| Objective:1.To explore the application value of Reflectance confocal microscopy(RCM)in the diagnosis of tinea corporis and tinea cruris by observing the fungal clearance during the treatment of tinea corporis and tinea cruris by comparison with traditional direct microscopy in KOH preparation.To provide reference for the diagnosis of tinea corporis and tinea cruris.2.By means of questionnaire survey,Dermatology Life Quality Index(DLQI)score and related causes of patients with tinea corporis and tinea cruris were collected to explore the impact of tinea corporis and tinea cruris on patients’ quality of life and the susceptibility factors of tinea corporis and tinea cruris.Methods:A total of 106 patients who met the requirements and visited the dermatology department of the First Affiliated Hospital of Wannan Medical College from May 2021 to December 2022 were collected.All patients were treated with the antifungal agent(Naftifine hydrochloride cream)twice a day for 4 weeks for topical use.At the second and fourth week of follow-up,RCM and KOH preparation were used for microscopic observation,respectively.At the second and fourth week of treatment,RCM was used at the same target lesions to observe the microscopic changes during the treatment of tinea corporis and tinea cruris,and the comparison was made with direct microscopy in KOH preparation.Statistical methods were used to analyze and compare the positive microscopic results of RCM and KOH at the second and fourth week of treatment,and the rash severity score,itch score,DLQI and questionnaire survey were analyzed.Results:1.Before treatment,the positive rate of RCM was 100%in 106 patients suspected of tinea corporis and tinea cruris and confirmed by direct microscopy in KOH preparation.At the second week of treatment,there were 19 patients with characteristic high-refraction branching structures in the cuticle observed by RCM,and 17 patients with positive KOH preparation,the difference was not statistically significant(χ~2=0.123,P>0.05).At the fourth week of treatment,there were 2 patients with characteristic high-refraction branching structures in the cuticle,and 1 patient with positive KOH preparation,with no statistical significance.(χ~2=0.338,P>0.05)2.The DLQI score of patients was 16.15±6.08 before treatment and 4.54±4.48 at the second week of treatment,the difference was statistically significant(t=34.71,P<0.01).DLQI at the fourth week of treatment was 0.47± 1.49,and the difference was statistically significant compared with the 2th week of treatment(t=11.56,P<0.01).3.In this study,there were significant differences in the gender,Body Mass Index(BMI),education level,occupation,pet contact history,sweating and exercise of the patients with tinea corporis and tinea cruris compared with the normal control population(P<0.05).Further Logistic regression analysis showed that gender,BMI,sweating and exercise were independent risk factors for tinea corporis and tinea cruris infection.Conclusion:1.The traditional direct microscopy in KOH preparation is widely recognized in clinical practice and can be regarded as a standard for the diagnosis and curative effect observation of tinea corporis and tinea cruris.However,this study showed that there was no significant difference in the positive rate of RCM and KOH preparation,suggesting that RCM can also be used as a means of choice in the diagnosis and curative effect observation of tinea corporis and tinea cruris.2.Tinea corporis and tinea cruris can reduce the quality of patients,and after standard treatment,the quality of life is significantly improved.3.Male,BMI>23.9,sweating and exercise are the predisposition factors for tinea corporis and tinea cruris. |
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