皮膚感染
外觀
皮膚感染(英語:Skin infection)是指人類或其他動物的皮膚受到感染。皮膚感染不僅會影響皮膚,它還會影響相關的軟組織,例如蜂窩組織和黏膜。[來源請求]皮膚感染包括一類稱為皮膚和皮膚結構感染(SSSI)(也稱為皮膚和軟組織感染(SSTI)[1]或急性細菌性SSSI(ABSSSI))的感染。[2]皮膚感染不同於皮炎(發生在皮膚的炎症),[3][4]雖然皮膚感染可能導致皮炎。[5]
成因
[編輯]細菌
[編輯]2013年,細菌性皮膚感染影響了約1.55億人,而其中蜂窩組織炎約有6億人感染。[6]常見的細菌性皮膚感染包括:
- 蜂窩組織炎是結締組織的瀰漫性炎症,伴有真皮層和皮下組織層的嚴重炎症。[7]此外,根據最可能的致病因素和症狀表現,可以將蜂窩組織炎分為化膿性和非化膿性蜂窩組織炎。[8]化膿性蜂窩組織炎通常由金黃色葡萄球菌引起,包括甲氧西林敏感金黃色葡萄球菌(MSSA)和耐甲氧西林金黃色葡萄球菌(MRSA)。[8][7]而非化膿性蜂窩組織炎常由A組β溶血性的鏈球菌引起,例如化膿性鏈球菌。[8][7]在極少數情況下,感染會發展為壞死性筋膜炎,這是一種嚴重且可能致命的感染。[9]
- 丹毒是一種細菌感染,主要影響淺表真皮,並且通常涉及淺表淋巴管。[10]與蜂窩組織炎不同,它不會影響更深層的皮膚。它主要由A組β溶血性的鏈球菌引起,化膿性鏈球菌是最常見的病原體。[10]
- 毛囊炎是一種皮膚病,患者位於真皮層的毛囊受到感染和發炎。它主要是由細菌感染引起的,尤其是金黃色葡萄球菌,可導致淺表細菌性毛囊炎。[11]毛囊炎的其他致病因子包括真菌(最常見的是馬拉色菌屬里的物種)、病毒(例如單純疱疹病毒)和蟎蟲(蠕形蟎屬里的物種)。[11][12]
- 膿痂疹是一種高度傳染性的ABSSSI,在學齡前兒童中很常見,主要由金黃色葡萄球菌和化膿性鏈球菌這兩種病原體引起。[13][14]膿痂疹具有特徵性外觀,在口、鼻和下巴周圍出現黃色(蜂蜜色)結痂病變。[15]據估計,在任何時間,全球會有至少1.4億人感染此病。[15]膿痂疹可進一步分為大疱性和非大疱性形式。[15][16]非大疱性膿痂疹是最常見的形式,約佔確診病例的70%。[15]其餘30%的病例呈大疱性形式,主要由金黃色葡萄球菌引起。[15][17]在極少數情況下,大疱性膿痂疹會擴散並導致葡萄球菌皮膚燙傷樣綜合症(SSSS),這是一種可能危及生命的感染。[17]
真菌
[編輯]真菌性皮膚感染可能表現為皮膚、毛髮或指甲的淺表或深層感染。足菌腫是一大類真菌感染,其特徵是起源於足部的皮膚和皮下組織。[18]如果沒有及時進行適當地治療,足菌腫感染可以擴展到更深的組織,如骨骼和關節,導致骨髓炎。[19]廣泛的骨髓炎可能需要手術切除骨甚至下肢截肢。[19]截止至2010年,它們影響了全球約10億人。[20]常見的真菌性皮膚感染包括:
- 皮膚癬菌病,也稱為癬,是由幾種不同種類的真菌引起的皮膚淺表真菌感染。引起人類皮膚感染的真菌屬包括毛癬菌屬、表皮癬菌屬和小孢癬菌屬。[21]雖然皮膚癬菌病是世界範圍內相當常見的真菌性皮膚感染,但它在濕度和環境溫度高的地區更為普遍。[21]據估計,全世界大約20至25%的人受到淺表真菌感染的影響,其中皮膚癬菌病佔主導地位。[22]
- 口腔念珠菌病,通常稱為鵝口瘡,是一種主要由白色念珠菌引起的真菌感染,它主要影響口腔和舌頭的黏膜。[23]白色念珠菌約佔口腔念珠菌病病例的95%。[23]這種真菌是正常口腔菌群的一部分,只有當宿主免疫系統和微生物群屏障受損時才會引起感染,從而為白色念珠菌提供過度生長的機會。[24]據估計,全世界每年約有200萬人受到口腔念珠菌病的影響。[25]
- 甲癬是一種真菌感染,主要影響腳趾甲。[26]兩種最常見的甲癬病原體是須癬毛癬菌和紅色毛癬菌。[26]常見的體徵和症狀包括指甲變色和增厚、指甲與甲床分離以及指甲變脆。[27]在北美,甲癬的患病率在8.7%到13.8%之間。[27]
寄生蟲
[編輯]寄生蟲性皮膚感染是由幾個生物門引起的,包括環節動物門、節肢動物門、外肛動物門、脊索動物門、刺胞動物門、藍藻門、棘皮動物門、線蟲動物門、扁形動物門和原生動物門。[28]
病毒
[編輯]這些強制性的細胞內製劑引起的與病毒有關的皮膚病源於DNA和RNA病毒。[29]常見的病毒性皮膚感染包括:
- 疣是由人類乳頭瘤病毒(HPV)引起的良性增生性皮膚病變。[30][31]疣的形狀、大小、外觀和它們出現在身體上的位置各不相同。例如,跖疣發生在腳底,看起來像厚厚的老繭。[30][32]其他類型的疣包括尖銳濕疣、扁平疣、鑲工疣和甲周疣。[30]常見的治療選擇包括水楊酸和液氮冷凍療法。[30]
- 水痘是一種由水痘帶狀疱疹病毒(VZV)引起的高度傳染性皮膚病。[33]它的特徵是瘙癢性水疱樣皮疹,可能覆蓋全身,並且會影響所有年齡組。[33][34]在缺乏足夠免疫計劃的國家,水痘的發病率更高。據估計,2014年全球需要住院治療的嚴重水痘感染病例約為420萬。[35]
- 發疹性水疱性口腔炎(HFMD)也稱手足口症,是一種常見的、通常具有自限性的病毒性疾病,通常影響嬰兒和兒童,但也可能發生在成人身上。[36]其特徵是手掌、腳底和嘴巴周圍出現低燒和斑丘疹。[36][37]它是由人類腸道病毒和克沙奇病毒引起的,是一種陽性單鏈RNA病毒。[36][37]
參考文獻
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