本文選題：Majocchi肉芽腫 + 紅色毛癬菌�。� 參考：《臨床皮膚科雜志》2014年01期

【摘要】：目的:報(bào)告1例紅色毛癬菌引起的皮下膿腫型Majocchi肉芽腫,并對國內(nèi)報(bào)道的類似病例進(jìn)行文獻(xiàn)回顧。方法:對患者的臨床資料、真菌學(xué)檢查、分子生物學(xué)鑒定、組織病理及療效進(jìn)行分析,并對1998—2012年國內(nèi)報(bào)道的16例紅色毛癬菌肉芽腫進(jìn)行分析比較。結(jié)果:患者為女性,23歲�；加刑匕l(fā)性血小板減少性紫癜,長期應(yīng)用糖皮質(zhì)激素,左小腿出現(xiàn)結(jié)節(jié)、膿腫及潰瘍4個(gè)月。潰瘍表面分泌物真菌鏡檢菌絲陽性,真菌培養(yǎng)及分子生物學(xué)鑒定為紅色毛癬菌。皮損組織病理可見真皮深層及皮下組織大片壞死,有較多中性粒細(xì)胞和少量多核巨噬細(xì)胞浸潤,PAS染色可見菌絲。診斷為:紅色毛癬菌皮下膿腫型Majocchi肉芽腫。伊曲康唑治療3個(gè)月皮疹消退留有瘢痕,隨訪3個(gè)月無復(fù)發(fā)。文獻(xiàn)回顧發(fā)現(xiàn),紅色毛癬菌肉芽腫病程長,大部分患者免疫功能正常,皮損多為結(jié)節(jié)、斑塊,出現(xiàn)皮下膿腫較少見。應(yīng)用伊曲康唑或特比萘芬治療一般均有較好治療效果。結(jié)論:紅色毛癬菌致皮下膿腫型Majocchi肉芽腫較少見,及時(shí)足量應(yīng)用伊曲康唑治療,療效確切。
[Abstract]:Objective: to report a case of subcutaneous Majocchi granuloma caused by Trichophyton rubrum. Methods: the clinical data, mycological examination, molecular biological identification, histopathology and curative effect of the patients were analyzed and compared with 16 cases of Trichophyton rubrum granuloma reported in China from 1998 to 2012. Results: the patient was 23 years old. Patients with idiopathic thrombocytopenic purpura, long-term use of glucocorticoid, left leg nodules, abscesses and ulcers for 4 months. The mycelium of ulcer surface secretion fungi was positive under microscope, and the fungus culture and molecular biology identified as Trichophyton rubrum. Histopathology showed extensive necrosis of deep dermis and subcutaneous tissue. Mycelium was stained by pas staining with more neutrophils and a few multinucleated macrophages. Diagnosis: subcutaneous Majocchi granuloma of Trichophyton rubrum. Treatment with itraconazole for 3 months the rash subsided scar, follow up for 3 months no recurrence. Literature review showed that the course of granuloma of Trichophyton rubrum was long, the immune function of most patients was normal, the lesions were mostly nodules, plaque and subcutaneous abscess were rare. Itraconazole or terbinafine generally has a good therapeutic effect. Conclusion: the subcutaneous Majocchi granuloma caused by Trichophyton rubrum is rare.
【作者單位】： 安徽省立醫(yī)院皮膚科;安徽省立醫(yī)院病理科;安徽醫(yī)科大學(xué)生命科學(xué)學(xué)院;
【分類號】：R756.6

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本文編號：1847394