萎缩性花斑糠疹

Atrophying pityriasis versicolor

患者女，26岁。因胸腹部鳞屑性红斑伴萎缩近2年就诊。取皮屑直接镜检，见较多粗短的菌丝及成簇孢子。皮损组织病理检查，过碘酸雪夫（PAS）染色见角质层内较多菌丝和孢子。弹力纤维染色示弹力纤维减少，部分弹力纤维纤细、断裂。诊断：萎缩性花斑糠疹。治疗：口服伊曲康唑胶囊200mg/d共1周，外用2％舍他康唑乳膏4周，皮疹消退，真菌直接镜检复查阴性。

A 26-year-old woman presented with scaly atrophic erythema on the chest and abdomen tor nearly 2 years. Direct microscopic examination of the lesion scrapings revealed numerous stubby hyphae and clustered spores. Periodic acid-Schiff （PAS） staining of the biopsy tissue showed the presence of numerous hyphae and spores in the horny layer. The stain for elastic fibers revealed that the number of elastic fibers decreased, and some elastic fibers became fine and disrupted. The patient was diagnosed with atrophying pityriasis versicolor. The lesions subsided and direct microscopic examination was negative after 1-week treatment with oral itraconazole of 200 mg once daily and 4-week treatment with topical 2% sertaconazole cream.