【摘要】 目的了解早期梅毒临床表现及误诊原因,探讨组织病理学在梅毒诊断中的意义。方法对1 200例早期梅毒进行了临床分析,所有患者均做梅毒血清学检测,其中35例做了病理学检查。结果Ⅰ期梅毒181例,RPR(快速血浆反应素试验)及TPPA(苍白密螺旋体抗体凝集试验)阳性175例;Ⅱ期梅毒956例,RPR及TPPA均呈阳性;隐性梅毒60例,RPR及TPPA均呈阳性;Ⅰ期梅毒易误诊为软下疳、生殖器疱疹、疥结节、女阴溃疡等;Ⅱ期梅毒斑疹及斑丘疹易误诊为玫瑰糠疹、过敏性皮炎等;鳞屑性丘疹易误诊为银屑病;扁平湿疣疹易误诊为尖锐湿疣等。结论梅毒血清学检测对早期梅毒的诊断具有重要意义,病理检查对硬下疳、扁平湿疣、鳞屑性丘疹皮疹诊断有一定意义,而斑疹呈非特异性炎症改变,不具诊断意义。更多还原

【Abstract】 OBJECTIVE To study the clinic feature and cause of misdiagnosis of early stage syphilis and evaluate the significance of histopathology in the diagnosis of the disease. METHODS Totally 1 200 early syphilis cases were analyzed.The serologic test for syphilis was performed.Thirty five of them were performed with histopathological examination. RESULTS The primary syphilis was found to be commonly misdiagnosed as chancroid,genital herpes,scabies nodules and ulcus vulvae acutum.For secondary syphilis,macular syphilide and maculopapular syphilide were easily misdiagnosed as pityriasis rosea or dermatitis.The papulosquamous syphilide was commonly misdiagnosed as psoriasis.The condyloma latum was commonly misdiagnosed as condyloma acuminatum. CONCLUSIONS The serologic test is important in diagnosis of primary syphilis.The histopathologic test plays a role in diagnosis of primary syphilis,condyloma latum and papulosquamous syphilide,but of limited value in diagnosis of macular syphilide.更多还原