慢性皮肤黏膜念珠菌病1例及文献分析

A case report of chronic mucocutaneous granuloma caused by Candida and review of references

目的探讨慢性皮肤黏膜念珠菌病的临床表现和诊疗方法。方法对1例慢性皮肤黏膜念珠菌病患者的临床资料进行分析,并行文献检索。结果患者男性,24岁。因右侧颈部出现浸润性斑块,表面密集增厚疣样痂2年。真菌检查:镜下见菌丝。组织病理示表皮大致正常,真皮见大量淋巴样细胞、浆细胞浸润,并见多核巨细胞反应,呈炎性肉芽肿改变。给予伊曲康唑抗真菌治疗后,皮疹好转。结论慢性皮肤黏膜念珠菌病临床表现具有多样性,组织病理检查和真菌培养对慢性皮肤黏膜念珠菌病的诊断具有重要意义,伊曲康唑抗真菌治疗对本病有效,但易复发。

Objective To report a case of chronic mucocutaneous candidiasis,and to search methods for diagnosis and treatment of this disease. Methods Clinical data of this patient were analyzed and combined with review of relative references in order to make a clear concept for this disease especially in diagnosis and treatment. Results A 24-year-old male patient presented with 2-year history of infiltrated plaques covered with thick crust on the skin of right neck and chest accompanied by pain. Some suspected fungal spores were found in the crust by microscopy. Histopathological study revealed an intensive intradermal infiltration of lymphocytes and plasma cells and multinucleated giant cell reaction,it showed a characteristic change of inflammatory granuloma. After one month of treatment with itraconazole,the dermal lesions were gradually subsided. Conclusion The clinical features of this disease were multifarious. Histological examination and fungal culture play an important role in diagnosis of this disease. Itraconazole is effective in treatment of this disease,but it is easy to be relapsed.