红色毛癣菌致头癣4例临床分析及近10年文献回顾

中国真菌学杂志　 2020, Vol. 15 　Issue (4): 218-222.

红色毛癣菌致头癣4例临床分析及近10年文献回顾

杨虹, 高志琴, 陈健, 任弘瑾, 蔡晴, 谭静文, 刘小萍, 戴鹤骏, 杨连娟

上海市皮肤病医院真菌病科, 上海 200050

收稿日期:2019-12-02 出版日期:2020-08-28 发布日期:2020-08-28
通讯作者: 杨连娟,E-mail:zhy52808290@qq.com E-mail:zhy52808290@qq.com
作者简介:杨虹,女(汉族),硕士,副主任医师.E-mail:yanghcn@sina.com
基金资助:
上海申康临床研究培育项目（SHDC12017X25）

The clinical characteristics of tineacapitis caused by Trichophyton rubrum and the literature review of the recent 10 years

YANG Hong, GAO Zhi-qin, CHEN Jian, REN Hong-jin, CAI Qing, TAN Jing-wen, LIU Xiao-ping, DAI He-jun, YANG Lian-juan

Department of Mycology, Shanghai Dermatology Hospital, Shanghai 200050, China

Received:2019-12-02 Online:2020-08-28 Published:2020-08-28

摘要/Abstract

摘要：

目的通过对4例红色毛癣菌致头癣的临床分析及近10年的文献复习，探讨红色毛癣菌致头癣的临床特征。方法根据临床表现和真菌学检查确诊的头癣4例，致病菌均为红色毛癣菌。收集患者一般资料、皮损特征、病程、治疗情况，总结分析；并对近10年与红色毛癣菌相关头癣的文献进行回顾总结。结果 4例头癣，前3例为学龄前儿童，第4例为老年女性，仅1位有宠物接触史。病史显示，与儿童患者密切接触的家庭成员均患有不同程度的足癣和甲癣，且有抠脚等不良习惯；第4例患有糖尿病和甲癣多年，且头癣与其甲癣的真菌培养鉴定结果一致，均为红色毛癣菌。经口服抗真菌药物规范治疗，4位患者均在4~8周内治愈。近10年来文献回顾发现，头癣中红色毛癣菌的分离率国内文献的数据是0.6%~15.8%，英文文献的数据是0.8%~28.8%。因红色毛癣菌而发生的头癣，临床表现呈多样性，有红斑性鳞屑、脱发、渗出等病变，也有脓癣型和黑点型。结论红色毛癣菌导致头癣的报道并不少见。与患有浅部真菌病的家庭成员密切接触以及自身传播，可能是红色毛癣菌性头癣的主要传播来源。无论儿童或成人，只有提高对不同临床形式的头癣的认识和警惕性，把真菌学检查作为常规检查手段，才能有助于更多病例的确诊。

关键词: 红色毛癣菌, 头癣, 成人头癣

Abstract:

Objective The clinical characteristics of tinea capitis caused by Trichophyton rubrum were studied by the clinical analysis of 4 cases and the literature review of the recent 10 years. Methods According to clinical and mycology manifestation, 4 cases of tinea capitis caused by T. rubrum were diagnosed. We summarized their clinical characteristics, and review of the literatures in recent 10 years. Results The first 3 cases were preschool children, the fourth case was elderly female, and only 1 case had pet contact history. The three children's patients suffered from different degrees of tinea pedis and onychomycosis and were used to scratching feet; The fourth case suffered from diabetes mellitus and onychomycosis more than 10 years. The results of the fungal culture of the infected hair and nails scales were all T. rubum. After standardized oral antifungal drug treatment, all 4 patients were cured within 4-8 weeks. Literature review found that in the last 10 years, the frenquency of T. rubrum in tinea capitis was 0.6%-15.8% in domestic literature, and 0.8%-28.8% in English literature. The clinical manifestations were diverse, including erythema scale, alopecia, exudation and other lesions, kerion and black spots. Conclusion Tinea capitis caused by T. rubrum is not uncommon. Close contact infection with family members suffering from superficial fungal disease and self infection is an important mode of transmission of T. rubrum. Only by raising the awareness of different clinical forms of tinea capitis and using fungal examination as a routine examination method can help us to confirm more cases of tinea capitis.

Key words: Trichophton rubum, tinea capitis, adult tinea capitis

中图分类号:

R756.1

杨虹, 高志琴, 陈健, 任弘瑾, 蔡晴, 谭静文, 刘小萍, 戴鹤骏, 杨连娟. 红色毛癣菌致头癣4例临床分析及近10年文献回顾[J]. 中国真菌学杂志, 2020, 15(4): 218-222.

YANG Hong, GAO Zhi-qin, CHEN Jian, REN Hong-jin, CAI Qing, TAN Jing-wen, LIU Xiao-ping, DAI He-jun, YANG Lian-juan. The clinical characteristics of tineacapitis caused by Trichophyton rubrum and the literature review of the recent 10 years[J]. Chinese Journal of Mycology, 2020, 15(4): 218-222.

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