背景:自2022年5月以来,全球范围内已报告了水痘病例。关于这种疾病的长期病程的知识有限。评估初次感染后4-6个月水痘患者的瘢痕形成和生活质量(QoL)方面的后遗症。
方法:对聚合酶链反应(PCR)证实的痘痘患者的临床特征和症状进行前瞻性观察研究,包括门诊病人和住院病人。随访时间为4-6个月,评估患者和观察者疤痕评估量表(POSAS),皮肤病生活质量指数(DLQI)和性功能障碍,使用数字评分量表(NRS)从0到10。
结果:43名患者,年龄范围19-64岁,41名男性(均为MSM)和2名女性,包括在内。诊断后,93.0%的病例出现皮肤或粘膜病变,73.3%报告疼痛(中位数强度:8,Q1-Q3:6-10)。肛门受累导致疼痛的频率明显高于生殖器病变(RR:3.60,95%-CI:1.48-8.74)。因疼痛住院治疗,重叠感染,20例患者需要脓肿或其他指征(46.5%)。4-6个月后,大多数患者没有明显的局限性,伤疤或疼痛。然而,与没有这种并发症的患者相比,急性期双重感染或脓肿患者的瘢痕形成明显更广泛(中位PSAS:24.0vs.11.0,p=0.039),并且经历了明显更大的QoL损害(中位数DLQI:2.0vs.0.0,p=0.036)和性(NRS中位数:5.0vs.0.0,p=0.017)。
结论:我们观察到广泛的临床痘表现,一些患者经历了严重的疼痛,需要住院治疗。4-6个月后,大多数患者康复,没有明显的后遗症,但是在初次感染期间患有脓肿或重复感染的患者的QoL和性行为显着降低。充分的治疗,包括急性期的抗菌和抗生素治疗,可能有助于预防这种并发症,因此,改善长期结果。
BACKGROUND: Cases of mpox have been reported worldwide since May 2022. Limited knowledge exists regarding the long-term course of this disease. To assess sequelae in terms of scarring and quality of life (QoL) in mpox patients 4-6 months after initial infection.
METHODS: Prospective observational
study on clinical characteristics and symptoms of patients with polymerase chain reaction (PCR)-confirmed mpox, including both outpatients and inpatients. Follow-up visits were conducted at 4-6 months, assessing the Patient and Observer Scar Assessment Scale (POSAS), the Dermatology Life Quality Index (DLQI) and sexual impairment, using a numeric rating scale (NRS) from 0 to 10.
RESULTS: Forty-three patients, age range 19-64 years, 41 men (all identifying as MSM) and 2 women, were included. Upon diagnosis, skin or mucosal lesions were present in 93.0% of cases, with 73.3% reporting pain (median intensity: 8, Q1-Q3: 6-10). Anal involvement resulted in a significantly higher frequency of pain than genital lesions (RR: 3.60, 95%-CI: 1.48-8.74). Inpatient treatment due to pain,
superinfection, abscess or other indications was required in 20 patients (46.5%). After 4-6 months, most patients did not have significant limitations, scars or pain. However, compared to patients without such complications, patients with
superinfection or abscess during the acute phase had significantly more extensive scar formation (median PSAS: 24.0 vs. 11.0, p = 0.039) and experienced a significantly greater impairment of their QoL (median DLQI: 2.0 vs. 0.0, p = 0.036) and sexuality (median NRS: 5.0 vs. 0.0, p = 0.017).
CONCLUSIONS: We observed a wide range of clinical mpox manifestations, with some patients experiencing significant pain and requiring hospitalization. After 4-6 months, most patients recovered without significant sequelae, but those with abscesses or superinfections during the initial infection experienced a significant reduction in QoL and sexuality. Adequate treatment, including antiseptic and antibiotic therapy during the acute phase, may help prevent such complications, and hence, improve long-term outcomes.