断发毛癣菌所致成人黑点癣1例

中国真菌学杂志　 2015, Vol. 10 　Issue (5): 294-296.

断发毛癣菌所致成人黑点癣1例

杨阳¹, 刘涵¹, 景东云², 彭琳琳², 王玲², 夏玉坤², 杨蓉娅¹, 吕雪莲¹

1. 中国人民解放军北京军区总医院皮肤科, 北京 100700;
2. 大连市皮肤病医院, 大连 116021

收稿日期:2015-02-09 出版日期:2015-10-28 发布日期:2015-10-28
通讯作者: 吕雪莲,E-mail:mycoses@gmail.com E-mail:mycoses@gmail.com
作者简介:杨阳,女(土家族),硕士研究生在读.E-mail:83397518@qq.com

A case of adult black-dot ringworm due to Trichophyton tonsurans

YANG Yang¹, LIU Han¹, JIN Dong-yun², PENG Lin-lin², WANG Ling², XIA Yu-kun², YANG Rong-ya¹, LV Xuelian¹

1. General Hospital of BeiJing Military Command PLA, BeiJin 100700;
2. Dalian Deramatosis Hospital, Dalian 116021

Received:2015-02-09 Online:2015-10-28 Published:2015-10-28

摘要/Abstract

摘要：

患者女,68岁,福建农民,头顶部片状脱发3个月。体检:头顶部形状不规则暗红斑片,少量脱屑。红斑区毛发根部紧贴头皮脱落,呈黑点状,脱发区毛囊轻度红肿,皮损区头皮局部有轻度波动感。直接镜检可见断发内大量孢子集聚沿发干呈链状分布,真菌培养分离黄白色绒毛状菌落,小培养镜下可见棒形,梨形小分生孢子,尿素酶试验阳性。临床分离株进行rDNA ITS扩增测序,BLAST比对与GenBank中断发毛癣菌序列同源性100%。诊断:断发毛癣菌所致黑点癣。治疗采用伊曲康唑0.2~0.4/d口服及酮康唑洗剂、曲安奈德益康唑乳膏及酮康唑乳膏等外用,总疗程2个月,皮损完全消退,断发重新长出,无瘢痕秃发形成。停药后随访半年无复发。

关键词: 黑点癣, 头癣, 断发毛癣菌, 伊曲康唑, 成人

Abstract:

A 68-year old female farmer presented with hair loss for 3 months.Physical examination showed irregularly dark red patch with a little amount of scales.The hairs in the red lesion broke off from the scalp presented with black dotted like, while the hair follicles showed swollen with mild fluctuation.Direct fungal microscopic examination presented a large amount of chain-like spores distribution along the inside of hair shaft.Fungal culture isolated yellow-white woolly colony presented with short rod-like or pear-shaped microconidiain by slide culture and positive urease test.Molecular identification by BLAST based on rDNA ITS sequencing confirmed as Trichophyton tonsurans.The diagnosis was confirmed as black-dot ringworm caused by Trichophyton tonsurans.Therapeutic drugs included oral itraconazole, 0.2-0.4 per day, external ketoconazole lotion, triamcinolone acetonide and econazole nitrate cream, and ketoconazole cream.After 2 months treatment, skin lesions completely faded and broken hair grew back without scarring alopecia.No recurrence after treatment was observed in 6-month follow-up.

Key words: black dot ringworm, tinea capitis, Trichophyton tonsurans, itraconazole, adult

中图分类号:

R756.1

杨阳, 刘涵, 景东云, 彭琳琳, 王玲, 夏玉坤, 杨蓉娅, 吕雪莲. 断发毛癣菌所致成人黑点癣1例[J]. 中国真菌学杂志, 2015, 10(5): 294-296.

YANG Yang, LIU Han, JIN Dong-yun, PENG Lin-lin, WANG Ling, XIA Yu-kun, YANG Rong-ya, LV Xuelian. A case of adult black-dot ringworm due to Trichophyton tonsurans[J]. Chinese Journal of Mycology, 2015, 10(5): 294-296.

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