红色毛癣菌所致成人头面部Majocchi肉芽肿1例

Majocchi granuloma of head and face caused by Trichophyton rubrum

报道1例经组织病理学检查、真菌培养明确为红色毛癣菌所致头面部毛囊周围炎型Majocchi肉芽肿。患者男,84岁,双侧头皮颞顶部皮损1年余,渐多。专科检查:双侧头皮颞顶部可见多发红色丘疹、结节,部分融合成片。取左侧头皮皮疹行组织病理学检查示:真皮中下层炎症浸润区,以中性粒细胞为主,有较多组织细胞及多核巨细胞浸润,其内见一毛囊,毛干内较多菌丝,周围较多孢子。组织真菌培养及鉴定:红色毛癣菌。诊断:红色毛癣菌所致头面部Majocchi肉芽肿。治疗:予以伊曲康唑0.2 g,2次/日,口服2个月,皮疹较前消退,目前随访中。

We reported a case of Majocchi granuloma with inflammation around hair follicles in the scalp caused by Trichophyton rubrum,which was diagnosed by histopathology and fungal culture and strain identification.The patient was a 84-year-old male with papules and nodules on the bilateral temporal scalp for more than 1 year.Multiple red papules and nodules were observed on the bilateral temporal scalp,and some of them are fused into pieces.Histopathological examination showed an inflammatory infiltration area in the middle and lower dermis,with predominantly neutrophils and many tissue cells and multinucleated giant cells.Many hyphae and spores were observed in a hair shaft.Trichophyton rubrum was identified by fungal culture and strain identification.This patient was finally diagnosed as Majocchi granuloma on the scalp caused by Trichophyton rubrum.This patient was treated with itraconazole 0.2 g,twice a day,orally for 2 months.The patient's rash subsided.He is currently under follow-up.