刺猬毛癣菌导致双手难辨认癣1例

Trichophyton erinacei-induced tinea incognito on both hands:a case report

患者女,20岁,因双手部红斑、脓疱伴瘙痒1个月就诊。皮肤科检查:双手大鱼际、尾指处可见片状红斑,表面覆有黄色痂皮,红斑基础上可见黄豆至蚕豆大小脓疱,疱液浑浊,疱壁松弛,未见破溃。皮屑真菌镜检显示菌丝阳性。对刺猬的刺与患者皮屑进行真菌培养,菌落镜检均显示分隔菌丝,经测序比对后,两样本菌落均提示为刺猬毛癣菌,且同源性高达99.8%。诊断:刺猬毛癣菌导致的难辨认癣。经伊曲康唑及盐酸萘替芬治疗2周后症状消退。

A 20-year-old female patient presented with erythema and pustules on both hands accompanied by itching for one month.Skin examination showed patchy erythema on the thenar eminence and little finger of both hands,covered with yellow crusts;on the basis of erythema,soybean-to broad bean-sized pustules were observed,with turbid pustular fluids and flaccid pustular walls,but without rupture.Fungal microscopy of skin scales revealed the presence of hyphae.After the fungal culture of hedgehog spines and the patient's skin scales,microscopy showed septate hyphae in colonies;the sequencing of the two colony samples mentioned above both indicated Trichophyton erinacei,and the homology was as high as 99.8%.Finally,the patient was diagnosed with Trichophyton erinacei-induced tinea incognito.The patient′s symptoms subsided after 2-week treatment with itraconazole and naftifine hydrochloride.