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中国真菌学杂志 2017, Vol. 12  Issue (5): 291-292,294.

病例报告 上一篇    下一篇

紫色毛癣菌所致老年头癣继发头面部带状疱疹1例

冉昕, 汪盛, 王琳, 冉玉平   

  1. 四川大学华西医院皮肤性病科, 成都 610041
  • 收稿日期:2017-03-06 出版日期:2017-10-28 发布日期:2017-10-28
  • 通讯作者: 冉玉平,E-mail:ranyuping@vip.sina.com E-mail:ranyuping@vip.sina.com
  • 作者简介:冉昕,男(汉族),硕士,住院医师.E-mail:ranfjk@126.com

A case of tinea capitis caused by Trichophyton violaceum and supervene of craniofacial herpes zoster in an elderly patient

RAN Xin, WANG Sheng, WANG Lin, RAN Yu-ping   

  1. Department of Dermatoverenology, West China Hospital, Sichuan University, Chengdu 610041
  • Received:2017-03-06 Online:2017-10-28 Published:2017-10-28

摘要:

患者女,62岁,头皮红斑、丘疹、鳞屑1个月,加重伴脓疱3周,结痂1周。取痂壳直接镜检发现真菌菌丝,将痂壳接种沙堡弱培养基25℃培养25 d见紫色菌落生长,周围有红色色素。提取菌落DNA做PCR扩增后测序为紫色毛癣菌,诊断为老年头癣。经牛奶送服伊曲康唑联合2%酮康唑洗剂洗头后外用萘替芬酮康唑治疗3周后患者头皮痂壳消退,但于右侧头面部出现带状分布簇集张力性水疱,诊断为带状疱疹。服用溴夫定片125 mg/d治疗9 d后水疱消退。

关键词: 头癣, 紫色毛癣菌, 伊曲康唑, 带状疱疹, 溴夫定

Abstract:

A 62-year-old female patient,whose scalp developed pruritus erythema for 1 month,exacerbated to pustules for 3 weeks,formed scabs for 1 week.KOH direct microscopic examination finds typical hyphae on scalp scales.Culture on Sabouraud Dextrose Agar (SDA),with 25℃ for 25 days,shows purple colonies with reddish periphery.The pathogen's DNA was extracted for PCR amplification and the products was sequenced and identified as Trichophyton violaceum,which confirmed the patient's diagnose of tinea capitis.She was administrated itraconazole 200 mg twice a day taken with milk,combine with 1% naftifine-0.25% ketoconazole cream,after wash with 2% ketoconazole shampoo.Her scalp scales are improved 3 weeks later.However,band clustery tension blisters appeared on right scalp,right ear,right cheek,lips and underjaw,which was diagnosed as herpes zoster.The lesion was controlled after we prescribed brivudine 125 mg daily for 9 days.

Key words: tinea capitis, Trichophyton violaceum, itraconazole, herpes zoster, brivudine

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