断发毛癣菌所致成人黑点癣1例  

A case of adult black-dot ringworm due to Trichophyton tonsurans

作　　者：杨阳[1] 刘涵[1] 景东云[2] 彭琳琳[2] 王玲[2] 夏玉坤[2] 杨蓉娅[1] 吕雪莲[1] 

机构地区：[1]中国人民解放军北京军区总医院皮肤科,北京100700 [2]大连市皮肤病医院,大连116021

出　　处：《中国真菌学杂志》2015年第5期294-296,共3页Chinese Journal of Mycology

摘　　要：患者女,68岁,福建农民,头顶部片状脱发3个月。体检：头顶部形状不规则暗红斑片,少量脱屑。红斑区毛发根部紧贴头皮脱落,呈黑点状,脱发区毛囊轻度红肿,皮损区头皮局部有轻度波动感。直接镜检可见断发内大量孢子集聚沿发干呈链状分布,真菌培养分离黄白色绒毛状菌落,小培养镜下可见棒形,梨形小分生孢子,尿素酶试验阳性。临床分离株进行r DNA ITS扩增测序,BLAST比对与Gen Bank中断发毛癣菌序列同源性100%。诊断：断发毛癣菌所致黑点癣。治疗采用伊曲康唑0.2~0.4/d口服及酮康唑洗剂、曲安奈德益康唑乳膏及酮康唑乳膏等外用,总疗程2个月,皮损完全消退,断发重新长出,无瘢痕秃发形成。停药后随访半年无复发。A 68-year old female farmer presented with hair loss for 3 months.Physical examination showed irregularly dark red patch with a little amount of scales.The hairs in the red lesion broke off from the scalp presented with black dotted like,while the hair follicles showed swollen with mild fluctuation. Direct fungal microscopic examination presented a large amount of chain-like spores distribution along the inside of hair shaft. Fungal culture isolated yellow-white woolly colony presented with short rod-like or pearshaped microconidiain by slide culture and positive urease test. Molecular identification by BLAST based on r DNA ITS sequencing confirmed as Trichophyton tonsurans.The diagnosis was confirmed as black-dot ringworm caused by Trichophyton tonsurans.Therapeutic drugs included oral itraconazole,0. 2-0. 4 per day,external ketoconazole lotion,triamcinolone acetonide and econazole nitrate cream,and ketoconazole cream.After 2 months treatment,skin lesions completely faded and broken hair grew back without scarring alopecia.No recurrence after treatment was observed in 6-month follow-up.

关 键 词：黑点癣 头癣 断发毛癣菌 伊曲康唑 成人 

分 类 号：R756.1[医药卫生—皮肤病学与性病学]