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。     

迁延性黑点癣1例

目的报道病程30余年、由紫色毛癣菌感染所致成人黑点癣1例。方法对头发及鳞屑标本进行多次真菌直接镜检和培养,对病原菌进行形态学鉴定和药物敏感性试验。结果鉴定为紫色毛癣菌。体外药敏试验该菌对特比萘芬、伊曲康唑敏感。结论本病例证实为紫色毛癣菌感染导致黑点癣,患者经口服伊曲康唑和局部治疗痊愈。     

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。     

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。     

更正声明

本刊2020年10月出版的第15卷第5期刊登的“湖北省及周边地区625例头癣病原菌分析”一文中存在错误,表1中须癣毛癣菌引起两例黄癣,实际为须癣毛癣菌引起的脓癣。经作者仔细核查原始资料发现这两例须癣毛癣菌所致的儿童“黄癣”,临床表现有似黄癣痂样改变,经菌种鉴定为须癣毛癣菌,结合患者有与兔接触史,应诊断为脓癣。黄癣由许兰毛癣菌引起,此两例患者应归入脓癣中。表中脓癣列“12(16.00),4(5.33),39(52.00),4(5.33),13(17.33),3(4.00),0,0,75(14.79)”更正为“12(15.58),4(5.19),41(53.25),4(5.19),13(16.88),3(3.90),0,0,77(15.19)”;黄癣列“1(33.33),3(0.59)”更正为“1(100),1(0.20)”;χ^2值列“93.258”更正为“177.61”。特此更正。     

密切接触宠物兔后幼儿鼻孔周围体癣1例

报道1例密切接触宠物兔后发生在幼儿双侧鼻孔周围及上唇部的体癣。患儿4岁,因“鼻唇部红斑、鳞屑、伴瘙痒10余日”就诊。取皮屑镜检见真菌菌丝及毳毛内孢子,培养见棒形分隔大分生孢子、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。经内服伊曲康唑胶囊和外用萘替芬酮康唑乳膏治疗6d后红斑瘙痒明显减轻,34d后皮损消退。复查真菌阴性。     

须癣合并面颈部体癣1例

患者男,57岁。面部红斑、丘疹、唇部脓疱灼痛2个月余。曾口服和外用多种中药治疗无效且呈加重趋势。取皮屑、胡须镜检见大量真菌菌丝,培养见棒状分隔大分生孢子、葡萄串状小分生孢子。尿素酶实验阳性、毛发穿孔实验阳性,鉴定为须癣毛癣菌。经内服伊曲康唑胶囊和外用盐酸布替萘芬乳膏治疗10 d后病情好转,2个月后皮损消退。复查真菌阴性。     

难辨认癣1例

36岁女性患者,右小腿丘疹红斑、脓疱、渗液伴瘙痒5个月。查体见:右小腿可见大小不等的丘疹红斑,伴有糜烂渗液。真菌荧光镜检:阳性,真菌培养:须癣毛癣菌,诊断:难辨认癣。口服伊曲康唑分散片0.1 g,2次/日,外用酮康唑乳膏2次/日,治疗2周后,皮损明显好转,治疗1个月后,右小腿皮肤基本恢复正常,目前随访中。     

母女共患须癣毛癣菌感染3例CSCD

病例1,女,9岁,头皮红斑、丘疹、脱屑,伴脓肿1个月,切开引流术后1 d;病例2,女,9岁,鼻背红斑2周伴脓疱3 d。病例3,女,38岁,面部红斑、脱屑,伴瘙痒1周。病例1、2为孪生姐妹,病例3为病例1、2的母亲。3例患者皮损经真菌镜检、培养及分子生物学测序均鉴定为须癣毛癣菌。病例1密切接触过流浪猫。病例1诊断为脓癣,经口服甲泼尼龙(美卓乐)片,口服伊曲康唑胶囊,外用酮康唑洗剂后病情明显好转。病例2、3诊断为面癣,外用卢立康唑4周后痊愈,未留瘢痕。以上病例目前仍在随访中。     

不典型泛发性体癣误诊银屑病1例

报道1例由犬小孢子菌感染引起的泛发性体癣。患者,女,44岁,以面、颈、胸、腹部及四肢散在、形态为指甲至钱币大小的不规则红斑。曾被误诊为银屑病,治疗1个月后,皮损增多。再次就诊,真菌学检查阳性,真菌培养为犬小孢子菌。经口服伊曲康唑,外涂兰美抒软膏后治愈。     

Antifungal effects of herbal essential oils alone and in combination with ketoconazole against Trichophyton spp

AIMS: To determine the effects of herbal essential oils on Trichophyton spp. growth and to evaluate the effects of Pelargonium graveolens oil and its main components citronellol and geraniol combined with ketoconazole against Trichophyton spp. METHODS AND RESULTS: Growth inhibition of six Trichophyton spp. by herbal essential oils was accessed and the combined effects of P. graveolens oil and its main components citronellol and geraniol were evaluated using a checkerboard microtitre assay against T. schoenleinii, T. erinacei and T. soudanense. The essential oil fraction of P. graveolens and its main components, geraniol and citronellol, exhibited strong synergism with ketoconazole against T. schoenleinii and T. soudanense, with fractional inhibitory concentration (FIC) indices in the range of 0.18-0.38. CONCLUSIONS: The antifungal effects of ketoconazole against Trichophyton spp. are enhanced significantly by administering it in combination with the essential oil fraction of P. graveolens or its main components, because of strong synergism, especially against T. soudanense and T. schoenleinii. SIGNIFICANCE AND IMPACT OF THE STUDY: The combination of ketoconazole and the essential oil fraction from P. graveolens or its main components for treatment of infections caused by Trichophyton species may reduce the minimum effective dose of ketoconazole, and thus minimize the side-effects of ketoconazole.     

Immunological Studies on Dermatophytes III. Further Analyses of the Reactivities of Neutral Polysaccharides with Rabbit Antisera to Microsporum quinckeanum, Trichophyton schoenleinii, Trichophyton rubrum, Trichophyton interdigitale, and Trichophyton granulosum

The serological reactivities of polysaccharides isolated from five species of dermatophytes, Microsporum quinckeanum, Trichophyton granulosum, T. interdigitale, T. rubrum, and T. schoenleinii, with rabbit antisera to these species were studied qualitatively by precipitation in gel and quantitatively by complement-fixation analyses. Significant differences in the serological reactivities of the galactomannans I were detected with antisera to T. schoenleinii and T. interdigitale. The differences appeared to be related to the specificity of these antisera for the galactofuranose residues in the polysaccharides. Antisera to M. quinckeanum, T. granulosum, or T. rubrum did not detect differences between the galactomannans I. The serological reactivities of the galactomannans II were different with each of the five antisera. The reactivities of the glucans could be correlated with the amount of alpha 1 --> 6 linked glucopyranose residues when antisera to T. schoenleinii and M. quinckeanum were used.     

Tinea Corporis Bullosa Due to Trichophyton schoenleinii: Case Report

We report the first case of tinea corporis bullosa due to Trichophyton schoenleinii in a 41-year-old Romanian woman, without any involvement of the scalp and hair. The species identification was performed using macroscopic and microscopic features of the dermatophyte and its physiological abilities. Epidemiological aspects of the case are also discussed. The general treatment with terbinafine and topical applications of ciclopiroxolamine cream have led to complete healing, with the lesions disappearing in 2?weeks.     

Extracellular Collagenase from Trichophyton schoenleinii

The dermatophyte Trichophyton schoenleinii elaborates an extracellular collagenase which is specific for native collagen and gelatin and is separable from an enzyme which is active against Azocoll. The fungal enzyme differs from the bacterial collagenases in its acid pH and small molecular weight. In addition, the fungal enzyme is irreversibly inhibited by ethylenediaminetetraacetic acid, whereas the bacterial enzymes can be restored by divalent cations, such as Mg(++) and Ca(++).     

A study of Tinea capitis in Libya (Benghazi)

Tinea capitis formed 20% of all superficial mycotic infections, which in turn represented 12% of all skin disease diagnosed at the skin outpatient department of Al-Jamaheria hospital in Benghazi. The majority (94%) of tinea capitis occurred in children. A sample of 200 cases cultured revealed Trichophyton schoenleinii to be the most prevalent species of dermatophyte (69.5%) followed by Microsporum audouinii. (23.8%).     

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。     

表现为脂溢性皮炎样的儿童头癣1例

报道临床表现类似脂溢性皮炎的头癣1例。患儿5岁,因头皮丘疹半年、鳞屑增多并脱落半个月就诊。刮取皮屑、病发直接镜检查见菌丝和发内孢子,对鳞屑、病发培养有紫色菌落生长,转种作小培养后光镜下观察见菌丝粗细不一,分隔、分支多,并有不规则突起,间生厚壁孢子多见,鉴定为紫色毛癣菌。经内服和外用特比萘芬治疗3周后痊愈。     

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。