石膏样小孢子菌所致面部难辨认癣1例

报道1例由石膏样小孢子菌引起的面部难辨认癣。患者为青年女性,因右眼上眼睑及周围出现浸润性斑块2个月就诊。2个月前发疹部位有烫伤史。经真菌培养和病理检查确诊为“石膏样小孢子菌感染”。予伊曲康唑胶囊口服、外用特比萘芬乳膏1周后痊愈。     

犬小孢子菌致皮肤癣菌病162例回顾分析

目的回顾分析2011—2012年期间上海地区犬小孢子菌致病的临床特征。方法依据真菌学检查确诊162例为犬小孢子菌感染,分析患者资料、病程、动物接触史、家庭成员感染情况、用药史及治疗情况。结果15岁以下的儿童患者（≤15岁）39例,平均年龄6．3岁,男16例,女23例,男女比例为0．70：1,头癣21例（85．7％为白癣）、面癣11例、体癣7例。成人患者（〉15岁）123例,平均年龄36．6岁,男20例,女103例,男女比例为0．19：1,体癣91例、面癣28例、头癣4例。家庭成员同时患病16例（8对）。139例（85．8％）有确切的动物接触史,宠物为可能的传染源（猫、犬等）。结论犬小孢子菌引起的皮肤癣菌病在年龄性别分布和临床类型上具有特殊性：儿童患者性别差异不明显,以头癣为主;而成人患者以体癣为主,21—40岁感染的患者最多见,女性患者明显多于男性,暴露处是最常见的感染部位。经规范治疗,所有患者的犬小孢子菌均清除治愈。对家里的宠物也要同时治疗,以消灭传染源。     

皮肤癣菌体外蛋白水解酶活性测定

目的观察皮肤癣菌的体外蛋白水解酶活性;比较分离自不同感染部位的红色毛癣菌的体外蛋白水解酶活性。方法实验菌株包括来自不同感染部位的红色毛癣菌22株、须癣毛癣菌3株、犬小孢子菌5株,进行体外培养,并利用9-羟基乙酚噻唑标识的酪蛋白和酶标仪检测真菌细胞外蛋白水解酶的活性。结果须癣毛癣菌的体外蛋白水解酶活性高于红色毛癣菌和犬小孢子菌（P〈0.05）,而红色毛癣菌和犬小孢子菌之间无差异（P〉0.05）。红色毛癣菌的细胞外蛋白水解酶活性在分离自浅部感染部位的菌株之间无差异（P〉0.05）,但高于引起毛癣菌肉芽肿的菌株（P〈0.05）。结论不同的皮肤癣菌体外蛋白水解酶活性可能不同;分离自不同感染部位的同一菌种的体外蛋白水解酶活性也有可能不同。     

阴囊黄癣痂样石膏样小孢子菌感染1例

报道1例石膏样小孢子菌感染引起阴囊黄癣痂样皮损。患者,男,20岁,阴囊黄色痂皮3周。皮损取材真菌镜检可见分隔菌丝,培养为石膏样小孢子菌。口服伊曲康唑200mg/d,连续2周。停药时皮损消退,真菌学检查阴性。     

石膏样小孢子菌致脓癣、体癣103例临床分析

石膏样小孢子菌系亲土性皮肤癣菌,因其刺激人体产生的变态反应较强烈,易引起临床误诊误治。为进一步了解石膏样小孢子菌引起的脓癣、体癣的临床症状和鉴别要点。我们对2007年1月～2008年12月来我院皮肤科就诊的由石膏样小孢子菌引起的脓癣、体癣患者103例进行观察和分析,现将结果报告如下。     

15例人畜共患体癣的临床分析

目的通过对生活在同一家庭患有体癣的患者、家庭成员和所养宠物进行观察和分析,探讨人畜共患癣病的常见致病菌种以及治疗方案。方法收集2005年3月～2009年1月就诊于我院因接触宠物而致病的体癣患者,对其宠物的带菌情况进行调查,确诊后给予外用特比萘芬乳膏或联苯苄唑凝胶,未愈者给予口服伊曲康唑治疗。结果共收集15例患者,真菌培养结果显示8例为石膏样小孢子菌,4例为须癣毛癣菌,3例为犬小孢子菌。患者皮损真菌培养结果和所养宠物皮损真菌培养结果一致。按上述方法对患者及其宠物进行治疗,所有患者和10只(3只被丢弃)宠物全部治愈。结论 15例人畜共患体癣中,石膏样小孢子菌感染所致的比例最高,其次是须癣毛癣菌和犬小孢子菌,外用特比萘芬乳膏或联苯苄唑凝胶以及口服伊曲康唑胶囊可以有效治疗此类人畜共患皮肤癣菌病。     

红色毛癣菌菌株的特异性PCR鉴定方法研究

目的建立一种快速的红色毛癣菌分子生物学鉴定方法。方法根据红色毛癣菌保守区域-真菌核糖体DNA（rDNA）的转录间隔区（ITS）设计特异性引物,采用上游：ITS19865＇GAC ACC AAG AAA AAA TTC TCT GAA GA3＇,下游：ITS24415＇GTC CTG AGG GCG CTG AA3＇为引物对45株红色毛癣菌、5株须癣毛癣菌和1株紫色毛癣菌菌株的DNA进行PCR扩增,观察产物电泳带型的差异。结果 45株红色毛癣菌均能扩增出目的片段,5株须癣毛癣菌和1株紫色毛癣菌均无目的片段扩增出。结论红色毛癣菌可用特异引物PCR方法快速鉴定。     

3例不同临床表现的石膏样小孢子菌感染

报道3例由石膏样小孢子菌感染引起的、临床表现不同的皮肤癣病.例1表现为阴囊红色斑片,上覆白色斑点状痂屑,刮去痂屑后见湿润的基底面,患者父亲有同样病变,父子穿用同一件内裤,其父与家猫有密切接触.例2患儿左面部擦伤后局部出现钱币大小红斑,中央为白色痂皮,边缘有渗出伴痒.例3患儿右面部出现钱币大小、边界清楚的红斑,表面有散在的丘疹及少许鳞屑伴痒,偶有家猫接触.3例患者均平素体健.取皮损表面组织直接镜检均发现大量菌丝;真菌培养及鉴定为石膏样小孢子菌.诊断为石膏样小孢子菌所致皮肤感染.3例患者经抗真菌治疗1～2周后痊愈,取得很好疗效.     

红色毛癣菌的研究进展

红色毛癣菌是最常见的也是世界范围内传播是广的一种皮肤癣菌,属毛癣菌属,本文简述了最近几年在该菌的基因鉴定,基因分类,基因结构的分子生物学研究和免疫学研究方面的主要进展,在基因鉴定中发展了红色毛癣菌特异性探针TR20S和毛癣菌属特异性引物TR1、TR2和NS5,NS6;利用测序方法对毛癣菌属进行了重新分类,并且用探针,限制性片段多态性分析等方法对红色毛癣菌进行了种内分型研究。     

家庭内红色毛癣菌病患者间菌株差异性分析

目的用PCR技术比较分离自同一家庭红色毛癣菌病患者的菌株差异性,分析家庭内多发的红色毛癣菌病的致病菌株是家内相互感染,还是家外感染。方法以家庭内多发的皮肤癣菌病患者为研究对象,分离致病菌株并以传统方法鉴定菌种。再分别用随机扩增多态性DNA(RAPD)和巢式PCR特异扩增红色毛癣菌的串联重复亚元件(TRSS:TRS-1/TRS-2)产生的指纹图谱分析种内株间有无差异性。结果纳入实验的16株菌分离自8个家庭,用形态学等方法及种特异引物均鉴定为红色毛癣菌。RAPD显示4个家庭内的菌株间有差异性,TRS-1区PCR指纹图谱显示5个家庭内菌株有株间差异,TRS-2区能鉴定出2个家庭内菌株间有差异。综合各方法共区分出6个家庭内的菌株间有带型差异。结论该研究提示家庭内多发红色毛癣菌病从家外途径感染率高于家内感染。TRS-1区PCR指纹图谱对红色毛癣菌的菌株区分度高于RAPD,更适于红色毛癣菌株间分型。结合多种分子分型方法可最大限度发现不同菌株间的差异。     

Amino acid- or protein-dependent growth of Trichophyton mentagrophytes and Trichophyton rubrum

Culture conditions were examined for Trichophyton mentagrophytes and Trichophyton rubrum, which are major pathogens involved in dermatophytosis. They grew well in Sabouraud's dextrose broth or RPMI 1640. Growth in phosphate-buffered yeast nitrogen base supplemented with glucose was very slow, although growth improved significantly with the addition of amino acids or proteins to the medium. The fungi could also grow using human nail fragments as the only source of nutrition. Examination of proteases by substrate gel electrophoresis indicated that distinct sets of proteases are secreted from the dermatophytes in two different media, Sabouraud's dextrose broth and nail fragments. A protease inhibitor, phenylmethanesulfonyl fluoride, inhibited the growth of the fungi on nail fragments, but it did not inhibit their growth in Sabouraud's dextrose broth.     

126例面癣临床因素及病原菌分析

目的探讨面癣的致病菌种、临床特点及发病相关因素。方法对126例面癣患者进行真菌分离培养鉴定及流行病学分析。结果面癣见于各年龄段,以11～30岁最多见。患病动物接触史、合并其他部位浅部真菌病史及糖皮质类固醇激素类药物外用史是面癣发病的重要危险因素。分离出皮肤癣菌108株,包括红色毛癣菌63株（58．3％）、犬小孢子菌25株（23．1％）、须癣毛癣菌18株（16．7％）和石膏样小孢子菌2株（1．9％）。结论面癣的发病没有年龄差异,患者可见于各个年龄阶段;面癣的常见致病真菌绝大多数为红色毛癣菌和犬小孢子菌,其发病可能与患者自体接种或接触患病动物相关。面癣容易被误诊,及时进行真菌镜检和培养是降低面癣误诊率的关键。     

Dermatophyte and non dermatophyte fungi in Riyadh City,Saudi Arabia

BackgroundDermatophytes are a scientific label for a group of three genera (Microsporum, Epidermophyton and Trichophyton) of fungus that causes skin disease in animals and humans. Conventional methods for identification of these fungi are rapid and simple but are not accurate comparing to molecular methods.ObjectiveThis study aimed to isolate human pathogenic dermatophytes which cause dermatophytosis in Riyadh City, Saudi Arabia and to identify these fungi by using conventional and molecular methods.MethodsThe study was conducted in Medical Complex, Riyadh and King Saud University. Samples of infected skin, hairs and nails were collected from 112 patients. Diagnosis of skin infections, direct microscopic test, isolation and identification of dermatophytes by conventional and molecular methods were carried out.ResultsThe results indicated that the tinea capitis infection had the highest prevalence among the patients (22.3%) while Tinea barbae had the lowest. In this study the identified dermatophyte isolates belong to nine species as Trichophyton violaceum, Trichophyton verrucosum, Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton schoenleinii, Trichophyton concentricum, Microsporum canis, Microsporum audouinii and Epidermophyton floccosum which cause skin infections were isolated during this study. Non dermatophyte isolates included 5 isolates from Aspergillus spp. 4 isolates from Acremonium potronii and 15 isolates from Candida spp. M. canis were the most common species (25% of isolated dermatophytes). Out of the 52 dermatophyte isolates identified by conventional methods, there were 45 isolates identified by the molecular method.ConclusionsThe results concluded that approximately M. canis caused a quarter of dermatophyte cases, tinea capitis infection was prevalent and the molecular method was more accurate than conventional methods.     

宠物猫致夫妻共患犬小孢子菌体癣

报道由犬小孢子菌引起的人畜共患体癣2例,二者系夫妻,家中饲养宠物猫。因多发环状红斑2周就诊。取患者及猫的皮屑真菌镜检及培养,鉴定为须癣毛癣菌,经口服及外用抗真菌药物后治愈。     

面部糖皮质激素依赖性皮炎伴难辨认癣1例

报道面部糖皮质激素依赖性皮炎伴难辨认癣1例.患者男,40岁,面部弥漫红斑、脱屑、丘疹,伴瘙痒、灼热症状,反复发作7a.曾在外院被诊断为脂溢性皮炎、湿疹、接触性皮炎,给予多种糖皮质激素药膏外用.取面部皮屑做真菌直接镜检为阳性,经鉴定为红色毛癣菌.诊断为面部激素依赖性皮炎、难辨认癣.给予伊曲康唑100 mg/次,2次/d,口服;第1周给予曲安奈德益康唑乳膏2次/d外用;第2周给予舍他康唑2次/d外用.2周后患者皮损明显好转,停用口服药物,给予他克莫司1次/d外用.4周后,患者皮损达临床治愈.     

我国大陆近年儿童头癣流行情况的回顾分析

目的 了解我国近年来头癣的流行情况.方法 采用回顾性方法 分析对2000年1月～2010年11月发表的中文或英文有关我国头癣报道的文章进行汇总分析.结果 共汇总文章50余篇,分析病例23 258例,其中男12 745例,女10513例,男女比例1.21:1.按照临床分型,有临床类型资料的有7 684例,其中白癣5 506例,占71.16%,居首位.除新疆南部外,犬小孢子菌仍是头癣的主要致病菌(67.99%),其次为紫色毛癣菌(8.51%)和须癣毛癣菌(8.14%).新疆南部以紫色毛癣菌为主(49.19%),其次为许兰毛癣菌和铁锈色小孢子菌(33.90%和12.60%).结论 我国头癣病原菌变迁缓慢,犬小孢子菌仍是我国主要致病菌,但是亲人性的紫色毛癣菌在东部比例较高,需进行长期监测.     

Cytobrush-culture method to diagnose tinea capitis

This is a comparative study to isolate the dermatophytes of tinea capitis using the cytobrush and comparing it versus the standard method. A prospective, observational, comparative trial of 178 probable cases of tinea capitis was conducted in two dermatological centers. Each patient underwent mycological tests that included direct exam with KOH and cultures with either of two methods: scraping the scalp to remove hair and cell debris, and the cytobrush. A total of 135 clinically and mycologically proven cases of tinea capitis were included; 119 were non-inflammatory and 16 inflammatory tinea. A total of 131 had a positive direct exam and subsequent primary isolation cultures were obtained in 135 cases. The main dermatophytes isolated were Microsporum canis (68%) and Trichophyton tonsurans (20%). A total of 115/135 (85.1%), were detected with the traditional method, with an average of 11.2 days until positive, while the number detected with the cytobrush was 132/135 (97.7%) with an average of 8.5 days until positive. The chi-square statistical method showed that the cytobrush culture was superior to the standard one with a chi-square of 5.078 (P = 0.025), with a statistically significant difference versus the standard method.     

1株致体股癣的颗粒型红色毛癣菌变种的形态学观察与基因鉴定

目的：探讨1株致体股癣的颗粒型红色毛癣菌变种的形态学特点及核糖体基因序列变化。方法1例体股癣患者皮损中分离出1株红色毛癣菌,观察形态学特点,并用PCR测定核糖体转录间区（ITS）、D1/D2区、非转录区基因序列（NTS区）内串联重复亚单位（TRS）。结果该菌株可产生鹿角形菌丝,大分生孢子有中空现象及单侧出芽产孢特征,可在42℃生长;ITS和D1/D2区基因测序鉴定为红色毛癣菌,但TRS-1和TRS-2基因序列分别有2个、1个碱基差异。结论该菌株可能是颗粒型红色毛癣菌的1个变种。     

First Case of Microsporum ferrugineum from Iran

This is a first case of Microsporum ferrugineum from Iranian patient. A 42 year old man was examined for tinea faciei infection. Direct KOH preparations from skin scrapping revealed hyaline septate branching mycelium. Cultures of skin scrapings yielded M. ferrugineum after three weeks. Isolate was identified based on colony morphology on Sabouraud’s dextrose agar medium (S), microscopic morphology of slide culture, and biochemical reactions.     

260例浅部真菌病及致病菌种分析

目的了解新疆乌鲁木齐市浅部真菌病发病情况及其病原菌的菌种分布。方法对2004年2月至2010年08月在新疆医科大学第一附属医院皮肤科门诊就诊,临床拟诊为头癣、甲癣、体股癣、手足癣的1 308例患者取病发、皮屑、甲屑行真菌镜检、培养。培养阳性标本在形态学鉴定的基础上行核糖体DNA(rDNA)ITS区序列测定确切鉴定菌种。使用SPSS 17.0统计软件对于结果进行统计分析。结果真菌镜检培养均为阳性患者260例,头癣培养阳性率最高,占33.1%,其次为体股癣占28.8%、甲癣占21.5%、手足癣占16.5%;菌种鉴定:红色毛癣菌为最常见的致病菌(28.5%),其次为须癣毛癣菌(22.3%)、犬小孢子菌(18.8%)、断发毛癣菌(10.0%)。犬小孢子菌为头癣最主要致病菌(16.2%)。统计学分析显示:不同性别、族别间体股癣、手足癣发病率有统计学意义(P<0.05),均好发于男性,汉族发病率高于维吾尔族。不同年龄头癣、甲癣、体股癣、手足癣发病率差异也均有统计学意义(P<0.05),甲癣、体股癣、手足癣好发于中青年,头癣好发于儿童。结论乌鲁木齐市浅部真菌病主要致病真菌是红色毛癣菌。头癣是本地区最主要的儿童浅部真菌病,主要病原菌为犬小孢子菌。