臺灣博碩士論文加值系統

中 文 摘 要
青少年的皮膚疾病在臺灣及全世界是十分常見的，然而有關青少年皮膚疾病的臨床分析報告卻不多。本研究主要的目的是針對某中部醫學中心青少年皮膚科門診中，常見皮膚疾病進行統計及分析。
總共收集2226人次( 994人)，年齡從11到21歲，從民國九十年一月至十二月前往臺中榮民總醫院皮膚科門診就醫的青少年。研究顯示無論是從門診人次及人數而言，痤瘡是最常見的皮膚疾病，其次是濕疹類，再來為皮膚感染性疾病。以年齡層來比較，痤瘡門診人次隨年齡增加有上升的趨勢，這與青少年隨年紀增加荷爾蒙的變化有關。而濕疹類中，異位性皮膚炎隨年齡增加而減少，可見此病會隨年齡增加而有減少的傾向。其他如脂漏性皮膚炎、接觸性皮膚炎則隨年齡增加而增加，可見晚期青少年患有此類濕疹的機會較多。至於皮膚感染類包括病毒疣，毛囊炎、癤癰、蜂窩性組織炎、黴菌感染及寄生蟲感染，人次隨年齡增加而增加，可見隨年齡增加青少年活動力強，流汗機會多，得到感染性皮膚疾病的機會也會隨之增加。從門診人次及人數比較，可以發現如痤瘡、異位性皮膚炎、灰指甲、乾癬為慢性、反覆發作性疾病，治療上較為困難。而感染性皮膚疾病如細菌感染則屬較易控制性及治療性的疾病。
本研究總結，青少年皮膚門診中以痤瘡、濕疹類、感染性為主要的三大類皮膚疾病，根據男女及年齡層間之疾病分佈有所不同，可作為日後臺灣青少年皮膚醫療保健提供相關的參考及資訊。
關鍵字： 皮膚疾病、青少年、門診

Abstract
Cutaneous diseases in adolescents are common in Taiwan and worldwide; however, there is little related data from clinical analysis that has been reported up to now. The purpose of this study was to investigate and to analyze the clinical data of the common cutaneous diseases aimed at the adolescent patients of a dermatologic outpatient department at a medical center in central Taiwan.
A total of 994 adolescent patients with 2,226 total visits, from 11 to 21 years of age, were collected from the Dermatologic Outpatient Department of the Taichung Veteran General Hospital from January to December, 2000.
Results reveal that the most common skin disease in adolescents is acne vulgaris, followed by eczema and infectious skin diseases, in both visit number and in patient number. Stratified by age, the results show that the number of visits for acne vulgaris increased with age, which is related to the hormonal change accompanied with adolescence. The number of visits for atopic dermatitis decreased with age. This showed that this disease is prone to spontaneously decrease as a patient ages. For other disorders, such as seborrheic dermatitis and contact dermatitis, the visit numbers increased with age. This indicates that there is a higher chance to get these diseases in the late stage of adolescence. Among the skin infectious diseases, including viral warts, folliculitis, carbuncle & furuncle, cellulitis and superficial fungal infection and parasite infection, the visit number also increased with age. This finding suggests that due to increased activity and sweating, which favors a microorganism colonization, late-stage adolescents are more prone to get infectious skin diseases.
After analyzing the number of patients in this study and the number of follow-up visits for each type of disease, it can be seen clearly that some skin problems are chronic recurrent diseases, such as acne vulgaris, atopic dermatitis, onychomycosis and psoriasis, and are more difficult to cure. In contrast, infectious skin disease such as bacterial infection can be controlled well.
In conclusion, acne vulgaris, eczema and infectious skin diseases are three major common problems in adolescent at the Dermatologic Outpatient Department. Furthermore this data on frequency distribution at different age and genders provides baseline information on the future works about medical adolescent skin care in Taiwan.
Key words: Cutaneous diseases, adolescence, outpatient department
　　　　　　　　

目　　　錄
誌 謝………………………………………………………………..I
中文摘要……………………………………………………………….II
英文摘要……………………………………………………………….IV
目 錄……………………………………………………………….VI
第 一 章 緒 論……………………………………………………….1
第 一 節 前 言…………………………………………………….1
第 二 節 文獻回顧及研究問題的形成…………………………….2
第 二 章 材料和方法………………………………………………….4
第 一 節 研究對象………………………………………………….4
第 二 節 研究程序………………………………………………….4
第 三 節 資料分析………………………………………………….5
第 三 章 結 果……………………………………………………….7
第 一 節 人數及疾病分佈的概況…………………………………7
第 二 節 痤瘡類皮膚疾病結果分析………………………………8
第 三 節 濕疹類皮膚疾病結果分析………………………………8
第 四 節 感染類皮膚疾病結果分析………………………………8
第 五 節 毛髮皮膚疾病結果分析………………………………..10
第 六 節 乾癬結果分析……………………………………….….11
第 七 節 色素異常結果分析……………………………………11
第 三 章 討　　論………………………………………………..12
　　第 一 節 青少年門診就醫的特性……………………………..12
　　第 二 節 青少年的痤瘡問題…………………………………..13
　　第 三 節 青少年的濕疹問題…………………………………..15
　　第 四 節 青少年皮膚感染問題………………………………..17
　　第 五 節 青少年毛髮疾病問題………………………………..20
　　第 六 節 青少年的色素問題…………………………………..20
　　第 七 節 青少年的乾癬問題…………………………………..21
　　第 八 節 結　論………………………………………………..22
　　第 九 節 本研究之限制………………………………………..23
　　第 十 節 未來展望……………………………………………..23
參 考 文 獻…………………………………………………………..25
附　　　表……………………………………………………………29
　　表　一、九十年一月至十二月就診人次資料…………………29
　　表　二、門診男女疾病就診人數比較…………………………30
　　表　三、門診男女疾病就診人次比較…………………………31
　　表　四、痤瘡門診人次男女及年齡層比較……………………32
　　表　五、溼疹類門診男女人次比較……………………………33
　　表　六、溼疹類門診人次之年齡層比較………………………34
　　表　七、感染性皮膚疾病男女門診人次比較…………………35
　　表　八、感染性皮膚疾病門診人次之年齡層比較……………36
　　表　九、毛髮疾病門診人次男女及年齡層比較……………….37
　　表　十、乾癬門診人次男女及年齡層比較…………………….38
　　表　十一、色素異常門診人次男女及年齡層比較…………….39
附　　　圖…………………………………………………………….40
　　圖　一、青少年就診月份分佈………………………………….40
　　圖　二、濕疹類門診人次年齡層比較………………………….41
　　圖　三、病毒感染類門診人次年齡層比較…………………….42　
圖　四、黴菌感染類門診人次年齡層比較…………………….43
　　圖　五、細菌感染類門診人次年齡層比較………… …………44　
　圖　六、寄生蟲感染類門診人次年齡層比較………………….45

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