两性霉素B成功治疗不规则毛霉引起的皮肤慢性毛霉病1例

中国真菌学杂志　 2023, Vol. 18 　Issue (4): 347-349,353.

两性霉素B成功治疗不规则毛霉引起的皮肤慢性毛霉病1例

王诗琪¹, 宋营改¹, 莫然¹, 万喆¹, 徐永豪², 李若瑜¹

1. 北京大学第一医院皮肤性病科真菌室, 国家皮肤与免疫疾病临床医学研究中心, 北京大学真菌和真菌病研究中心, 皮肤病分子诊断北京市重点实验室, 国家药品监督管理局化妆品质量控制与评价重点实验室, 北京 100034;
2. 山东大学齐鲁医院皮肤科, 济南 250063

收稿日期:2022-06-21 出版日期:2023-08-28 发布日期:2023-09-02
通讯作者: 李若瑜,E-mail:mycolab@126.com E-mail:mycolab@126.com
作者简介:王诗琪,女(汉族),博士,住院医师.E-mail:docshiqi@126.com
基金资助:
“十三五”科技重大专项题(2018ZX10712001)

A case of chroniccutaneous mucormycosis caused by Mucor irregulari treated with conventional amphotericin B

WANG Shiqi¹, SONG Yinggai¹, MO Ran¹, WAN Zhe¹, XU Yonghao², LI Ruoyu¹

1. Department of Dermatology, Peking University First Hospital;National Clinical Research Center for Skin and Immune Diseases;Research Center for Medical Mycology, Peking University;Beijing Key Laboratory of Molecular Diagnosis of Dermatoses;NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing 100034, China;
2. Department of Dermatology, Qilu Hospital of Shandong University, Ji'nan 250063, China

Received:2022-06-21 Online:2023-08-28 Published:2023-09-02

摘要/Abstract

摘要： 患者,女,44岁,面部红斑、丘疹16年,溃疡、结痂8年。皮肤科检查: 面部弥漫肿胀性红斑、大片状境界清晰的溃疡和坏死性焦痂。双眼睑外翻,右眼失明。真菌直接镜检、培养及分子生物学菌种鉴定,确诊为不规则毛霉所导致的皮肤慢性毛霉病,予两性霉素B静脉滴注治疗,皮损明显改善,遗留萎缩性瘢痕。

关键词: 两性霉素B, 不规则毛霉, 皮肤毛霉病

Abstract: The patient was a 44-year-old female with erythema and papules on her face for 16 years, ulcers and black crusts for 8 years. Dermatological examination: diffuse swelling erythema, large well-demarcated ulcers with necrotic eschar on her face. She presented bilateral eyelid ectropion and lost her sight of the right eye. The patient was diagnosed as chronic cutaneous mucormycosis caused by Mucor irregulari after direct microscopic examination, fungal culture and molecular identification. Intravenous amphotericin B was given. The lesions were significantly improved but left atrophic scar.

Key words: amphotericin B, Mucor irregulari, cutaneous mucormycosis

中图分类号:

R519.8

王诗琪, 宋营改, 莫然, 万喆, 徐永豪, 李若瑜. 两性霉素B成功治疗不规则毛霉引起的皮肤慢性毛霉病1例[J]. 中国真菌学杂志, 2023, 18(4): 347-349,353.

WANG Shiqi, SONG Yinggai, MO Ran, WAN Zhe, XU Yonghao, LI Ruoyu. A case of chroniccutaneous mucormycosis caused by Mucor irregulari treated with conventional amphotericin B[J]. Chinese Journal of Mycology, 2023, 18(4): 347-349,353.

参考文献

[1] SUN H Y, SINGH N. Mucormycosis: its contemporary face and management strategies[J]. Lancet Infect Dis, 2011, 11(4): 301-311.
[2] CORNELY O A, ALASTRUEY-IZQUIERDO A, ARENZ D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European confederation of medical mycology in cooperation with the mycoses study group education and research consortium[J]. Lancet Infect Dis, 2019, 19(12):e405-e421.
[3] JEONG W, KEIGHLEY C, WOLFE R, et al. The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports[J]. Clin Microbiol Infect, 2019,25(1):26-34.
[4] WANG X, WANG A, WANG X, et al. Cutaneous mucormycosis caused by Mucor irregularis in a patient with CARD9 deficiency[J]. Br J Dermatol, 2019, 180(1): 213-214.
[5] SKIADA A, RIGOPOULOS D, LARIOS G, et al. Global epidemiology of cutaneous zygomycosis[J]. Clin Dermatol, 2012, 30(6): 628-632.
[6] LU X L, NAJAFZADEH M J, Dolatabadi S, et al. Taxonomy and epidemiology of Mucor irregularis, agent of chronic cutaneous mucormycosis[J]. Persoonia, 2013, 30: 48-56. DOI:10.3767/003158513X665539.
[7] 夏志宽,刘畅,丛林等. 不规则毛霉感染引起的皮肤毛霉病20例回顾性分析[J]. 实用皮肤病学杂志, 2014, 7(3):161-165.
[8] ZHANG S, LI R, YU J. Drug combinations against Mucor irregularis in vitro[J]. Antimicrob Agents Chemother, 2013, 57(7): 3395-3397.
[9] 吕红莉, 李澄, 李燕,等. 中国原发性皮肤毛霉病32例回顾性分析[J]. 中国真菌学杂志, 2016, 11(2):103-107.
[10] CARVER P L. The battle for iron between humans and microbes[J]. Curr Med Chem, 2018, 25(1): 85-96.
[11] SPELLBERG B, IBRAHIM A S, CHIN-HONG P V, et al. The deferasirox-amBisome therapy for mucormycosis (DEFEAT Mucor) study: a randomized, double-blinded, placebo-controlled trial[J]. J Antimicrob Chemother, 2012, 67(3): 715-722.

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