摘要
50岁女性患者,左面部红色斑丘疹1年。皮肤科情况:左面部可见一4cm×2 cm大小暗红色形状不规则的斑丘疹,表面可见疣状增生及黄白色或黑色痴屑,红斑周围散发粟粒至黄豆大小红色丘疹。皮损组织病理检查表皮角化过度,真皮内大量淋巴细胞、浆细胞和少量巨噬细胞浸润,见疑似真菌菌丝及硬壳小体。痴下分泌物湿片直接镜检可见疑似棕色硬壳小体。组织标本经真菌培养见黑色菌落生长,ITS测序鉴定为卡氏枝孢瓶霉。诊断:卡氏枝孢瓶霉着色性真菌病。治疗:盐酸特比萘芬0.25g每日1次口服,盐酸特比萘芬乳膏和莫匹罗星软膏1:1混合外用,联合中药软坚散结、凉血、消斑方剂。治疗2周后皮损变薄,红斑消退,皮屑消失,治疗3个月后停药;4个月后红斑基本消退,18个月后皮损痊愈。
A 50-year-old female patient develope a red papule on her left face without obvious inducement 1 year ago,with slight pain and itching.Dermatological conditions:dark red maculopapular rashes on the left face,irregular in shape,with a long diameter of about 4cm and a short diameter of about 2cm.The surface was verrucous hyperplasia with yellow white and black crusts and dry desquamation.Histopathology showed hyperkeratosis of the epidermis,infiltration of a large number of lymphocytes and plasma cells,a small number of macrophages in the dermis,suspected fungal hyphae and thick-walled sclerotic bodies.Direct microscopic examination of wet skin secretions showed suspected brown sclerotic bodies.Black colonies were found in the tissue samples after fungal culture,and the strains were identified as Cladophialophora carrioni by ITS sequencing.Treatment:terbinafine hydrochloride tablets 0.25g,qd.Terbinafine hydrochloride cream and bagubon ointment 1:1 mix for external use,combined with softening hardness,blood-cooling,resolve masses prescription of traditional Chinese medicine.After 2 weeks of treatment,the skin rash became thinner,erythema continuted to subside over tine and dandruff disappeared.After 3 months of treatment,the patient stopped taking the medicine.The erythema had basically subsided after 4 months,and the skin color returned to normal after 18 months.
作者
刘志远
刘志军
方园
袁宏伟
陈秀荣
王毓新
许淑珍
寇景福
LIU Zhi-yuan;LIU Zhi-jun;FANG Yuan(Guanganmen Hospital,China Academy of Chinese Medical Science,Beijing 100053,China)
出处
《实用皮肤病学杂志》
2022年第5期316-318,共3页
Journal of Practical Dermatology
关键词
着色芽生菌病
卡氏枝孢瓶霉
Chromoblastomycosis
Cladophialophora carrionii
