河南不规则毛霉致原发性皮肤毛霉病一例  

A case of primary cutaneous mucormycosis caused by Mucor irregularis in Henan province

作　　者：李丽娜[1] 张守民[1] 冉玉平[2] 康道现[2] 李敏[1] 陈静 李振鲁[1] 王豫平[1] 李建国[1] 高丽[1] 王国芳[1] 

机构地区：[1]河南省人民医院皮肤性病科,郑州450003 [2]四川大学华西医院皮肤性病科

出　　处：《中华皮肤科杂志》2014年第2期81-84,共4页Chinese Journal of Dermatology

基　　金：河南省科技攻关研究项目（112102310249）

摘　　要：患者女，50岁。右上肢皮肤结节、斑块、红肿、溃烂6年，右臀部斑块2年，右面颊斑块1年。曾单独口服特比萘芬、伊曲康唑治疗无效。右上肢及臀部皮损组织病理及PAS染色均可见真皮内宽大呈直角分支菌丝。真菌培养及分子生物学鉴定为不规则毛霉。联合伊曲康唑和特比萘芬治疗2个月仍无效，改为静脉滴注两性霉素B（总量1 060 mg）治疗，患者右面颊、右臀部斑块肿胀逐渐消退，右上肢包括右手背斑块、红肿、坏死、黑痂消退，皮损愈合成瘢痕，取右上肢皮肤组织再次行真菌培养阴性。随访1年未复发。A 50-year-old female farmer presented with nodules, plaques and ulcers on as well as erythematous swelling of the right upper limb for six years, plaques on the right buttock for two years and on the right cheek for one year. She had been treated with terbinafine and itraconazole, but no obvious improvement was achieved. Broad, septated and right-angled branching hyphae were found by both routine pathological examination and periodic acid-Schiff （PAS） staining of the lesional tissue from the right upper limb and buttock. The fungus was identified as Mucor irregularis by culture and molecular biological approaches, and the patient was diagnosed with primary cutaneous mucormycosis and given intravenous amphotericin B with the total dose being 1 060 mg. Subsequently, the plaques on and swelling of the right cheek and buttock gradually regressed, and the plaques on, swelling and necrosis of the right dorsal hand subsided with shedding of black crusts and formation of scar. The repeated fungal culture of lesional tissue on the right limb was negative. The patient was followed for one year and no recurrence was observed.

关 键 词：不规则毛霉 多变根毛霉 两性霉素B 原发性皮肤毛霉病 

分 类 号：R756[医药卫生—皮肤病学与性病学]