摘要
患者男,47岁,右大腿红色丘疹7年,外用药后皮疹扩大伴糜烂1月余。皮肤科情况:右大腿一处局限性红肿,直径约7 cm,中央有4 cm糜烂面,上有点状脓痂和颗粒样肉芽组织增生。皮损组织病理示:表皮呈假上皮瘤样增生,真皮内慢性肉芽肿,见多数圆形、厚壁、棕色硬壳小体; PAS染色见到棕红色有分隔的硬壳小体;抗酸染色见到硬壳小体的细胞壁呈黑色。皮损组织土豆真菌培养基:灰黑色菌落生长缓慢,表面呈绒毛状,玻片法小培养见枝孢型和喙枝孢型产孢。菌落聚合酶链反应(PCR)扩增及测序鉴定为Fonsecaea monophora。诊断为Fonsecaea monophora所致着色芽生菌病。外用苯扎氯铵溶液治疗后出现瘢痕和脓肿。
A 47-year-old male had been presented with a red papula on the right thigh for seven years and the lesions were enlarged with erosion for more than one month after external application of drugs.Physical examination showed that localized flare on the right thigh was approximately seven cm in diameters and the erosion in the center of flare was approximately four cm in diameters with punctiform pus scabs and granulation hyperplasia.Histopathological examination revealed pseudoepitheliomatous hyperplasia and chronic granulomatous changes in the dermis with a number of brown and roundish thick-walled sclerotic bodies.PAS staining revealed brown septatus spores in the lesional tissue.The acid-fast staining showed black cell walls of sclerotic bodies.Fungal culture of rash tissue showed that gray-black colonies grew slowly with villous surface,and rhinocladiella type and cladosporium type conidia were observed in the slide culture.Fonsecaea monophora was identified by PCR amplification and sequencing.Diagnosis of chromoblastomycosis caused by Fonsecaea monophora was made.Scars and abscesses appeared after the external application of benzalkonium chloride solution.
作者
吴玮
王洁娣
黎炜
黎世杰
李定
陈嵘祎
史建强
WU Wei;WANG Jiedi;LI Wei;LI Shijie;LI Ding;CHEN Rongyi;SHI Jianqiang(The Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2019年第2期184-187,共4页
The Chinese Journal of Dermatovenereology
基金
广东医科大学附属医院博士科研启动经费(BK201604)
