误诊为坏疽性脓皮病的皮肤播散型孢子丝菌病1例

患者女,63岁,农民。胸腹部结节、斑块、溃疡2年半。曾被误诊为"坏疽性脓皮病",并予糖皮质激素、米诺环素等反复治疗1年余,用药时皮疹有所好转,停药后皮疹加重。皮损组织病理示:呈炎性肉芽肿改变,脓液真菌培养鉴定为孢子丝菌。诊断:皮肤播散型孢子丝菌病。予特比萘芬口服,治疗3个月后皮损明显好转,目前仍在随访治疗中。

A Case of Disseminated Cutaneous Sporotrichosis Misdiagnosed as Pyoderma Gangrenosum

The patient was a 63-year-old female farmer presented nodules,plaques and ulcers on her chest and abdomen for two and a half years.She was ever misdiagnosed as 11 pyoderma gangrenosum”and had been treated with glucocorticoid and minocycline for more than one year repeatedly.The lesions improved by glucocorticoid and minocycline treatment,but aggi'avated after medication withdrawal.Histopathological examination showed granulomatous inflammation.Sporothrix schenckii was identified by pus culture.The patient was diagnosed as cutaneous disseminated sporotrichosis.The lesions were significantly improved after three months terbinafine treatment.She was still under treatment and follow-up.