《獸醫(yī)臨床檢查技術(shù)》課件-14實(shí)訓(xùn)任務(wù)八 伍氏燈檢查

《伍氏燈檢查》Wood’sLampExamination授課專(zhuān)業(yè)：動(dòng)物醫(yī)學(xué)Outline2024/5/19《寵物臨床檢查技術(shù)》課件2PURPOSEToevaluatepatientswithlesionssuggestiveofdermatophyte(ringworm)infection評(píng)估患病寵物感染類(lèi)似皮膚真菌（錢(qián)癬）的病灶。2024/5/19《寵物臨床檢查技術(shù)》課件3INDICATIONSThisexamisusedfortheevaluationofdogsandcatswithdermatologiclesionsthatcouldberingworm.Theclassicallesionwouldbewelldemarcated,crusted,andpruritic.Dermatophyteinfectioncan,however,haveavariedappearance,soWood’slampexaminationshouldbeconsideredinanycasewithregionalorpatchyalopecia,scaling,crusting,seborrhea,pruritus,orregionalfolliculitis.評(píng)估犬與貓可能是錢(qián)癬的皮膚病灶。典型的病灶為明顯的界限，痂皮以及搔癢。然而皮膚真菌感染會(huì)出現(xiàn)各式不同的外觀(guān)，國(guó)此胡任何病例有區(qū)域性或片狀脫毛、痂皮、皮脂漏、搔癢或者區(qū)域性的毛囊炎，應(yīng)考慮以伍氏燈檢查。2024/5/19《寵物臨床檢查技術(shù)》課件42024/5/19《寵物臨床檢查技術(shù)》課件5CONTRAINDICATIONSANDCONCERNS1.Wearglovesbecausethedermatophytesinfectingdogsandcatscancauselesionsinhumans.需戴手套，因?yàn)楦腥救c貓的皮膚真菌也可感染人

2.TheWood’slampmustbeturnedonfor5to10minutesbeforeusebecausethestabilityofthelight’swavelengthandintensityistemperaturedependent.伍氏燈使用前要暖機(jī)5—10分鐘因?yàn)楣獠ㄩL(zhǎng)穩(wěn)定性以及強(qiáng)度取決于溫度。2024/5/19《寵物臨床檢查技術(shù)》課件63.Itisimportanttodistinguishnonspecificfluorescencethatoccursoncrustsandscalesfromthefluorescenceassociatedwithdermatophyteinfection.Scalesandcruststendtohaveadiffuse(notconfinedtothehairshaft)glowthatisolive-greentoyellowishgreen.Microsporumcanisfluorescenceisconfinedtotheindividualhairs(whichareoftenbrokenoff)andistypicallyapple-green(averybrightgreen,likeaflashlightshiningthroughalimelollipop).2024/5/19《寵物臨床檢查技術(shù)》課件7重要的是要區(qū)分出痂皮以及鱗屑上的發(fā)出的非特異性螢光，以及皮膚真菌感染所發(fā)出的螢光。鱗屑與痂皮往往呈擴(kuò)散分布（并不局限在毛干上），發(fā)出的光線(xiàn)為橄欖綠到黃綠色。犬小孢子菌的螢光則限定在個(gè)別的毛發(fā)上（常為脫落的毛發(fā)），且典型為蘋(píng)果綠（非常亮的綠色，如同燈光透過(guò)萊姆棒棒糖所發(fā)出的光）2024/5/19《寵物臨床檢查技術(shù)》課件84.ThefluorescenceofM.caniswillremainevenafterthefungushasbeenkilledbytreatment.Overtime,asthehairsgrow,thedeadfunguswillbelocatedneartheendsofthehairsinsteadofnearthebaseasexpectedwithanactiveinfection.犬小孢子菌的熒光會(huì)持續(xù)到真菌被治療之后。過(guò)一段時(shí)間后，當(dāng)毛發(fā)長(zhǎng)出，死亡的真菌會(huì)位于接近毛發(fā)的發(fā)尾，而非如感染活躍期時(shí)出現(xiàn)在發(fā)根。2024/5/19《寵物臨床檢查技術(shù)》課件9POSITIONINGANDRESTRAINTAdequaterestrainttokeeptheanimalstill適當(dāng)?shù)谋６ㄒ跃S持動(dòng)物不動(dòng)。2024/5/19《寵物臨床檢查技術(shù)》課件10EQUIPMENTTheWood’slampisanultravioletlightwithalightwavefilteredthroughacobaltornickelfilter.Greenfluorescenceoccurswithsomedermatophytesbecauseofthetryptophanthatisproducedbythefungus.伍氏燈是一種紫外線(xiàn)光，會(huì)透過(guò)鈷或鎳的過(guò)濾器過(guò)濾光波。有些皮皮膚真菌會(huì)出現(xiàn)綠色螢光，因?yàn)榇苏婢鷷?huì)制造色胺酸。2024/5/19《寵物臨床檢查技術(shù)》課件112024/5/19《寵物臨床檢查技術(shù)》課件12TECHNIQUE1.TurnontheWood’slampatleast5minutesbeforeusingittoexaminethepatient.檢查病患前，伍氏燈需暖機(jī)至少5分鐘。2.Weargloves,andexaminethepatientusingtheWood’slampinadarkenedroom.戴手套，并在暗房間內(nèi)以伍氏燈檢查病患。2024/5/19《寵物臨床檢查技術(shù)》課件132024/5/19《寵物臨床檢查技術(shù)》課件143.Lookforbrightgreenfluorescenceassociatedwiththehairsinthelesion.在病灶處找尋毛發(fā)上的亮綠色熒光。2024/5/19《寵物臨床檢查技術(shù)》課件15RESULTSOnlyM.canisshowspositiveresults,andonlyapproximately50%ofM.canisinfectionsarepositive.Suspiciouslesions(andallWood’slamp-positivelesions)shouldhavehairs,crusts,andswabsculturedtoconfirmthepresenceofadermatophyte.M.canisisresponsibleformostdermatophyteinfectionsincats(>98%)anddogs(50%to70%).LesscommonlydiagnosedpathogenicdermatophytesincludethenonfluorescingTrichophytonmentagrophytesandMicrosporumgypseum.2024/5/19《寵物臨床檢查技術(shù)》課件16只有犬小孢子菌感染會(huì)呈現(xiàn)陽(yáng)性，且只有大約50%的犬小孢子菌感染會(huì)呈現(xiàn)陽(yáng)性。因此對(duì)懷疑的病灶（及所有伍氏燈呈陽(yáng)性的病灶），應(yīng)做毛發(fā)、痂皮及及拭子進(jìn)行真菌培養(yǎng)，確診皮膚