层出镰孢致皮肤镰孢病模拟银屑病一例临床病理真菌学研究  

A clinicopathological mycological study of a case of skin Fusarium mimicking psoriasis caused by Fusarium proliferatum

作　　者：杨亚敏 孙婷婷[1] 张倩[1] 张春雷[1] 李东明[1] YANG Yamin;SUN Tingting;ZHANG Qian;ZHANG Chunlei;LI Dongming(Department of Dermatology and Mycological Laboratory,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院皮肤科真菌实验室,北京100191

出　　处：《菌物学报》2024年第5期41-47,共7页Mycosystema

基　　金：国家自然科学基金(31770013,32070019)。

摘　　要：镰孢菌引起的皮肤病,也称为皮肤镰孢病,通常表现为皮肤结节和顽固性溃疡,银屑病样皮疹很罕见,很容易误诊。由于镰孢菌的天然耐药菌株频繁存在,镰孢菌感染不仅难以诊断,而且难以治疗。现报告一例层出镰孢模拟的银屑病样镰孢病。病人女,59岁,右耳垂及其周围皮肤鳞屑性红斑至斑块30余年。病人先后被误诊为“湿疹、银屑病”等,并接受了多种药物治疗,但没有任何疗效。真菌直接镜检、组织真菌培养及病理学确诊为镰孢菌感染,DNA鉴定为层出镰孢,诊断为皮肤镰孢病。静脉注射两性霉素B脂质体后,皮肤损害显著改善,几乎消退。结论:皮肤镰孢菌可模拟银屑病,两性霉素B治疗有效。Skin diseases caused by Fusarium,also known as cutaneous fusariosis,usually present as nodules and persistent ulcers on the skin;psoriasis-like rashess are uncommon and are frequently misdiagnosed.Due to the frequent occurrence of naturally drug-resistant strains of Fusarium,Fusarium infection is not only challenging to identify but also challenging to cure.In this paper,a case of psoriasis-like fusariosis caused by Fusarium proliferatum is reported.The 59-year-old patient had been suffering from plaques and scaly erythema on her right earlobe and surrounding skin for more than 30 years.The patient had been misdiagnosed as"eczema and psoriasis"and had been treated with various medications,but without any efficacy.Direct microscopic examination of the fungus,tissue fungal culture and pathology confirmed the diagnosis of Fusarium infection,and DNA identification as Fusarium proliferatum led to the diagnosis of cutaneous fusariosis.Skin damage improved significantly and almost subsided after intravenous injection of liposomal amphotericin B.Cutaneous fusariosis can mimic psoriasis and amphotericin B treatment is effective.

关 键 词：镰孢病 皮肤结构感染 透明丝孢霉病 两性霉素B 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]