伊曲康唑治疗Fonsecaea monophora所致着色芽生菌病1例

Itraconazole Treatment for Chromoblastomycosis Caused by Fonsecaea Monophora

患者男,64岁,左前臂伸侧反复斑块3个月。皮肤科情况:左前臂伸侧散在暗红色疣状斑块,表面粗糙、痂皮覆盖,无破溃流脓;皮疹间可见切口瘢痕形成。皮损组织病理示:表皮内可见中性粒细胞微脓肿,真皮炎细胞混合性浸润,可见多核巨细胞及棕褐色圆形小体。真菌培养可见圆形棕褐色菌落,经ITS扩增测序鉴定为Fonsecaea monophora,诊断为着色芽生菌病。治疗予口服伊曲康唑,辅以外用萘替芬乳膏,用药后皮疹逐渐好转,停药3个月余未见复发。

A 64-year-old male presented with a three-month history of repeated plaques on the extension part of his left forearm.Physical examination showed that scattered dark red plaques on the extension part of left forearm appeared verrucous hyperplasia without ulcerations,purulence or bloody secretions.The surface of plaques was rough covered with crusts.The formative scar was observed between the rashes.Histopathology revealed neutrophil microabscess in the epidermis,and infiltration of mixed inflammatory cells in the dermis.Multinucleated giant cells,as well as brown and roundish sclerotic bodies were observed in the dermis.Fungal culture of tissues showed brown and roundish colonies.Identified by ITS amplification and sequence analysis,it turned out as Fonsecaea Monophora.Diagnosis of chromoblastomycosis caused by Fonsecaea monophora was made.The rashes were alleviated gradually after the treatment with oral itraconazole combined with topical naftifine hydrochloride cream.There was no recurrence after drug withdrawal for more than 3 months.