The Clinical Diagnosis And Treatment Of Eyelid Sporotrichosis

Objective:Sporotrichosis is caused by Sporothrix schenckii infection which is the common dermatomycosis.Eyelid is often the primariy location,therefore,ophthalmologists usually firstly accept and need to complete the diagnosis and treatment work.In this passage,we retrospectively analyze the eyelid sporotrichosis patients in the clinical datas and histopathological examination results,microbiological cultivation,treatment and prognosis,etc.Providing the reference for the clinical diagnosis of eyelid sporotrichosis.Methods:By collecting the patients from the northeastern region and visiting the orbital disease and ocular plastic surgery department in the Second Hospital of Jilin University from April 2014 to March 2015 and these patients were diagnosed with eyelid sporotrichosis,a total of 10 patients.These patients included men and women,no age limits.Retrospective analysis and study of the clinical diagnosis of eyelid sporotrichosis in the patients with clinical datas.Among them,including patient demographic information(gender,age),clinical manifestations,onset time,exposure history,using the HE staining or PAS staining on the histopathological examination of patients with lesions and using the fungal culture to microbiological analysis,and ultimately diagnose the criteria.In addition,analyzing the treatment programs to assess the prognosis of patients and its differential diagnosis which is similar to the disease.Results:A total of 10 patients(4 males,6 females;the average age is 46.5 years old,age range is 3-81 years).The exposure history to corn stalks,wood,rotten reeds,straw,etc,according to the clinical manifestations and histopathological examination of these patients,eyelid sporotrichosis can be divided into three main forms:(i)fixed cutaneous,The fixed cutaneous form was found to be the most common form in the eyelid(6/10 cases).It is characterized by localized cutaneous lesions approximately 0.5–3 cm in diameter and 1 or 2 differently sized nodular,ulcerative,plaque-like,or verrucous lesions restricted to the site of inoculation(ii)lymphocutaneous,The lymphocutaneous form was also found to be common(3/10 cases).It usually presents an indurated papule that progressively forms nodules,cysts,or ulcerations,and further nodules appear along the lymph trajectory.and(iii)eyelid abscess.In rare cases,S.schenckii infections can also produce eyelid abscesses(1/10 cases).These abscesses present as a tender mass with a diameter of about 1–3 cm.Histopathological examination shows that sporotrich granulomatous granules were present in 100% of the cases,and these granulomas consists of neutrophils and necrotic central microcapsules.As another characteristic of the performance was the stellate body,which is in 70% of the cases have appeared.In addition,fungal culture was carried out at 25 °C on Shabu Glucosamine Agar Solid Medium(SDA).Black Creamy Colonies were grown in about two weeks,and the positive rate was 90%.All patients were treated with oral terbinafine antifungal therapy for 12 weeks.Treatment showed that eyelid nodules,papules and abscess subsided after treatment.After the end of treatment of the 12 weeks follow-up,we found that the 10 patients were no signs of recurrence.Conclusions:Patients often live in the high-prevalence area and have a identcal hi history of exposure and typical skin lesions,we can usually make the initial diagnosis of the disease.Further confirmed the disease,we can use the histopathological examination and tissue fungal culture.The diagnosis of cases usually requires the use of antifungal agents for long-term systemic treatment and the treatment effect is obvious,the recurrence rate is low.Eyelid sporotomyosis usually does not need a surgical resection.