红色毛癣菌致皮下脓肿型Majocchi肉芽肿

发布时间：2018-05-05 10:46

本文选题：Majocchi肉芽肿 + 红色毛癣菌　；参考：《临床皮肤科杂志》2014年01期

【摘要】：目的:报告1例红色毛癣菌引起的皮下脓肿型Majocchi肉芽肿,并对国内报道的类似病例进行文献回顾。方法:对患者的临床资料、真菌学检查、分子生物学鉴定、组织病理及疗效进行分析,并对1998—2012年国内报道的16例红色毛癣菌肉芽肿进行分析比较。结果:患者为女性,23岁。患有特发性血小板减少性紫癜,长期应用糖皮质激素,左小腿出现结节、脓肿及溃疡4个月。溃疡表面分泌物真菌镜检菌丝阳性,真菌培养及分子生物学鉴定为红色毛癣菌。皮损组织病理可见真皮深层及皮下组织大片坏死,有较多中性粒细胞和少量多核巨噬细胞浸润,PAS染色可见菌丝。诊断为:红色毛癣菌皮下脓肿型Majocchi肉芽肿。伊曲康唑治疗3个月皮疹消退留有瘢痕,随访3个月无复发。文献回顾发现,红色毛癣菌肉芽肿病程长,大部分患者免疫功能正常,皮损多为结节、斑块,出现皮下脓肿较少见。应用伊曲康唑或特比萘芬治疗一般均有较好治疗效果。结论:红色毛癣菌致皮下脓肿型Majocchi肉芽肿较少见,及时足量应用伊曲康唑治疗,疗效确切。
[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.
【作者单位】：安徽省立医院皮肤科;安徽省立医院病理科;安徽医科大学生命科学学院;
【分类号】：R756.6

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