马拉色菌病误诊为痤疮、湿疹2例分析

Malassezia infection misdiagnosed as acne and eczema:report of two cases

报道2例马拉色菌感染引起的毛囊炎和花斑糠疹。患者1,男,19岁,背部红色丘疹2个月,1个月后红色丘疹增多至双颌下、颈前,按痤疮治疗无效。患者2,女,13岁,腹部淡红色斑片1个月,3周后斑片增大,按湿疹治疗1周后无效。真菌镜检病例1可见球形出芽酵母细胞,病例2可见酵母细胞及香蕉样菌丝,含橄榄油SDA培养可见表面呈白色酵母样菌落,生长缓慢。2例分别诊断为马拉色菌属导致的毛囊炎和花斑糠疹。治疗:马拉色菌毛囊炎给予口服伊曲康唑胶囊及外用抗真菌药物综合治疗6周后,复查真菌镜检及培养阴性,外用抗真菌药物6周后花斑糠疹患者红色斑片消退。

To report one case of folliculitis and one case of pityriasis versicolor caused by Malassezia species.Patient 1 was a man acquired red papules on the back for 2 months.After 1 month,the red papules spreaded to the submandibular and front of the neck.The acne treatment was invalid.Patient 2 was a 13 years old girl,who had light red patches on the abdomen for 1 month.The patches enlarged after 3 weeks,and the treatment for eczema was ineffective after 1 week.Fungal microscopic examination of case 1 showed spherical budding yeast cells,sample from case 2 showed yeast cells and banana-like hyphae.SDA culture with olive oil showed white yeast-like colonies on the surface,which grow slowly.They were diagnosed with folliculitis and pityriasis versicolor caused by Malassezia species,respectively.Malassezia folliculitis was treated with oral itraconazole capsules and topical antifungal drugs,and the fungal microscopy and culture were negative after 6 weeks.The red patches of the pityriasis versicolor of case 2 disappeared after 6 weeks topical antifungal drugs.