| By retrospective study and epidemiological analysis, our study investigatedepidemic characteristics and clinical features of sporotrichosis in612children and1821adults, aiming to provide a theoretical support and practical basis for prevention,treatment and effective control of this disease.Methods:A retrospective study was undertaken of sporotrichosis in612children and1821adults in dermatology department of our hospital from January,2007to December,2013. Their clinical information and epidemiologic features were surveyed andcompared, focusing on gender, age, occupation, residence, trauma history, contacthistory, morbidity season, disease progression, lesion type, fungal culture, pathologicbiopsy as well as treatment.Results:1、 Gender: In patients with sporotrichosis, sex ratios were as following.370(60.5%) of612children enrolled in the study were male, and242(39.5%) werefemale. For children, the male-to-female sex ratio was1.53:1,640(35.1%) of1821adults were male, and1181(64.9%) were female. For adults, the male-to-female sexratio was1:1.85, children patients and adults patients have significant statisticaldifference in gender.2、Age:25.2%of patients enrolled were children, under the age of14years.Their age ranged from2months to14years.224(36.6%) of them were between4to7years, which had the highest proportion. Followed by186(30.4%) of them werebetween8to14years and151(24.7%) of them were between1to3years, In contrast,age distribution for adults was as following.1269(69.7%) were young adults (19to59years), and510(28%) were old adults (60years or over). The peak incidenceoccurred in young adults. 3、Disease progression：The average duration was2.50±2.00months inChildren’s group, the average duration was4.00±8.00months in the adult group,There was a statistically significant difference between two groups of course, theadult group is higher than Children’s group in disease progression：4、Skin lesions: For543(92.8%) of612children, sporotrichosis originated fromthe face, which was the most common location of involvement, including212(39.04%)on the cheek,99(18.2%) under the jaw and56(10.3%) on the nose.18(3%) on theleft arm and15(2.5%) on the right arm. In contrast, only723(40.4%) of1821adultsoriginated from the face.443(24.3%) on the left arm and521(28.6%) on the right arm.Adult patients with skin lesions were significantly different from children,92.8%oflesions in pediatric patients distributed in the face, skin lesions in adult group mostlylocated in the upper limbs,964cases (53.9%), followed by facial723cases (40.4%).5、Clinical presentation：The main clinical presentation of sporotrichosis wasnodular type, with51%of children and40.3%of adults. Secondly, The presentationof sporotrichosis was infiltrated plaques type, with23.5%of children and21.6%ofadults.6、Clinical classification：Fixed type was the lesion type of sporotrichosis inchildren, the ratio of which was82.7%,while fixed type and lymphatic type was thelesion type of sporotrichosis in the adult, the ratio of which was63.5%and34.10%。7、Fungal culture：612cases of children Sporothrix fungal culture-positivepatients with398(65%),1821cases of adult patients with fungus Sporothrix culturepositive1225cases (67%), The positive fungal culture was similar between childrenand adult.8、Histopathology Result: Histopathological examination and PAS stain hadbeen underwent for612children and1821adults. The main histopathology findingswere infectious intradermal granulomas, some accompanied with typical "threeregions" changes. Spores and steroid bodies were found in117children (19.1%) and360adults (19.8%). The histopathology changes for children with sporotrichosis weresimilar to that of adults. 9、Treatment:10%potassium iodide was used by most patients. As followed up,their lesions had significantly turned better or cured.10、Trauma history and pollutants contact history: The ratio of trauma historywas significantly higher in adults than children (5.1%). And the pollutants contacthistory was found in183children (29.90%) and485adults (26.63%).11、Morbidity season：Morbidity season for children was different from that ofadults. Autumn and winter were seasons with high rates of sporotrichosis incidencefor children. By contrast, winter was the most common season for adults, followedby spring and autumn.12、Residence：Residences for children with sporotrichosis were similar to thatof adults. Most children came from Jilin province, and the city of Changchun is themost common residence, followed by Songyuan and Siping.Results:1、Jilin province was a high risk region for sporotrichosis, and Changchun wasthe most common residence, followed by Song yuan and Siping.2、Incidence rate of sporotrichosis in children was higher, and children between4to7years had the highest proportion.3、Sporotrichosis in children had comparely shorter disease course, and the facewas the most common distribution of lesions. In contrast, the ratio of upper limbsdistribution was higher in adults. The main clinical presentation of sporotrichosis wasnodular type for both children and adults.4、Morbidity season for children was different from that of adults. Autumn andwinter were seasons with high rates of sporotrichosis incidence for children. Bycontrast, winter was the most common season for adults, followed by spring andautumn. And the ratio of trauma history was significantly higher in adults thanchildren. |
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