裴氏着色霉所致皮肤着色芽生菌病1例

报道1例前臂着色芽生菌病。患者女，46岁。左前臂斑块结节10余年，抗感染治疗无效，皮肤组织病理和真菌培养均符合着色芽生菌病。     

氟康唑治愈1例着色芽生菌病

氟康唑治愈１例着色芽生菌病虞瑞尧，高岭作者于１９９０年５月～１９９３年１２月用氟康唑（大扶康，由美国辉瑞公司提供），治愈１例着色芽生菌病，为着色芽生菌病的治疗提供了有效，安全的治疗方法，报告如下。患者，田×，５３岁，河北人，建筑工人。因双上肢、左下肢...     

伊曲康唑治愈着色芽生菌病5例

应用伊曲康唑，采用不同方案与剂量治疗5例由卡氏枝孢霉引起的着色芽生菌病，均痊愈，未出现不良反应。表明伊曲康唑对着色芽生菌病人较好疗效与安全性。     

口服伊曲康唑与冷冻法联合治疗裴氏着色芽生菌病

目前用于治疗着色真菌病的各种方法多不令人满意。该文报道了单独服用伊曲康唑或联合使用液氮冷冻法治疗10例由裴氏着色芽生菌引起的着色芽生菌病的结果。 10例患者均为男性,年龄39～83岁,病期7.5月～27年,均依据临床表现、普通病理确诊,真菌培养均为裴氏着色芽生菌。大部分患者     

Foxp3在着色芽生菌病患者皮损中的表达及意义

目的:检测着色芽生菌病患者皮损Foxp3 mRNA的表达水平及Foxp3蛋白在皮损中的表达部位,探讨其在着色芽生菌病慢性感染中的作用。方法:收集20例着色芽生菌病患者皮损及20例正常对照皮肤组织,实时荧光定量RT-PCR检测Foxp3 mRNA的表达水平,免疫组化法检测Foxp3蛋白的表达部位,并进行比较。结果:实时荧光定量RT-PCR结果显示,与正常对照皮肤比较,着色芽生菌病皮损Foxp3 mRNA的相对表达量为(4.34±0.49),差异有统计学意义(t=12.12,P0.05);免疫组化结果显示Foxp3蛋白在着色芽生菌病皮损真皮层高表达,定位于细胞核及胞质内,呈棕黄色颗粒;正常皮肤组织不表达或少量表达。结论:着色芽生菌病患者皮损内Foxp3的高表达提示Treg细胞增多,其增多可为病原体免疫逃逸提供条件,可能与着色芽生菌病慢性感染有关。     

裴氏着色芽生菌病1例

目的:本文报告了1例病期长达10多年的由裴氏着色真菌感染引起的着色芽生菌病。皮疹位于腿部皮肤表面,经病理组织活检、PAS染色和真菌培养结合临床症状证实为裴氏着色芽生菌病。     

本刊相关文献集锦

正[1]章强强,隗祎,王家俊.裴氏着色真菌所致皮肤着色芽生菌病1例[J].中国皮肤性病学杂志,2003,16(2):118-119.[2]张雅洁,张桂梅,郑利雄,等.裴氏着色霉所致着色芽生菌病深圳首例报告及分析[J].中国皮肤性病学杂志,2003,17(5):333-335.[3]江情,金云,李智华.裴氏着色真菌致着色芽生菌病1例[J].中国皮肤性病学杂志,2010,24(1):65-66.[4]李桂珍,刘亚红,李建军,等.皮肤着色芽生菌病1例[J].中国皮肤性病学杂志,2010,24(9):878-879.     

裴氏着色霉所致着色芽生菌病深圳首例报告及分析

目的　报告深圳首例裴氏着色霉 (Fonsecaeapedrosoi)所致着色芽生菌病 1例。方法　全面临床检查排除其他疾病 ;皮肤组织病理检查及皮损表面痂皮多次真菌培养、直接镜检证实为着色芽生菌病 ;菌种与标准菌株对照进行培养、鉴定确定为裴氏着色霉 ;临床系统抗真菌治疗观察。结果　组织病理HE染色于表皮角栓内和真皮浅层脓肿内见棕黄色厚壁孢子 (硬壳细胞 )。真菌学培养均为同一菌落生长 (3次 ) ,菌落呈暗棕色 ,绒毛状 ,紧凑感 ,镜下见喙枝孢型分生孢子梗和棕色分枝分隔菌丝。经伊曲康唑和特比萘芬联合治疗辅以高温灯照射 ,5个月后病情明显好转 ,各种真菌学检查阴性。结论　此例着色芽生菌病为深圳特区成立 2 0年来首次发现的病例 ,经联合治疗获成功     

对几种皮下真菌病的新认识

真菌感染好发于具有免疫功能抑制者 ,正逐渐成为一个公共卫生问题。近来还出现了一些鲜为人知的真菌感染。通过对着色芽生菌病、孢子丝菌病、暗色丝孢霉病、皮下接合菌病、链状芽生菌病和马内菲青霉病等临床上较少见的 6种皮下真菌病的文献复习 ,就其病原体、临床表现、诊断及治疗等方面的进展进行了综述。     

面部裴氏着色芽生菌病

报告1例裴氏着色芽生菌所致的面部着色芽生菌病.患者男,54岁.面部反复浸润性斑块1年,表面覆有鳞屑及黑色痂皮.皮损组织病理检查见淡褐色厚壁孢子.痂皮直接镜检见圆形厚壁暗棕色孢子及棕色分隔菌丝.真菌培养出黑色菌落,小培养见喙枝孢型及瓶型分生孢子梗,鉴定为裴氏着色芽生菌.口服伊曲康唑,疗效良好.     

着色芽生菌病的治疗进展

着色芽生菌病是暗色真菌引起的感染性疾病中最为常见的一种。患者多是通过外伤将病原菌接种于机体而导致皮肤及皮下感染。该病治疗困难且易复发,至今仍无治疗的金标准。目前多采用手术疗法、物理疗法(CO_2激光、冷冻治疗)、化学疗法及联合疗法等,光动力、免疫调节剂等新的治疗手段和方法也应用于临床。本文就目前该病的治疗进展进行综述。     

Onychomycosis therapies: strategies to improve efficacy

The combination of relatively high treatment failure rates and infection relapse rates warrants consideration of ways in which antifungal therapy can be delivered so that efficacy rates can be improved. These involve the combination of available therapies and/or a modification of treatment regimens.     

Pulse therapy with amikacin and dapsone for the treatment of actinomycotic foot: a case report

Actinomycetoma is a chronic disease caused by aerobic actinomycetes and affecting the skin, subcutaneous tissue, and bones. It causes significant morbidity and clinically manifests as abscesses and sinus/fistulae with or without granules. Early diagnosis is based on the color, size, histopathology of the granules; culture and metabolic studies are used for further species differentiation. Although sulfamethoxazole-trimethoprim alone or in combination with dapsone for a variable period of time are used as first line agents for treatment, slow response to the therapy and high relapse rates have led to increasing usage of alternative agents like gentamycin, amikacin and cefotaxime. We report a case of actinomycetoma foot who had complete treatment failure with a sulfamethoxazole-trimethoprim-dapsone combination and was successfully treated with combination therapy of amikacin and dapsone without any side effects.     

日光性黑子的治疗进展

日光性黑子的治疗主要分为物理治疗和局部药物治疗。物理治疗包括冷冻、激光、强脉冲光和化学剥脱术,治疗成功率高,时间短,但也伴随着一定的不良反应和复发率。局部药物治疗包括氢醌、维甲酸、阿达帕林、对甲氧酚和维甲酸混合制剂。局部药物治疗的疗程比物理治疗时间长,但能取得更好的疗效。本文对其治疗进展进行了综述。     

Relapses in multibacillary leprosy patients: effect of length of therapy

Two groups of MB leprosy patients, one treated to the point of smear negativity (TSN) and the other given therapy for fixed duration (24 doses of WHO MB regimen) (FDT), were compared for relapse rates during treatment and in the post-treatment period. During the follow-up of 980.2 person years in 260 patients treated with FDT, 20 relapses (2.04/100 patient years) were observed. In the other group of 301 patients, who received therapy till smear negativity, 12 relapses in 1085.46 person years (1.10/100 patient years) occurred. Comparison of survival rates (without relapse) has shown that although there is no difference up to 4 years, the risk of relapse was significantly higher on longer follow-up in the FDT group. In addition, when patients were compared on the basis of initial bacterial load, it was found that the relapse rates in patients with BI > or = 4 was significantly higher (P < 0.01) in the FDT group as compared to those receiving treatment till the point of smear negativity (4.29 versus 1.27/100 patient years). All the relapsed patients responded to retreatment with the same drug combination, indicating that the exacerbation in their condition was because of insufficient treatment. It is suggested that to prevent or reduce relapses, treatment where feasible would be continued till smear negativity, at least in patients with high BI.     

Buschke-L?wenstein giant condylomata acuminata. A case report

A case of chronic disseminated genital and perigenital warts type Buschke-L?wenstein is presented. The therapeutic problems of such cases are discussed in detail. The authors considered, that an efficient and safe treatment of the genital warts is of special importance because of the complications and psychotraumatic effect of the surgical therapy; the high relapse rate and inefficiency of local chemotherapy; the worldwide increase of such lesions induced by human papilloma virus (HPV) during the last years in connection of the induced immunosuppression; the possible link between them and some kind of invasive cancer of the penis, vulva and cervix uteri. They implicate that the systemic new therapy with immunopharmaca as the retinoids and especially the interferons or the combination of both of them, open new therapeutic ways.     

Topical Tazarotene

Tazarotene (Tazorac) is a topical retinoid indicated for the treatment of plaque psoriasis. When used as monotherapy, topical tazarotene was effective at controlling signs and symptoms of plaque psoriasis, and had significantly lower post-treatment relapse rates than fluocinonide cream. The most common adverse events associated with tazarotene therapy are skin-associated events, such as pruritus, burning, and erythema. Combination therapy with tazarotene and mid-to-high potency topical corticosteroids generally resulted in a greater therapeutic effect than that with tazarotene alone, reduced the irritancy of tazarotene, and decreased the risk of post-treatment disease flare seen with corticosteroids; it also has the potential to reduce the degree of skin atrophy associated with topical corticosteroids. The combination of tazarotene and phototherapy also appears promising. Thus, tazarotene, as monotherapy or in combination with topical corticosteroids or UV light therapy, represents a useful treatment option in patients with plaque psoriasis.     

Relapse of paucibacillary leprosy after short course multidrug therapy

Among 25 patients who had short-course multidrug therapy as recommended by the WHO for paucibacillary leprosy, 3 were observed to develop relapse of their disease 8 to 12 months after completion of treatment. These three cases of relapse are reported in detail. The duration of chemotherapy recommended by the WHO in paucibacillary cases appears to be too short.     

Leser-Trélat sign presenting in a patient with recurrent pre-B-cell acute lymphocytic leukemia

The presence of multiple seborrheic keratoses appearing abruptly in association with an underlying malignancy is known as Leser-Trélat sign, a rare paraneoplastic cutaneous syndrome. Although this finding is most commonly associated with solid organ tumors, it also can be a clue for the presence of underlying hematologic malignancies. We present a unique case of Leser-Trélat sign in a 20-year-old man who experienced a relapse of pre-B-cell acute lymphocytic leukemia (ALL) that was previously treated with multiple courses of chemotherapy and external radiation therapy. The patient was admitted for a new cycle of chemotherapy with etoposide and cyclophosphamide and was noted to have an eruption of yellowish brown papules and plaques over his upper body. Biopsy of a representative lesion was consistent with seborrheic keratosis. A large number of rapidly appearing seborrheic keratoses is an uncommon finding in young patients and should be considered clinically suspicious as a potential indicator of Leser-Trélat sign. A thorough history and physical examination should be performed in patients presenting with this sign to rule out possible internal solid organ and hematologic malignancies.     

Retinoids and systemic chemotherapy in cases of advanced mycosis fungoides. A report from the Scandinavian Mycosis Fungoides Group

In cases of advance mycosis fungoides, the systemic chemotherapy combination of bleomycin, cyclophosphamide and prednisolone was given to 8 cases, and the same 3-drug combination with the addition of oral retinoids given to 12 cases. All cases were in a progressive phase of the disease. Remission was obtained in 5/8 cases treated with the combination and in 7/12 cases treated with the combination plus retinoids. The remissions were complete in half of the cases, but relapse occurred within 3 to 6 months in all but 2 cases. The two treatment patient groups were not fully comparable but the conclusion is that the addition of retinoids to systemic chemotherapy combination regimens is of some advantage. There still exists, however, need of more adequate treatment modalities in advanced mycosis fungoides.