中华皮肤科杂志 ›› 2011, Vol. 44 ›› Issue (8): 564-566.

• 论著 • 上一篇    下一篇

疣状瓶霉引起皮肤暗色丝孢霉病一例

胡素泉1,李筱芳2,吕桂霞2,沈永年2,陈浩2,张晓利3,刘维达2   

  1. 1. 中国医学科学院北京协和医学院皮肤病研究所
    2. 南京 中国医学科学院北京协和医学院皮肤病研究所
    3. 暨南大学临床医学博士后流动站
  • 收稿日期:2011-01-12 修回日期:2011-03-16 出版日期:2011-08-15 发布日期:2011-07-26
  • 通讯作者: 刘维达 E-mail:liumyco@hotmail.com

Cutaneous phaeohyphomycosis caused by Phialophora verrucosa

2, 2, 2, 2,   

  • Received:2011-01-12 Revised:2011-03-16 Online:2011-08-15 Published:2011-07-26

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摘要：

患者男，19岁，耳后、面部红斑、结节6年。取皮屑10％ KOH镜检，见有棕黄色分隔菌丝；沙堡弱培养基（SDA）培养出局限性、绒状、黑色菌落；马铃薯葡萄糖琼脂培养基（PDA）小培养，瓶梗生于菌丝顶端或侧生于菌丝上，领口结构清晰，顶端喇叭状，瓶孢子半内生呈圆形或椭圆形，由黏液包裹聚集于瓶梗顶端如花朵状。体外药敏实验对伊曲康唑、特比萘芬和两性霉素B敏感，对氟康唑耐药。皮损组织病理检查，PAS染色及银染色均见真皮内棕色菌丝和芽生酵母孢子。分子生物学检查与疣状瓶霉的ITS1-ITS4片段序列比对，结果98%符合。诊断：疣状瓶霉所致的皮肤暗色丝孢霉病。治疗：口服伊曲康唑胶囊400 mg/d有效。

关键词: 伊曲康唑

Abstract:

A 19-year-old man was admitted to the hospital for erythema and nodules on the face and postauricular region for 6 years. Microscopic examination of lesion scrapings revealed brown septate hyphae. A restricted, velvety and black colony grew on Sabouraud′s dextrose agar. Slide culture on potato dextrose agar plate showed flask-shaped phialides at the apex of or around the hyphae with clear collarettes and flaring apex, mucilage-encapsuled, round to oval, semi-endogenous phialosporae accumulating at the apex of the phialides, giving a flower-like appearance. Anti-fungal susceptibility test showed that the fungus was sensitive to itraconazole, terbinafine and amphotericin B, but resistant to fluconazole. Sequence analysis of the ITS1-ITS4 region revealed a 98% consistency with the reference sequence of ITS1-ITS4 of Phialophora verrucosa. On the basis of above findings, the patient was diagnosed with cutaneous phaeohyphomycosis. Clinical improvement was seen after treatment with oral itraconazole （400 mg/d）.

Key words: itraconazole