括:
- 蜂窝组织炎是结缔组织的弥漫性炎症,伴有真皮层和皮下组织层的严重炎症。[7]此外,根据最可能的致病因素和症状表现,可以将蜂窝组织炎分为化脓性和非化脓性蜂窝组织炎。[8]化脓性蜂窝组织炎通常由金黄色葡萄球菌引起,包括甲氧西林敏感金黄色葡萄球菌(MSSA)和耐甲氧西林金黄色葡萄球菌(MRSA)。[8][7]而非化脓性蜂窝组织炎常由A组β溶血性的链球菌引起,例如化脓性链球菌。[8][7]在极少数情况下,感染会发展为坏死性筋膜炎,这是一种严重且可能致命的感染。[9]
- 丹毒是一种细菌感染,主要影响浅表真皮,并且通常涉及浅表淋巴管。[10]与蜂窝组织炎不同,它不会影响更深层的皮肤。它主要由A组β溶血性的链球菌引起,化脓性链球菌是最常见的病原体。[10]
- 毛囊炎是一种皮肤病,患者位于真皮层的毛囊受到感染和发炎。它主要是由细菌感染引起的,尤其是金黄色葡萄球菌,可导致浅表细菌性毛囊炎。[11]毛囊炎的其他致病因子包括真菌(最常见的是马拉色菌属里的物种)、病毒(例如单纯疱疹病毒)和螨虫(蠕形螨属里的物种)。[11][12]
- 脓痂疹是一种高度传染性的ABSSSI,在学龄前儿童中很常见,主要由金黄色葡萄球菌和化脓性链球菌这两种病原体引起。[13][14]脓痂疹具有特征性外观,在口、鼻和下巴周围出现黄色(蜂蜜色)结痂病变。[15]据估计,在任何时间,全球会有至少1.4亿人感染此病。[15]脓痂疹可进一步分为大疱性和非大疱性形式。[15][16]非大疱性脓痂疹是最常见的形式,约占确诊病例的70%。[15]其余30%的病例呈大疱性形式,主要由金黄色葡萄球菌引起。[15][17]在极少数情况下,大疱性脓痂疹会扩散并导致葡萄球菌皮肤烫伤样综合征(SSSS),这是一种可能危及生命的感染。[17]
真菌
真菌性皮肤感染可能表现为皮肤、毛发或指甲的浅表或深层感染。足菌肿是一大类真菌感染,其特征是起源于足部的皮肤和皮下组织。[18]如果没有及时进行适当地治疗,足菌肿感染可以扩展到更深的组织,如骨骼和关节,导致骨髓炎。[19]广泛的骨髓炎可能需要手术切除骨甚至下肢截肢。[19]截止至2010年,它们影响了全球约10亿人。[20]常见的真菌性皮肤感染包括:
- 皮肤癣菌病,也称为癣,是由几种不同种类的真菌引起的皮肤浅表真菌感染。引起人类皮肤感染的真菌属包括毛癣菌属、表皮癣菌属和小孢癣菌属。[21]虽然皮肤癣菌病是世界范围内相当常见的真菌性皮肤感染,但它在湿度和环境温度高的地区更为普遍。[21]据估计,全世界大约20至25%的人受到浅表真菌感染的影响,其中皮肤癣菌病占主导地位。[22]
- 口腔念珠菌病,通常称为鹅口疮,是一种主要由白色念珠菌引起的真菌感染,它主要影响口腔和舌头的黏膜。[23]白色念珠菌约占口腔念珠菌病病例的95%。[23]这种真菌是正常口腔菌群的一部分,只有当宿主免疫系统和微生物群屏障受损时才会引起感染,从而为白色念珠菌提供过度生长的机会。[24]据估计,全世界每年约有200万人受到口腔念珠菌病的影响。[25]
- 甲癣是一种真菌感染,主要影响脚趾甲。[26]两种最常见的甲癣病原体是须癣毛癣菌和红色毛癣菌。[26]常见的体征和症状包括指甲变色和增厚、指甲与甲床分离以及指甲变脆。[27]在北美,甲癣的患病率在8.7%到13.8%之间。[27]
寄生虫
寄生虫性皮肤感染是由几个生物门引起的,包括环节动物门、节肢动物门、外肛动物门、脊索动物门、刺胞动物门、蓝藻门、棘皮动物门、线虫动物门、扁形动物门和原生动物门。[28]
病毒
这些强制性的细胞内制剂引起的与病毒有关的皮肤病源于DNA和RNA病毒。[29]常见的病毒性皮肤感染包括:
- 疣是由人类乳头瘤病毒(HPV)引起的良性增生性皮肤病变。[30][31]疣的形状、大小、外观和它们出现在身体上的位置各不相同。例如,跖疣发生在脚底,看起来像厚厚的老茧。[30][32]其他类型的疣包括尖锐湿疣、扁平疣、鑲工疣和甲周疣。[30]常见的治疗选择包括水杨酸和液氮冷冻疗法。[30]
- 水痘是一种由水痘带状疱疹病毒(VZV)引起的高度传染性皮肤病。[33]它的特征是瘙痒性水疱样皮疹,可能覆盖全身,并且会影响所有年龄组。[33][34]在缺乏足够免疫计划的国家,水痘的发病率更高。据估计,2014年全球需要住院治疗的严重水痘感染病例约为420万。[35]
- 发疹性水疱性口腔炎(HFMD)也称手足口症,是一种常见的、通常具有自限性的病毒性疾病,通常影响婴儿和儿童,但也可能发生在成人身上。[36]其特征是手掌、脚底和嘴巴周围出现低烧和斑丘疹。[36][37]它是由人类肠道病毒和克沙奇病毒引起的,是一种阳性单链RNA病毒。[36][37]
参考文献
- ^ Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clinical Infectious Diseases. July 2014, 59 (2): 147–159. PMID 24947530. doi:10.1093/cid/ciu296 .
- ^ Guidance Compliance Regulatory Information (PDF). www.fda.gov. [2019-09-15]. (原始内容存档 (PDF)于2018-07-27).
- ^ International Statistical Classification of Diseases and Related Health Problems 10th Revision. apps.who.int. [2019-09-15]. (原始内容存档于2014-01-09).
- ^ In the WHO classification, it is noted that the infection classification "Excludes:... infective dermatitis...". See the WHO classification, op. cit.
- ^ Skin inflammation due to skin infection is called "infective dermatitis". See the WHO classifications, op. cit.
- ^ Vos, Theo; et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. August 2015, 386 (9995): 743–800. PMC 4561509 . PMID 26063472. doi:10.1016/s0140-6736(15)60692-4. 已忽略未知参数
|collaboration=
(帮助) - ^ 7.0 7.1 7.2 Raff AB, Kroshinsky D. Cellulitis: A Review. JAMA. July 2016, 316 (3): 325–337. PMID 27434444. S2CID 241077983. doi:10.1001/jama.2016.8825.
- ^ 8.0 8.1 8.2 Breyre A, Frazee BW. Skin and Soft Tissue Infections in the Emergency Department. Emergency Medicine Clinics of North America. November 2018, 36 (4): 723–750. PMID 30297001. S2CID 52942182. doi:10.1016/j.emc.2018.06.005.
- ^ Chen LL, Fasolka B, Treacy C. Necrotizing fasciitis: A comprehensive review. Nursing. September 2020, 50 (9): 34–40. PMC 8828282 . PMID 32826674. doi:10.1097/01.NURSE.0000694752.85118.62.
- ^ 10.0 10.1 Clebak KT, Malone MA. Skin Infections. Primary Care. Infectious Disease. September 2018, 45 (3): 433–454. PMID 30115333. S2CID 52022225. doi:10.1016/j.pop.2018.05.004.
- ^ 11.0 11.1 Winters R, Mitchell M. Folliculitis. StatPearls. Treasure Island (FL): StatPearls Publishing. 2021 [2021-12-03]. PMID 31613534. (原始内容存档于2022-04-22).
- ^ Henning MA, Jemec GB, Saunte DM. [Malassezia folliculitis]. Ugeskrift for Laeger. November 2020, 182 (47): V08200572 [2023-01-31]. PMID 33215579. (原始内容存档于2021-12-03).
- ^ Impetigo. nhs.uk. October 19, 2017 [2023-01-31]. (原始内容存档于2020-03-05).
- ^ Kumar V, Abbas AK, Fausto N, Mitchell RN. Robbins Basic Pathology 8th. Saunders Elsevier. 2007: 843. ISBN 978-1-4160-2973-1.
- ^ 15.0 15.1 15.2 15.3 15.4 Johnson MK. Impetigo. Advanced Emergency Nursing Journal. 2020, 42 (4): 262–269. PMID 33105179. S2CID 225081229. doi:10.1097/TME.0000000000000320.
- ^ Dollani LC, Marathe KS. Impetigo/Staphylococcal Scalded Skin Disease. Pediatrics in Review. April 2020, 41 (4): 210–212. PMID 32238552. S2CID 214768670. doi:10.1542/pir.2018-0206.
- ^ 17.0 17.1 Brazel M, Desai A, Are A, Motaparthi K. Staphylococcal Scalded Skin Syndrome and Bullous Impetigo. Medicina. October 2021, 57 (11): 1157. PMC 8623226 . PMID 34833375. doi:10.3390/medicina57111157 .
- ^ Verma P, Jha A. Mycetoma: reviewing a neglected disease. Clinical and Experimental Dermatology. March 2019, 44 (2): 123–129. PMID 29808607. S2CID 44123860. doi:10.1111/ced.13642 .
- ^ 19.0 19.1 El-Sobky TA, Haleem JF, Samir S. Eumycetoma Osteomyelitis of the Calcaneus in a Child: A Radiologic-Pathologic Correlation following Total Calcanectomy. Case Reports in Pathology. 21 September 2015, 2015: 129020. PMC 4592886 . PMID 26483983. S2CID 15644051. doi:10.1155/2015/129020 .
- ^ Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. December 2012, 380 (9859): 2163–2196. PMC 6350784 . PMID 23245607. doi:10.1016/S0140-6736(12)61729-2.
- ^ 21.0 21.1 Jartarkar SR, Patil A, Goldust Y, Cockerell CJ, Schwartz RA, Grabbe S, Goldust M. Pathogenesis, Immunology and Management of Dermatophytosis. Journal of Fungi. December 2021, 8 (1): 39. PMC 8781719 . PMID 35049979. doi:10.3390/jof8010039 .
- ^ Begum J, Mir NA, Lingaraju MC, Buyamayum B, Dev K. Recent advances in the diagnosis of dermatophytosis. Journal of Basic Microbiology. April 2020, 60 (4): 293–303. PMID 32003043. S2CID 210983216. doi:10.1002/jobm.201900675.
- ^ 23.0 23.1 Vila T, Sultan AS, Montelongo-Jauregui D, Jabra-Rizk MA. Oral Candidiasis: A Disease of Opportunity. Journal of Fungi. January 2020, 6 (1): 15. PMC 7151112 . PMID 31963180. doi:10.3390/jof6010015 .
- ^ Quindós G, Gil-Alonso S, Marcos-Arias C, Sevillano E, Mateo E, Jauregizar N, Eraso E. Therapeutic tools for oral candidiasis: Current and new antifungal drugs. Medicina Oral, Patologia Oral y Cirugia Bucal. March 2019, 24 (2): e172–e180. PMC 6441600 . PMID 30818309. doi:10.4317/medoral.22978.
- ^ Bongomin F, Gago S, Oladele RO, Denning DW. Global and Multi-National Prevalence of Fungal Diseases-Estimate Precision. Journal of Fungi. October 2017, 3 (4): 57. PMC 5753159 . PMID 29371573. doi:10.3390/jof3040057 .
- ^ 26.0 26.1 Leung AK, Lam JM, Leong KF, Hon KL, Barankin B, Leung AA, Wong AH. Onychomycosis: An Updated Review. Recent Patents on Inflammation & Allergy Drug Discovery. 2020, 14 (1): 32–45. PMC 7509699 . PMID 31738146. doi:10.2174/1872213X13666191026090713.
- ^ 27.0 27.1 Gupta AK, Stec N, Summerbell RC, Shear NH, Piguet V, Tosti A, Piraccini BM. Onychomycosis: a review. Journal of the European Academy of Dermatology and Venereology. September 2020, 34 (9): 1972–1990. PMID 32239567. S2CID 214768942. doi:10.1111/jdv.16394. hdl:11585/871129 .
- ^ Diaz JH. Mite-transmitted dermatoses and infectious diseases in returning travelers. Journal of Travel Medicine. January 2010, 17 (1): 21–31. PMID 20074098. doi:10.1111/j.1708-8305.2009.00352.x.
- ^ Lebwohl MG, Rosen T, Stockfleth E. The role of human papillomavirus in common skin conditions: current viewpoints and therapeutic options. Cutis. November 2010, 86 (5): suppl 1–11; quiz suppl 12. PMID 21214125.
- ^ 30.0 30.1 30.2 30.3 Mulhem E, Pinelis S. Treatment of nongenital cutaneous warts. American Family Physician. August 2011, 84 (3): 288–293 [2023-02-01]. PMID 21842775. (原始内容存档于2022-04-24).
- ^ Soenjoyo KR, Chua BW, Wee LW, Koh MJ, Ang SB. Treatment of cutaneous viral warts in children: A review. Dermatologic Therapy. November 2020, 33 (6): e14034. PMID 32683782. S2CID 220655257. doi:10.1111/dth.14034 .
- ^ Witchey DJ, Witchey NB, Roth-Kauffman MM, Kauffman MK. Plantar Warts: Epidemiology, Pathophysiology, and Clinical Management. The Journal of the American Osteopathic Association. February 2018, 118 (2): 92–105. PMID 29379975. S2CID 25371618. doi:10.7556/jaoa.2018.024.
- ^ 33.0 33.1 Freer G, Pistello M. Varicella-zoster virus infection: natural history, clinical manifestations, immunity and current and future vaccination strategies. The New Microbiologica. April 2018, 41 (2): 95–105 [2023-02-01]. PMID 29498740. (原始内容存档于2022-04-24).
- ^ About Chickenpox | CDC. www.cdc.gov. 2022-03-23 [2022-04-24]. (原始内容存档于2022-04-26) (美国英语).
- ^ Wutzler P, Bonanni P, Burgess M, Gershon A, Sáfadi MA, Casabona G. Varicella vaccination - the global experience. Expert Review of Vaccines. August 2017, 16 (8): 833–843. PMC 5739310 . PMID 28644696. doi:10.1080/14760584.2017.1343669.
- ^ 36.0 36.1 36.2 Esposito S, Principi N. Hand, foot and mouth disease: current knowledge on clinical manifestations, epidemiology, aetiology and prevention. European Journal of Clinical Microbiology & Infectious Diseases. March 2018, 37 (3): 391–398. PMID 29411190. S2CID 3376169. doi:10.1007/s10096-018-3206-x.
- ^ 37.0 37.1 Saguil A, Kane SF, Lauters R, Mercado MG. Hand-Foot-and-Mouth Disease: Rapid Evidence Review. American Family Physician. October 2019, 100 (7): 408–414 [2023-02-01]. PMID 31573162. (原始内容存档于2021-11-13).