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目的探讨尖锐湿疣(CA)与外阴、阴道内壁、肛周有增生物的其他常见皮肤疾病的鉴别以及误诊原因。方法回顾性分析我院2006年9月至2011年9月间有80例误诊为CA。男32例,女48例,年龄16～70岁,平均28.5岁。皮损分布:包皮5例、龟头后缘近冠状沟处20例、大阴唇12例、小阴唇(内、外)13例、阴道前庭8例、阴阜5例、阴道内壁5例、肛周12例。病例情况:外阴及肛周有增生物73例、有白带异常6例(阴道检查中发现可疑增生物)、有不洁性交史55例。误诊情况:外阴皮内痣3例(3.75%);阴道正常皱壁5例(6.25%);鲍温样丘疹病5例(6.25%);传染性软疣7例(8.75%);扁平湿疣9例(11.25%);皮赘10例(12.50%);外阴假性湿疣20例(25.00%);阴茎珍珠状丘疹21例(26.25%)。结果 80例中有49例无需治疗,31例按相应病因治疗全部好转或治愈。结论尖锐湿疣的诊断应慎重对待,勿草率诊断,加强皮肤性病专业知识的培训,学习掌握尖锐湿疣的鉴别诊断,提高诊疗水平。
Objective To investigate the differential diagnosis and misdiagnosis of condyloma acuminatum (CA), vulva, vaginal wall and other common skin diseases with perianal proliferative. Methods Retrospective analysis of 80 cases misdiagnosed as CA from September 2006 to September 2011 in our hospital. 32 males and 48 females, aged 16 to 70 years, an average of 28.5 years old. Distribution of lesions: the foreskin in 5 cases, 20 cases of glans coronoid posterior margin, 12 cases of labia majora, labia minora (inside and outside) in 13 cases, 8 cases of vaginal vestibule, mons pubis 5 cases, 5 cases of vaginal wall, perianal 12 cases. Cases: There are 73 cases of genital and perianal proliferative, 6 cases of vaginal discharge abnormalities (vaginal examination found suspicious proliferative), 55 cases of unclean sexual intercourse. Misdiagnosis: 3 cases (3.75%) of genital nevus; 5 cases of normal vaginal wall (6.25%); 5 cases of Bowenoid papulosis (6.25%); 7 cases of molluscum contagiosum 9 cases (11.25%), 10 cases of skin graft (12.50%), 20 cases of genital warts (25.00%) and 21 cases (26.25%) of penis pearl papules. Results Of the 80 cases, 49 cases did not need treatment and 31 cases were cured or improved according to the corresponding etiology. Conclusions The diagnosis of condyloma acuminatum should be treated with caution. Do not rush the diagnosis, strengthen the training of dermatology venereal disease knowledge, master the differential diagnosis of condyloma acuminata and improve the diagnosis and treatment level.