This is caused by Sporothrix deep mycosis, mainly affects the skin, and occasionally also be violations of mucous membrane, lung, meninges, and other internal organs. Prior to the onset, the skin often prior history of trauma, and then contact with contaminated soil or plants, bacteria on the skin enter the body from injury, about 1 ~ 3 weeks after, on the part of the initial invasion produced as boils kind of damage is generally not painful or fever, ulceration, after the formation of ulcers, pus is small; also can papules, verrucous damage, plaque, and vegetables pattern pseudo-tumors. Damage can be fixed in a long time, or along the lymphatic spread upward, resulting in a string of similar damage to a few 10 arranged in a number of strips. Generally a maximum opportunity for upper limb disease, lower extremity followed the face is quite prevalent in recent years. Very few can invade the blood, causing wide spread skin and internal organs. Extrusion injury in sepsis as training can often be isolated from bacteria, you can confirm the diagnosis. Iodide effects of this disease in the general with 10% potassium iodide solution, per 10ml, three times a day, oral, treatment in the 2 ~ 3 months. Local hyperthermia therapy can play a supporting role. Prevention of skin injury is very important in preventing this disease. The dressing should be replaced burned patients to avoid polluting the environment, infecting others. A high incidence of this disease should be good publicity.
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(A) treatment
1. Inside the medication
(1) iodide: 5% ~ 10% potassium iodide 3g / d, can be gradually increased to 6 ~ 8g / d, the damage can be following the suit disappears 2 to 4 weeks, the general course of 2 to 3 months. Potassium iodide saturated solution 10 drops / time, 3 times / d, can be gradually increased to 40 drops, 3 times / d, usually 1 week are effective, 1 ~ 2 months curable. Oral potassium iodide have indigestion or nausea, vomiting, poor appetite and other gastrointestinal reactions, can be used sodium iodide 1g / d intravenous injection. If patients have tuberculosis, potassium iodide should not be applied.
(2) griseofulvin: less effective, generally do not. Those who are allergic to iodine may consider, 0.8g / d, for 1 ~ 3 months.
(3) Flucytosine: According to 100 ~ 200mg/kg body weight, until cured.
(4) Itraconazole: ① lymphatic tube: 100 ~ 200mg / d, for 3 to 6 months; ② fixed: 50 ~ 100mg / d, for 3 to 6 months.
(5) Terbinafine: 2 times / d, each 0.25g, generally serving a ~ 2 months.
(6) Fluconazole: 200 ~ 400mg / d.
(7) of amphotericin B on the skin type and disseminated lymphatic sporotrichosis can be applied. The first dose of 3 ~ 5mg, adults can be added to the 30 ~ 35mg, continuing a ~ 2 months.
2. For external use 2% potassium iodide or 0.2% iodine solution can be topical; 2% dimethyl sulfoxide ball erythromycin penetration agent, 2 times / d; amphotericin B250 ~ 500mg, dimethyl sulfoxide 30ml, glycerol 20ml, water 50m1, formulated into a thoroughly topical agent; thermotherapy local heating heater 45 ℃, 3 times / d, every 60min, for the effective isolation of the damage.
(B) the prognosis
Cutaneous lymphatic type, nodules gradually softening, ulceration of the formation of chronic ulcers, difficult to heal. More after the formation of scar.