须癣毛癣菌致儿童脓癣1例

报道由须癣毛癣菌引起的儿童头部脓癣1例.患儿为4岁幼女,因头皮部丘疹1个月,脓肿4d就诊.内服青霉素V钾无效.取断发镜检查见发外真菌孢子,培养鉴定为须癣毛癣菌,细菌培养为棒状杆菌.经内服和外用特比萘芬抗真菌,静脉输入头孢噻肟钠联合克林霉素及万古霉素抗细菌治疗,12d后脓肿减轻,细菌培养阴转,但真菌培养仍阳性,继续抗真菌治疗2个月后皮损消退,真菌检查阴性.     

须癣毛癣菌致成人眉区脓癣1例

报告1例由须癣毛癣菌引起的眉毛区域脓癣。患者女性,46岁,左眉部周围红斑1个月。致病菌株经真菌学鉴定为须癣毛癣菌。给予盐酸特比萘芬250mg/d口服,硝酸舍他康唑软膏外用,治疗1个月后皮损完全愈合。     

幼儿脓癣1例

患儿,女,3岁,因“头部、右颞部、右耳后红斑、丘疹”就诊,曾被诊为“特应性皮炎”,予糠酸莫米松乳膏外擦后皮疹加重,出现发热,完善真菌镜检、培养鉴定及皮肤镜,诊断“脓癣”,经抗感染、抗真菌等治疗后出现病情好转出院。于我科就诊时复查真菌镜检阴性,局部遗留瘢痕性脱发。     

致脓癣的须癣毛癣菌鉴定及体外药敏试验

须癣毛癣菌是皮肤癣菌病中常见的致病真菌之一,其分型复杂,具有多个变种和有性型,引起脓癣的常为亲动物性分离菌。从形态学角度难以明确区分不同种型,需要从分子生物学角度加以鉴定。rDNA序列测定是目前最常用于真菌鉴定的一种方法。我们从一脓癣患儿头部分离出一株须癣毛癣菌,对其形态学、rDNA序列和体外对抗真菌药物的敏感性进行了研究。     

须癣毛癣菌所致脓癣病发的扫描和透射电镜观察及菌体外酶活性分析：2例报告

目的报道2例由须癣毛癣菌引起的脓癣,并对病发做扫描和透射电镜观察及菌体外分泌酶活性测定。方法例1为6岁女孩,表现为头顶部炎性肿块、脓血伴脱发;例2为1岁8个月男孩,表现为头部红斑,无脓肿及脱发。家中分别饲养宠物狗和兔。病发真菌镜检均阳性后做真菌培养、生化鉴定及分子生物学鉴定。对2例患儿病发用扫描和透射电镜进行超微结构观察。对2株分离的菌株分别进行细胞外分泌酶测定。结果2株菌均鉴定为万博节皮菌（须癣毛癣菌的有性期）。扫描电镜见例1的病发受累毛干表面大量炎性组织碎屑、红细胞、脓细胞及上皮细胞;透射电镜在毛皮质内发现菌体。扫描电镜见例2的受累毛干表面真菌孢子及炎性渗出物;透射电镜见毛发内外菌体。2株菌的外分泌酶主要为碱性磷酸酶、白氨酸芳胺酶、β-葡萄糖甙酶、N-乙酰-葡萄糖胺酶、α-甘露糖甙酶。经口服伊曲康唑胶囊等综合治疗后2例均痊愈,未见不良反应。结论确诊2例须癣毛癣菌所致脓癣,伊曲康唑胶囊等药物联合治疗有效。     

误诊为头皮脓肿经抗生素及植皮治疗无效的脓癣——附2例报告

目的 报道2例误诊为头皮脓肿经长期抗生素及植皮治疗失败的须癣毛癣菌所致的脓癣病患者,分析脓肿和脓癣的鉴别要点。方法 例1为9岁男童,头皮外伤后脓肿、溃疡28d,经抗生素治疗无效,行植皮术后5d再发生脓肿溃疡。取皮损处断发行10％KOH涂片镜检、培养,发现并分离出致病真菌,沙堡弱琼脂培养基上呈白色粉状菌落,可使含尿素培养基变红,即尿素酶试验阳性,小培养见螺旋菌丝及分隔棒状大分生孢子,鉴定为须癣毛癣菌。例2为8岁女童,头顶脓肿、溃疡24d,抗感染治疗不愈而接受植皮,术后7d再发脓性丘疹。从皮损处标本中发现、分离出致病真菌,经上述方法鉴定为须癣毛癣菌。结果 2例患者结合真菌学检查和临床表现确诊为脓癣,予伊曲康唑100mg／d内服近2个月皮损均痊愈,但供皮区遗留瘢痕和色素改变。结论 真菌病原学检查是避免脓癣误诊的关键,伊曲康唑内服治疗脓癣有效、安全。     

20例儿童脓癣临床特征分析

目的 探讨分析儿童脓癣的临床特征,以提高临床医师对儿童脓癣的认识。方法 回顾性分析2017—2022年我院确诊的20例儿童脓癣患儿的临床资料、治疗和预后。结果 20例脓癣中,单发脓肿型17例,多发毛囊炎型3例。19例饲养过猫、犬或兔子,1例有足癣接触史。经口服盐酸特比萘芬片联合口服糖皮质激素和抗生素再辅以外用药物治疗,所有患儿在6～12周内临床治愈。1例有胃部不适,余未见不良反应。3例伴有癣菌疹。结论 儿童脓癣临床表现有时不典型,容易误诊。真菌荧光染色直接镜检阳性率高。脓癣培养的病原真菌以犬小孢子菌最常见,其次为须癣毛癣菌。盐酸特比萘芬片治疗脓癣预后较好,安全有效。     

红色毛癣菌致儿童脓癣1例

报道儿童脓癣1例。患儿男,5岁,头部左后侧圆形脓肿破溃结痂伴瘙痒疼痛半个月余。取断发及脓液直接镜检及真菌培养均阳性,做小培养确定菌种为红色毛癣菌,经综合治疗后痊愈。     

脓癣伴急性丹毒样癣菌疹1例

报道1例由脓癣引起的急性丹毒样癣菌疹。患者女,68岁,因头皮多发性脓肿伴四肢肿痛入院。头发及脓痂真菌直接镜检阳性,真菌培养为犬小孢子菌。经口服伊曲康唑等药物治疗皮疹基本消退。     

须癣毛癣菌肉芽肿1例

1 临床资料 患者男,31岁,因右小腿皮损伴痒痛2年 ,于1997年6月23日就诊。2年前患者无明显诱因于右小腿屈侧出现一处铜钱大小环形红斑,外用中药治疗无效。皮损逐渐向外扩大,伴剧烈瘙痒。之后皮损表面出现硬结,破溃及化脓,有时疼痛。患者既往病史不详,查体：一般情况可,浅表淋巴结未触及肿大,皮肤科检查：右小腿外侧,屈侧可见隆起的环形红斑,边界清楚,表面有丘疹,脓疱及脱屑。     

Effective photodynamic treatment of Trichophyton species with Rose Bengal

Photodynamic therapy (PDT) with Rose Bengal has previously achieved eradication of Trichophyton rubrum infections causing toenail onychomycosis; however, its antifungal activity against other clinically relevant dermatophytes has yet to be studied. Here, we test the efficacy of PDT using Rose Bengal (140 μM) and 532 nm irradiation (101 J/cm²) against Trichophyton mentagrophytes and Trichophyton interdigitale spores, in comparison to T. rubrum. A significant reduction (>99%) of T. mentagrophytes and T. interdigitale was observed, while actual eradication of viable T. rubrum was achieved (99.99%). Laser irradiation alone inhibited growth of T. rubrum (55.2%) and T. mentagrophytes (45.2%) significantly more than T. interdigitale (25.5%) (P = .0086), which may indicate an increased presence of fungal pigments, xanthomegnin and melanin. The findings suggest that Rose Bengal-PDT can act against a broader spectrum of fungal pathogens, and with continued development may be employed in a wider range of clinical antifungal applications.     

In vitro evaluation of photodynamic activity of methylene blue against Trichophyton verrucosum azole-susceptible and -resistant strains

The intense search for the “Holy Grail” of antifungal therapy can be observed today. The searches are not limited only to discovery of potential antifungal drugs, but also new therapeutic strategies involving the use of chemosensitizers to achieve synergistic effect or physicochemical factors inducing stress conditions in fungal cells. In this study was examined in vitro effectiveness of photodynamic antifungal strategy with methylene blue using a light beam with a wavelength equal to 635 nm toward the Trichophyton verrucosum susceptible and itraconazole- and/or fluconazole-resistant strains. Methylene blue used at concentration equal to 5 μg/mL and in the presence of 40 J/cm² of light energy showed fungicidal effect toward the susceptible strains. However, for azole-resistant isolates, only the energy dose equal to 60 J/cm² at 5 μg/mL of methylene blue allowed to kill the pathogen. This study confirms that methylene blue induced by red light has a definite inhibitory effect on zoophilic dermatophytes.     

Two combined photosensitizers: a goal for more effective photodynamic therapy of cancer

Photodynamic therapy (PDT) is a clinically approved therapeutic modality for the treatment of diseases characterized by uncontrolled cell proliferation, mainly cancer. It involves the selective uptake of a photosensitizer (PS) by neoplastic tissue, which is able to produce reactive oxygen species upon irradiation with light, leading to tumor regression. Here a synergistic cell photoinactivation is reported based on the simultaneous administration of two PSs, zinc(II)-phthalocyanine (ZnPc) and the cationic porphyrin meso-tetrakis(4-N-methylpyridyl)porphine (TMPyP) in three cell lines (HeLa, HaCaT and MCF-7), using very low doses of PDT. We detected changes from predominant apoptosis (without cell detachment) to predominant necrosis, depending on the light dose used (2.4 and 3.6 J/cm², respectively). Analysis of changes in cytoskeleton components (microtubules and F-actin), FAK protein, as well as time-lapse video microscopy evidenced that HeLa cells were induced to undergo apoptosis, without losing adhesion to the substrate. Moreover, 24 h after intravenous injection into tumor-bearing mice, ZnPc and TMPyP were preferentially accumulated in the tumor area. PDT with combined treatment produced significant retardation of tumor growth. We believe that this combined and highly efficient strategy (two PSs) may provide synergistic curative rates regarding conventional photodynamic treatments (with one PS alone).     

误诊2年的左上臂难辨认体癣1例

报道1例由须癣毛癣菌引起的难辨认体癣。患者女,45岁,左臂伸侧多处红斑、丘疹伴脱屑、瘙痒2a余。曾多次就医诊断不明,患处皮损取活检做病理检查倾向于＂银屑病＂但疗效不佳。刮取皮屑镜检见真菌菌丝,小培养见葡萄串状小分生孢子及螺旋菌丝,尿素酶试验阳性,毛发穿孔试验阳性,鉴定为须癣毛癣菌。经内服特比萘芬和外用萘替芬酮康唑乳膏治疗28d后皮损消退,复查真菌阴性。