巢式PCR检测石蜡包埋组织中着色霉、孢子丝菌和马尔尼菲青霉

目的 评价巢式PCR对不同深部真菌感染组织石蜡包埋标本检测的价值。方法 收集着色芽生菌病、孢子丝菌病、马尔尼菲青霉病及其他深部真菌病石蜡组织标本共44份,行组织病理观察并提取石蜡组织标本中DNA。使用针对着色霉、孢子丝菌及马尔尼菲青霉核糖体DNA特定区域的特异性巢式PCR引物,分别对所提取的真菌DNA进行扩增。分析巢式PCR对这3种病原真菌扩增的敏感性和特异性,并与组织病理检查方法比较。结果 20例着色芽生菌病组织蜡块中8例扩增阳性,10例孢子丝菌病组织蜡块中7例扩增阳性,10例马尔尼菲青霉病组织蜡块均扩增阳性,其余对照深部真菌病组织蜡块扩增均为阴性,巢式PCR检测3种真菌的敏感性分别为40%、70%和100%,特异性均达到100%。组织病理检查3种真菌的阳性率分别为95%、70%、80%。结论 巢式PCR扩增石蜡包埋组织中的真菌DNA是诊断深部真菌病的一种方法,尤其适用于诊断马尔尼菲青霉病。     

芽生菌病样孢子丝菌病

孢子丝菌病(限局性皮肤型)可以模拟许多疾病,如痤疮、放线菌病、溴疹、碘疹、着色真菌病、球孢子菌病、皮肤霉菌性肉芽肿、梅毒树胶肿、利什曼病、北美芽生菌病、副球孢子菌病、银屑病、化脓性肉芽肿、结节病及疣状皮肤结核等。作者报告1例具有10cm 大的北美芽生菌病样疣状损害的孢子丝菌病,持续达7年之久。病例:男性,21岁,右腋窝皮肤发生损害已5年,皮损是在农场过夏天之后发生的。在发病前4个月左右于右肘部发生1个溃疡和右腋窝淋巴结肿大,大约在该溃疡和腺病消退之时,发现右腋窝皮肤发生损害。体检发现右腋窝下部有一10×6cm 大新月形损害,具有疣状和紫罗兰色的表面,上部混有疤痕,下部高起,边缘锐利。两侧腹股沟皱襞各有一较小的类似     

皮肤结核误诊19例分析

分析皮肤结核的误诊原因，探讨避免误诊的措施。方法：对收治的19例皮肤结核患者的临床资料进行回顾性分析。结果：本组误诊为结节病5例，孢子丝菌病4例，着色芽生菌病3例，湿疹2例，血管瘤2例，汗管瘤1例，结节性红斑1例。误诊率52.8%。结论：皮肤结核菌检查，结核菌素试验。结核菌的分子生物学检查均能协助诊断。     

原发皮肤接种性孢子丝菌病14例报告

孢子丝菌病由申克氏孢子丝菌所致慢性传染病.1898年Schenck首先报告本病以来,其后关于本病的临床分类繁多.根据Lever 19T5年对本病的分类^①,本文报告的14例应属于原发皮肤接种性孢子丝菌病.14例中男性11例女性3例,9例有明显外伤史.均在病理组织内发现了申克氏孢子丝菌的星状体和孢子.3例霉菌培养证实申克氏孢子丝菌.本组14例病人均经服用碘化钾液而临床治愈.     

特比萘芬连续和间歇疗法治疗孢子丝菌病临床疗效观察

孢子丝菌病为申克孢子丝菌所致的一种深部真菌病,在吉林省为常见、多发的深部真菌病,患者多为体力劳动者.笔者2000年7月-2008年2月应用特比萘芬治疗160例皮肤型孢子丝菌病,获得满意疗效,现报告如下.     

皮肤结核19例临床分析

18例皮肤结核患者的临床表现差异较大,易被误诊为孢子丝菌病、结节病、慢性湿疹等。皮损组织活检病理、TB-PCR等检查有助于确定诊断。     

皮肤真菌病基础和临床研究新进展学习班通知

由冉玉平教授负责的国家级医学继续教育项目“皮肤真菌病基础和临床研究新进展”定于2011年3月30日至4月4日在成都市举行。培训对象：皮肤性病科医师、综合医院医师和检验科技术人员、在读研究生等。培训主要内容：真菌的分类与命名；酵母菌的鉴定、分型、分子生物学及念珠菌病的临床和实验研究进展；浅部真菌病、念珠菌病、隐球菌病、镰刀菌病、孢子丝菌病、着色真菌病、马尔尼菲青霉病、组织胞浆菌病、皮炎芽生菌病、球孢子菌病、曲霉病、结合菌病；马拉色菌的研究进展，包括最新的命名、分类及鉴定方法；     

一株引起皮肤播散性孢子丝菌病的孢子丝菌临床分离株的基因型鉴定

孢子丝菌病是由申克孢子丝菌引起的常见深部真菌病,临床多见于淋巴管型及固定型,播散性孢子丝菌病少见.孢子丝菌进入人体后引起不同临床类型的孢子丝菌病与机体免疫状态有关^[1],但是否与菌型有关尚无定论.为此,我们从一皮肤播散性孢子丝菌病患者皮损中分离1株孢子丝菌菌株,利用常规真菌学和分子生物学方法对其进行鉴定,并探讨该菌株与皮肤淋巴管型孢子丝菌在基因水平上的异同.     

游泳池肉芽肿2例报告

报告2例游泳池肉芽肿，均为鱼类饲养者，表现类似淋巴管型孢子丝菌病，病理呈感染性肉芽肿及结核样结节改变，皮损处组织经低温培养分离出分枝杆菌，利福平与复方新诺明联合治疗有效。疗程需3－6个月，作者提出本病有三种皮肤损害类型。     

固定型孢子丝菌病1例

孢子丝菌病是由申克孢子丝菌引起的慢性深部感染性真菌病。当人皮肤有外伤时接触此菌易被感染，一般见于暴露部位，尤其是手足多见。现将笔者诊治的1例报道如下。     

裴氏瓶霉致皮肤着色芽生菌病误诊为疣状皮肤结核1例

报告裴氏瓶霉致皮肤着色真菌病误诊为疣状皮肤结核1例。患者男，52岁。右上肢红斑、结节、疣状增生5年，无明显自觉症状。组织病理及真菌学检查结果符合裴氏瓶霉，结合临床表现及外伤史确诊为裴氏瓶霉致皮肤着色真菌病。     

老年及儿童孢子丝菌病131例分析报告

本文报告1975~1983年间我所在苏北地区发现孢子丝菌病234例,其中儿童及老年孢子丝菌病共131例,与15~59岁的中年组相比,患者占55.93%.在老年组73例中,女多于男(1.92:1),儿童组58例中男多于女(1.32:1).临床上老年组中皮肤固定型占52.05%,儿童组中达86.21%.131例中有33例曾误诊为肿瘤、疖肿、化脓性溃疡、酒渣鼻、结核等.尤其是儿童患者误诊更多,应引起重视.     

Comparison of tuberculosis cutis luposa and cutaneous leishmaniasis

We present a comparative study concerning two cases of tuberculosis cutis luposa and cutaneous leishmaniasis, respectively. These two Turkish female patients had suffered from changes of the facial skin since 20 years (tuberculosis cutis luposa) and for 5 months (cutaneous leishmaniasis). The tuberculosis cutis luposa had been misdiagnosed as cutaneous leishmaniasis and surgically treated. Both cases showed an apple jelly-like color at the edges of the lesions with soft tissue. With tuberculosis cutis luposa, the lesions had a larger extension and a more hyperkeratotic picture. We discuss the different histopathologic changes of both cases. As bacteriologic culture revealed mycobacterium tuberculosis, on one hand, and histopathology leishmania species intrahistiocytically, on the other, we could finally make the corresponding diagnoses.     

复方倍他米松穴位注射联合口服阿维A及抗结核药物治疗皮肤结核8例

目的探讨复方倍他米松穴位注射联合口服阿维A及抗结核药物治疗皮肤结核的疗效。方法运用复方倍他米松穴位注射联合口服阿维A及抗结核药物治疗8例皮肤结核。结果4例患者4周皮损基本消退;3例患者6~8周皮损基本消退,仅1例患者11周皮损基本消退。结论复方倍他米松穴位注射联合口服阿维A及抗结核药物是治疗皮肤结核的一种有效的方法。     

438例皮肤真菌病病原菌的分析

本文对我科1982～1986年培养阳性的438例皮肤真菌病进行了临床和实验室分析。结果证明在西安地区浅部皮肤真菌病致病菌主要为石膏样毛癣菌和石膏样小孢子菌,其次为红色毛癣菌和絮状表皮癣菌。感染源主要为病猫,倾向于群发或小范围流行,可表现为体癣、头癣和脓癣。深部真菌病在陕西地区少见,但着色真菌病和孢子丝菌病在农村偶可看到。     

CUTANEOUS TUBERCULOSIS IN HONG KONG: A 10-YEAR RETROSPECTIVE STUDY

Background. Cutaneous tuberculosis was once a relatively common skin disease in Hong Kong. Tuberculosis verrucosa cutis was the commonest type. Because the last survey was carried out 25 years ago, it was thought necessary to find out the new incidence and pattern of this important disease in this locality. Methods. A 10-year (1983-1992) retrospective survey on the epidemiologic and clinicobacteriologic aspects of cutaneous tuberculosis had been done in the public sector of Hong Kong. The records of the confirmed cases were retrieved for statistical analysis. Results. A total of 176 cases are included in the final analysis. This represents 0.066% of all new skin cases seen during the 10-year period. Among these, 79.5% are erythema induratum, 6.3% lupus vulgaris, and 4.5% tuberculosis verrucosa cutis. They are further divided into true cutaneous tuberculosis (14.8%, n=26) and the tuberculide (85.2%, n=150). Among the patients with true tuberculosis, 42.3% had lupus vulgaris, 30.8% had tuberculosis verrucosa cutis, and 26.9% had scrofuloderma. Among the tuberculides, erythema induratum accounted for 93.3%. Conclusions. Cutaneous tuberculosis is now uncommon in Hong Kong. Tuberculosis verrucosa cutis is no longer the commonest type in Hong Kong as described in some textbooks. Erythema induratum is now the most common among the total cases and lupus vulgaris is the most common among the true cutaneous forms of tuberculosis.     

Leg ulcers caused by deep mycotic infection

Leg ulcers causing deep mycosis following fungi are encountered in temperate and tropical climates. They are usually asymetrical, and are located over trauma-prone areas of the legs. The ulcers are usually asympatomatic and insidious at onset. They are often confined to certain geographic regions; sporadic cases have, however, been seen elsewhere. The common deep mycoses causing leg ulcers are mycetoma, sporotrichosis, chromomycosis, and blastomycosis. Histoplasmosis and lobomycosis may occasionally produce bizarre leg ulcers. The causative fungus in them may either be identified through smears/histopathologic sections or on culture.     

Multifocal Childhood Cutaneous Tuberculosis: Report of Two Interesting Cases from Sikkim,India

Abstract: Cutaneous tuberculosis is an important health problem in developing countries such as India. Poverty, overcrowding, malnutrition, and ignorance are predisposing factors. The commonly seen variants of cutaneous tuberculosis are scrofuloderma, lupus vulgaris, and tuberculosis verrucosa cutis. Malnourished children may present with unusual forms of cutaneous tuberculosis. Herein we report two interesting cases of multifocal cutaneous tuberculosis in malnourished children.