【摘要】 患者，男，37岁。左下肢皮疹4周，伴轻压痛。无发热等全身症状。患者曾在伊拉克援外工作。皮肤科专科检查：左小腿屈侧见3个暗红色斑块，中央见浅溃疡面，上覆淡黄色分泌物。皮损组织病理学检查：皮肤溃疡形成及散在小灶状微脓肿形成，伴淋巴细胞、组织细胞浸润，组织细胞内可见直径2～4μm嗜碱性圆形小体。Giemsa染色(+)。皮损组织PCR检测提示硕大利什曼原虫。特比萘芬片口服6周治疗无效后，改为氟康唑胶囊口服，8周后皮损基本痊愈。治疗期间未出现严重不良反应。更多还原

【Abstract】 A 37-year-old man presented with rashes on the left lower limb with mild tenderness for 4 weeks. There were no systemic symptoms such as fever. The patient had worked as an aid worker in Iraq. Phyical examination showed 3 dark red plaques on the left leg, with a shallow ulcerated surface covered with pale yellow secretions in the center. Histological examination of lesions showed ulceration and scattered focal microabscesses with infiltration of lymphocytic cells and histiocytes, basophilic round bodies with diameters of 2-4 μm in histiocytes. Giemsa stain was positive. PCR analysis of the skin tissue indicated the L. major. Terbinafine was ineffective after 6 weeks of oral treatment, then fluconazole capsules were taken orally for 8 weeks and the lesions were cured. There were no serious adverse reactions during the treatment.更多还原