《兽医临床检查技术》课件-14实训任务八 伍氏灯检查

《伍氏灯检查》Wood’sLampExamination授课专业：动物医学Outline2024/5/19《宠物临床检查技术》课件2PURPOSEToevaluatepatientswithlesionssuggestiveofdermatophyte(ringworm)infection评估患病宠物感染类似皮肤真菌（钱癣）的病灶。2024/5/19《宠物临床检查技术》课件3INDICATIONSThisexamisusedfortheevaluationofdogsandcatswithdermatologiclesionsthatcouldberingworm.Theclassicallesionwouldbewelldemarcated,crusted,andpruritic.Dermatophyteinfectioncan,however,haveavariedappearance,soWood’slampexaminationshouldbeconsideredinanycasewithregionalorpatchyalopecia,scaling,crusting,seborrhea,pruritus,orregionalfolliculitis.评估犬与猫可能是钱癣的皮肤病灶。典型的病灶为明显的界限，痂皮以及搔痒。然而皮肤真菌感染会出现各式不同的外观，国此胡任何病例有区域性或片状脱毛、痂皮、皮脂漏、搔痒或者区域性的毛囊炎，应考虑以伍氏灯检查。2024/5/19《宠物临床检查技术》课件42024/5/19《宠物临床检查技术》课件5CONTRAINDICATIONSANDCONCERNS1.Wearglovesbecausethedermatophytesinfectingdogsandcatscancauselesionsinhumans.需戴手套，因为感染犬与猫的皮肤真菌也可感染人

2.TheWood’slampmustbeturnedonfor5to10minutesbeforeusebecausethestabilityofthelight’swavelengthandintensityistemperaturedependent.伍氏灯使用前要暖机5—10分钟因为光波长稳定性以及强度取决于温度。2024/5/19《宠物临床检查技术》课件63.Itisimportanttodistinguishnonspecificfluorescencethatoccursoncrustsandscalesfromthefluorescenceassociatedwithdermatophyteinfection.Scalesandcruststendtohaveadiffuse(notconfinedtothehairshaft)glowthatisolive-greentoyellowishgreen.Microsporumcanisfluorescenceisconfinedtotheindividualhairs(whichareoftenbrokenoff)andistypicallyapple-green(averybrightgreen,likeaflashlightshiningthroughalimelollipop).2024/5/19《宠物临床检查技术》课件7重要的是要区分出痂皮以及鳞屑上的发出的非特异性萤光，以及皮肤真菌感染所发出的萤光。鳞屑与痂皮往往呈扩散分布（并不局限在毛干上），发出的光线为橄榄绿到黄绿色。犬小孢子菌的萤光则限定在个别的毛发上（常为脱落的毛发），且典型为苹果绿（非常亮的绿色，如同灯光透过莱姆棒棒糖所发出的光）2024/5/19《宠物临床检查技术》课件84.ThefluorescenceofM.caniswillremainevenafterthefungushasbeenkilledbytreatment.Overtime,asthehairsgrow,thedeadfunguswillbelocatedneartheendsofthehairsinsteadofnearthebaseasexpectedwithanactiveinfection.犬小孢子菌的荧光会持续到真菌被治疗之后。过一段时间后，当毛发长出，死亡的真菌会位于接近毛发的发尾，而非如感染活跃期时出现在发根。2024/5/19《宠物临床检查技术》课件9POSITIONINGANDRESTRAINTAdequaterestrainttokeeptheanimalstill适当的保定以维持动物不动。2024/5/19《宠物临床检查技术》课件10EQUIPMENTTheWood’slampisanultravioletlightwithalightwavefilteredthroughacobaltornickelfilter.Greenfluorescenceoccurswithsomedermatophytesbecauseofthetryptophanthatisproducedbythefungus.伍氏灯是一种紫外线光，会透过钴或镍的过滤器过滤光波。有些皮皮肤真菌会出现绿色萤光，因为此真菌会制造色胺酸。2024/5/19《宠物临床检查技术》课件112024/5/19《宠物临床检查技术》课件12TECHNIQUE1.TurnontheWood’slampatleast5minutesbeforeusingittoexaminethepatient.检查病患前，伍氏灯需暖机至少5分钟。2.Weargloves,andexaminethepatientusingtheWood’slampinadarkenedroom.戴手套，并在暗房间内以伍氏灯检查病患。2024/5/19《宠物临床检查技术》课件132024/5/19《宠物临床检查技术》课件143.Lookforbrightgreenfluorescenceassociatedwiththehairsinthelesion.在病灶处找寻毛发上的亮绿色荧光。2024/5/19《宠物临床检查技术》课件15RESULTSOnlyM.canisshowspositiveresults,andonlyapproximately50%ofM.canisinfectionsarepositive.Suspiciouslesions(andallWood’slamp-positivelesions)shouldhavehairs,crusts,andswabsculturedtoconfirmthepresenceofadermatophyte.M.canisisresponsibleformostdermatophyteinfectionsincats(>98%)anddogs(50%to70%).LesscommonlydiagnosedpathogenicdermatophytesincludethenonfluorescingTrichophytonmentagrophytesandMicrosporumgypseum.2024/5/19《宠物临床检查技术》课件16只有犬小孢子菌感染会呈现阳性，且只有大约50%的犬小孢子菌感染会呈现阳性。因此对怀疑的病灶（及所有伍氏灯呈阳性的病灶），应做毛发、痂皮及及拭子进行真菌培养，确诊皮肤