国内首例威尼克外瓶霉引起的手腕掌黑癣并文献回顾  

The first case of tinea nigra on wrist caused by Hortaea werneckii in Chinese Mainland and literature review

作　　者：季梅 沈雪花 谭静文 高志琴 杨连娟 JI Mei;SHEN Xue-hua;TAN Jing-wen;GAO Zhi-qin;YANG Lian-juan(Shanghai Fengxian Dermatology Control Center,Shanghai 201408,China;Department of Mycology,Shanghai Dermatology Hospital,Shanghai 200050,China)

机构地区：[1]上海市奉贤区皮肤病防治所,上海201408 [2]上海市皮肤病医院真菌病科,上海200050

出　　处：《中国真菌学杂志》2020年第4期193-196,222,共5页Chinese Journal of Mycology

基　　金：上海申康临床研究培育项目SHDC12017X25。

摘　　要：目的报道1例手腕部掌黑癣病例,并复习国内文献探讨该病的临床特征。方法39岁男性患者,无明显诱因出现左手腕屈侧黑褐色斑疹1年,无自觉症状。刮取患处皮屑做真菌涂片、真菌培养和分子生物学检查进行确诊。结果临床怀疑为手腕部掌黑癣,真菌培养可见黑色圆形菌落,表面呈絮状,显微镜下可见厚壁有隔菌丝,大量圆形和椭圆形的棕色有隔孢子聚集在菌丝两侧和顶端,呈树枝状分布。分子生物学鉴定为威尼克外瓶霉(Hortaea werneckii)。予外用咪康唑联苯苄唑霜2周,每日2次,皮疹完全消退。结论掌黑癣常见于手掌,由威尼克外瓶霉引起的手腕掌黑癣国内首次报道。真菌培养可以初步诊断,基因测序能进一步明确菌种。Objective We present the case of tinea nigra on the left wrist caused by Hortaea werneckii(H.werneckii)and review the literature in Chinese Mainland to summary the clinical characteristics of the disease.Method A 39-year-old man was presented with a dark brown asymptomatic plaque on the flexion side of his left wrist for 1 years.Diagnosis was based on mycology and molecular identification.Result A round black colony with flocculent surface grew at the SDA medium after 1 week.The microscopic examination revealed rich,round,oval,brown and septate spores which gathered on both sides and the top of the thickwalled septate hyphae.The result of gene sequencing was H.werneckii.The patient was treated with miconazole bifonazole cream for 2 weeks and cured completely.Conclusion The main clinical location of tinea nigra was the palm.This case is the first of tinea nigra on wrist by H.werneckii in Chinese Mainland.The characteristic morphological features of colony could been observed in microscopic examination and the specie could be identified furtherly by gene sequencing.

关 键 词：掌黑癣 威尼克外瓶霉 文献回顾 

分 类 号：R519.8[医药卫生—内科学]