目的 总结我国自1991年至今报道的所有多变根毛霉感染所致皮肤接合菌病的临床资料,探讨其流行病学特点、临床特征和治疗.方法 文献搜索并回顾分析我国13例多变根毛霉原发性皮肤感染的临床资料.结果 13例皮肤多变根毛霉病,平均发病年龄为34±17(5～65)岁,男6例,女7例,病程5个月～16 a不等,感染报道多集中于长江流域；临床多表现为局部红斑、丘疹和/或结节,可缓慢扩展形成浸润性斑块伴溃疡坏死；发病前有明确皮肤损伤病史6例,无明确诱因7例.皮损多发生于暴露部位,面部10例,上肢3例.所有病例均经真菌学和病理学诊断确诊.治疗主要为两性霉素B和唑类抗真菌药物,其中8例治愈,2例疗效不佳,3例失随访.结论 多变根毛霉皮肤接合菌病是一种重要的毁容性感染病,多与皮肤屏障损伤有关,提高对本病的认识有利于开展早期诊断和及时治疗,治疗首选两性霉素B.%Objective To investigate the epidemic and clinical characteristics of primary cutaneous zygomycosis due to Rhizomucor variabilis in China since 1991. Methods Thirteen cases of cutaneous mucormycosis caused by Rhizomucor variabilis were searched from the electrical database, and all the clinical information was collected and evaluated. Results Of the 13 case records , 7 were female while 6 were male. Median age was 34 ± 17 (5-65) year and the course ranged from 5 months to 16 years. Most cases were mainly reported in Yangtze River valley. The major clinical manifestations were local erythema, papula, and/or nodule, which might spread into infiltrating plaque associated with ulceration and necrosis. Six patients had defined mucocutaneous damage histories before the onset. All the lesions primarily occurred in exposure parts of the body (10 in the face and 3 in the upper limb) and all the diagnoses were made by mycological and histopathological examinations. The major treatments were amphotericin B and azole drugs. Eight patients were cured, and two had poor results while three lost follow-up. Conclusions Primary cutaneous zygomycosis due to Rhizomucor variabilis is severe disfiguring disease. Enhancing the understanding of its clinical characterisctics will contribute to the early diagnosis and timely treatment, and amphotericin B should be considered as a preferred choice.
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