Clinical Analysis Of 972 Children With Cutaneous Sporotrichosis In Jilin Province

Background:Sporotrichsis is a subacute or chronic deep fungal infection of human skin,subcutaneous tissue,mucosa and local lymphatic system caused by sporotrichosis complex.according to the infection site,sporotrichosis can be divided into skin sporotrichosis and systemic sporotrichosis.skin sporotrichosis can be divided into skin fixation type,skin lymphatic vessel type and skin dissemination type.human sporotrichosis is mainly cutaneous sporotrichosis.the sporotrichosis complex that infects humans includes the narrow sense of schencker richosis,brazilian sporotrichosis,globosa sporotrichosis mexican sporotrichosis,lueri sporotrichosis,and alternaria albicans.the disease is widely distributed in the world.northeast china,especially jilin province,is the high incidence area of the disease.sporothrix globosa is the main strain isolated in china.the disease is reported illegally,but the number of patients repo-rted each year is very large,including many children.at present,there are few reports on dermato sporotrichosis in children in china.Objective:972 cases of cutaneous sporotrichosis in children in jilin province from 2011 to2018 were analyzed retrospectively.the clinical and epidemiological characteristics were summarized to provide guidance and help for the prevention and treatment of cutaneous sporotrichosis in children.Methods:Selection criteria: from january 2011 to december 2018,dermatology department of bethune first hospital of jilin university diagnosed the cases of dermatosporotrichosis in jilin province(aged less than 15 years).criteria:all clinical types of cutaneous sporotrichosis wese characterized by skin lesions,and fungaicultures of the lesion were positive for sporothrichosis in biopsy or tissue fluid,purulent secretion,blood secretion,abscess and cyst puncture fluid.The collected case data were analyzed by SPSS 19.0.Result:1.972 children with cutaneous sporotrichosis were enrolled.there were 573males(58.95%)and 399 females(41.05%),male: female=1:0.69.the average age at the time of consultation was 5.72±3.59 yearsold.with an average duration of 2.92 ±2.88 months.299 cases(30.76%)occurred in spring(2.3.4 months),84 cases(8.64%)in summer(5.6.7 months),155 cases(15.94%)in autumn(8.9.10 months),434cases(44.65%)in winter(11.12.1 months),68 patients had a history of trauma(6.99%).2.There were 860 patients with dermatostationary sporotrichosis(88.48%),110 patients with cutaneous lymphatic sporo-trichosis(11.31%),and no patients with cutaneous disseminated sporotrichosis,but 2 patients could notm be typed clearly(0.21%).897 patients(92.28%)were involved in maxillofacial lesions and 75patients(7.72%)were not involved in maxillofacial lesions.the clinical manifestations of lesions were nodular type in 434 cases(44.65%),infiltating plaque type in 307cases(31.58%),and other types in 231 cases(23.77%).3.The positive rate of fungal culture was 100%.PAS staining was performed in all the patients.211 of them found purplered round or oval chlamydospore or germinating spore,accounting for 21.70% of all patients,and 4 patients were found to have stellate structure in pathological sections.4.Statistical analysis showed that there was no significant difference in the proportion of traumatic history among children of different age groups(less than or equal to 1 year old,older than 1 year and lsee than 3 years old,older than or equal to 3years and less than 7 years old,older than or equal to 7 years and less than 15 years old)and in different seasons(winter,spring,summer and autumn)(p=0.068,p=0.276).there was no significant difference in the lesion sites(maxil-lofacial and nonmaxillofacial)between children of different age groups(less than or equal to 1 year old,older than 1 year and lsee than 3 years old,older than or equal to 3 years and lessthan 7 years old,older than or equal to 7 years and less than 15 years old)and between children of different clinical types(skin lymphatic vessel type and skin fixation type)(p=0.095,p=0.851).there were statistical differences in the lesion affected parts(maxillofacial and nonmaxillofaci-al)of children in different seasons(winter,spring,summer and autumn).the proportion of lesion affected non-maxillofacial in summer and autumn was higher than that in winter and spring(?~2=14.324 p=0.000).children with different female),age group(less than or equal to 1year old,older than 1 year and lsee than 3 years old,older than or equal to 3 years and less than 7 years old,older than or equal to 7 years and less than 15 years old),different course of disease(more than 2 months or less than or equal to months)and different PAS staining results(positive and negative)have different clinical(skin lymphatic line,skin fixed type).there was no statistical difference(p=0.978,p=0.184,p=0.116,p=0.611).the clinical types of children with different seasons(winter,spring,summer and autumn)had statistical significance.the proportuon of fixed skin type in children with winter and spring was higher than that in children with summer and autumn(?~2=5.692,p=0.017).there were significant differences in skin lesions among children with different clinical types(skin-fixed type,Skin-lymphatic type).the proportion of nodal lesions in children with skin-lymphatic type was higher than that of infiltrating plaque type(?~2 =16.786 p=0.000).PAS staining results were different(negative,positive)in children with skin lesions(nodular,infiltrating plaque type)there statistical differences,the positive rate of PAS staining in nodular lesions was higher than that in infiltrating plaque type(?~2=7.452,p=0.024).Conclusion:1.From 2011 to 2018,there were more male than female children with cutaneous sporotrichosis in jilin province.the number of patients in winter and spring was the largest.the distribution of skin lesions was mainly in maxillofacial region.the clinical type was mainly skin-fixed type,and nodular type was the main manifestation of skin lesions.2.The traumatic history of children with cutaneous sporotrichosis in jilin province from 2011 to 2018 was not related to their age and onset season.the locationof lesions is not related to the age and clinical type of the children,but to the season.the proportion of non-maxillofacial lesions in summer and autumn is higher than that in winter and spring.the clinical type was not related to gender,age,course of disease and PAS staining results,but reated to the onset season.the proportion of skin fixation type was higher in winter and spring.the clinical types of the children were relatrd to the lesions the proportion of nodal lesions in lymphatic type of skin was higher than that in infiltrating plaque type.the results of PAS staining were also related to the lesions.the positive rate of PAS staining in nodular lesions was higher than that in infiltrating plaque lesions.