红色毛癣菌自体接种致免疫正常患者Majocchi’s 肉芽肿1例及文献复习

Majocchi’s granuloma due to autoinoculation of Trichophyton rubrum and review of literature

目的通过报告1例Majocchi’s肉芽肿病例及文献复习,进一步了解Majocchi’s肉芽肿的临床特征,为诊治Majocchi’s肉芽肿提供思路。方法报告1例红色毛癣菌自体接种致面部Majocchi’s肉芽肿,并对既往文献进行复习,总结免疫正常患者Majocchi’s肉芽肿的临床特点。结果共检索到Majocchi’s肉芽肿病例报告及相关文献58篇,与本例病例共计71例患者,其中免疫功能正常患者35例,占49.3%,男性24例,女性11例;总结了35例免疫功能正常患者Majocchi’s肉芽肿临床及微生物学特征,根据病史,患者初次就诊误诊率达57.1%(20/35)。治疗推荐采用系统性抗真菌药物。结论全面认真的体格检查、确定基本皮疹性质、采集详细病史及接触史等可以为皮肤科医生提供诊断线索,真菌镜检及培养是重要的诊断的依据。

Objective To report a case of Majocchi’s granuloma due to autoinoculation and review related literatures to provide ideas for diagnosis and treatment of Majocchi’s granuloma.Method A case of Majocchi’s granuloma on face was due to autoinoculation of Trichophyton rubrum.Clinical characters of Majocchi’s granulomain immunocompetent patients were also reviewed.Results Totally there were 58 published papers including case reports and related articles were enrolled.Among71 cases,there were 35 immunocompetent patients including 24 males and 11 females.The clinical characters of the 35 immunocompetent patients were summarized.The initial misdiagnosis rate during the first clinic visit was 57.1%(20/35).Systemic antifungal drugs were the first choice for treatment.Conclusion Comprehensive and careful physical examination,confirmation of basic skin lesion and collection of detailed medical history could provide important clues for accurate diagnosis.