73例儿童毳毛面癣病原菌分析

目的：明确儿童毳毛面癣常见致病菌种及易感因素。方法：分析2014年4月至2019年3月我院就诊的73例儿童毳毛面癣患儿的临床资料。皮损部位刮取鳞屑及毳毛接种到沙堡弱培养基,27℃恒温培养2周,对培养出的病原菌进行形态学及分子生物学鉴定。结果：共分离出皮肤癣菌62株,其中须癣毛癣菌 38株（61%）,犬小孢子菌12株（19%）,石膏样小孢子菌10株（16%）,紫色毛癣菌2株（3%）。62例患儿有动物接触史,45例患儿有外用糖皮质激素史。患儿外用特比萘芬乳膏或联苯苄唑乳膏,部分患者口服特比萘芬片,治疗4~8周后均达到临床和真菌学治愈。结论：毳毛面癣的优势致病菌是须癣毛癣菌,其次依次是犬小孢子菌和石膏样小孢子菌。发病因素与接触动物密切相关。     

尿素-吲哚培养液快速鉴别石膏样毛癣菌和红色毛癣菌

石膏样毛癣菌（石毛）和红色毛癣菌（红毛）是最常见的皮肤癣菌［１］，因菌落形态及显微结构相近，常不易鉴别。我们用尿素－吲哚培养液对医学真菌中心保藏的３个属１７种皮肤癣菌标准株和临床分离的３个属７种１３８株皮肤癣菌进行实验观察，现总结报告如下。一、菌种标准株为中国微生物菌种保藏管理委员会医学真菌中心保藏的菌种，分别是：毛癣菌属：红毛（ＩＤ００００１），石毛（ＩＤ０００１２），许兰氏毛癣菌（许兰：ＩＤ００００２），紫色毛癣菌（紫毛：ＩＤ００００４），断发毛癣菌（断毛：ＩＤ０００１８），猴类毛癣菌（猴毛…     

Biolog微生物自动分析系统建立六种皮肤癣菌的鉴定数据库

目的 探讨Biolog微生物自动分析系统鉴定皮肤癣菌的应用前景。 方法 采用表型及DNA测序的方法,将临床收集的菌株鉴定至种;选取红色毛癣菌、须癣毛癣菌、断发毛癣菌、犬小孢子菌、石膏样小孢子菌和絮状表皮癣菌6种常见皮肤癣菌接种于FF微量板,记录皮肤癣菌对95种不同碳源的利用情况,描述其各自的生长反应谱,建立鉴定数据库。结果 6种皮肤癣菌对一些碳源的利用具有明显的差别,通过是否利用棉子糖可以将须癣毛癣菌、断发毛癣菌同其他4种毛癣菌进行区分;而葵二酸可以区分须癣毛癣菌、断发毛癣菌;通过延胡索酸和琥珀酸可以将红色毛癣菌同石膏样小孢子菌、絮状表皮癣菌和犬小孢子菌进行区分;通过是否利用丙氨酸和苯丙氨酸可以对石膏样小孢子菌进行鉴定。而糊精的利用可以区分絮状表皮癣菌和犬小孢子菌。结论 Biolog微生物鉴定系统采用一种特殊的表型鉴定方法,可以对常见皮肤癣菌进行鉴定。     

某些皮肤癣菌凝集素结合形式

我们采用凝集素ＡＢＣ组织化学染色方法对１４种皮肤癣菌的凝集素糖基受体进行了检测，结果报道如下。一、材料和方法１．菌种：红色毛癣菌、须癣毛癣菌、断发毛癣菌、马类毛癣菌、犬小孢子菌、铁锈色小孢子菌、石膏样小孢子菌、絮状表皮癣菌均为本科真菌室保存菌种；紫色...     

动物源性皮肤癣菌病32例菌种鉴定与流行病学分析北大核心CSCD

目的对动物源性皮肤癣菌病进行病原菌鉴定,了解引起动物源性皮肤癣菌病的病原菌分布情况。方法收集2013年10月-2014年11月就诊于本科并被临床诊断为动物源性皮肤癣菌病患者的临床资料,收集患者和动物分离的皮肤癣菌,用形态学及生理生化学方法鉴定菌种。以微卫星序列(GACA)4为引物对菌株的DNA进行扩增,随后针对非转录间隔区(NTS)设计引物,用随机扩增DNA多态性(RAPD)方法鉴定来源于患者和动物间菌株的差异性。结果 42例病例中,有10例与所接触动物分离出的菌种不一致,只有32例和所接触动物分离出的菌种一致。32例患者与所接触动物分离出57株菌,共鉴定出3种皮肤癣菌:犬小孢子菌、趾间毛癣菌(原:须癣毛癣菌)和石膏样小孢子菌,经RAPD的结果表明,患者和所接触动物感染的皮肤癣菌具有同源性。结论动物源性皮肤癣菌病的致病菌以犬小孢子菌最常见,其次为趾间毛癣菌和石膏样小孢子菌;猫为主要的传染源,其次为狗和兔;人和所接触动物同时患癣菌病不一定都是动物源性皮肤癣菌病。     

动物源性皮肤癣菌病32例菌种鉴定与流行病学分析

目的对动物源性皮肤癣菌病进行病原菌鉴定,了解引起动物源性皮肤癣菌病的病原菌分布情况。方法收集2013年10月-2014年11月就诊于本科并被临床诊断为动物源性皮肤癣菌病患者的临床资料,收集患者和动物分离的皮肤癣菌,用形态学及生理生化学方法鉴定菌种。以微卫星序列(GACA)4为引物对菌株的DNA进行扩增,随后针对非转录间隔区(NTS)设计引物,用随机扩增DNA多态性(RAPD)方法鉴定来源于患者和动物间菌株的差异性。结果 42例病例中,有10例与所接触动物分离出的菌种不一致,只有32例和所接触动物分离出的菌种一致。32例患者与所接触动物分离出57株菌,共鉴定出3种皮肤癣菌:犬小孢子菌、趾间毛癣菌(原:须癣毛癣菌)和石膏样小孢子菌,经RAPD的结果表明,患者和所接触动物感染的皮肤癣菌具有同源性。结论动物源性皮肤癣菌病的致病菌以犬小孢子菌最常见,其次为趾间毛癣菌和石膏样小孢子菌;猫为主要的传染源,其次为狗和兔;人和所接触动物同时患癣菌病不一定都是动物源性皮肤癣菌病。     

万博节皮菌感染引起的头皮脓癣1例

正脓癣是相对少见的儿童皮肤癣菌感染,主要由亲动物性或亲人性的小孢子菌属和毛癣菌属感染,如犬小孢子菌、石膏样小孢子菌、须癣毛癣菌、断发毛癣菌等[1-3],此类皮肤癣菌感染可引起宿主强烈变态反应,主要表现为头皮脱发和毛囊性脓疱,可融合成痈状脓肿,愈合后可形成瘢痕及永久性脱发,严重影响患儿的身心健康。我们报告1例由患体癣的宠物兔引起的儿童脓癣,并进行菌种分型鉴定及临床诊治,随访。     

红色毛癣菌、石膏样小孢子菌对人角质形成细胞TLR2/c-Jun、NF-κB信号通路的差异性诱导

 目的:探讨不同生态学分类皮肤癣菌对人角质形成细胞TLR2/c-Jun、NF-κB信号通路的诱导。 方法：将红色毛癣菌、石膏样小孢子菌分别与HaCaT细胞共培养24 h后,蛋白免疫印迹检测p65、relb、IκB、c-Jun的总蛋白及其磷酸化水平。然后将红色毛癣菌、石膏样小孢子菌分别与HaCaT细胞TLR2敲除细胞株（HaCaT TLR2-/-细胞）共培养24 h后,采用蛋白免疫印迹检测TLR2、c-Jun蛋白及其磷酸化水平。结果：HaCaT细胞感染红色毛癣菌后c-Jun蛋白磷酸化水平无明显变化,而感染石膏样小孢子菌后c-Jun蛋白磷酸化水平升高。p65、relb、IκB的总蛋白及其磷酸化水平在两种菌的感染下均无明显变化。HaCaT TLR2-/-细胞感染红色毛癣菌后c-Jun蛋白磷酸化水平明显降低,而感染石膏样小孢子菌后c-Jun蛋白磷酸化水平无明显变化。 结论：红色毛癣菌与石膏样小孢子菌都可以通过TLR2激活人角质形成细胞c Jun信号通路,但并未激活NF-κB信号通路。此外,TLR2可能和其他受体共同介导了红色毛癣菌、石膏样小孢子菌对c Jun信号通路的差异性诱导。     

64组家庭人畜共患皮肤癣菌病分析北大核心CSCD

目的 了解人畜共患皮肤癣菌病病原菌分布及流行病学情况.方法 收集患者和所养宠物均培养出皮肤癣菌的64组病例,按家庭分组进行调查分析,同时运用ITS序列测定和随机扩增DNA多态性（RAPD）进行分子鉴定,分析两者的同源性.结果 64组组内均培养出同一菌种,共分离出146株菌,菌种为犬小孢子菌（93株）或指（趾）间毛癣菌（53株）,其中42组分离出犬小孢子菌（65.7％）,22组分离出指（趾）间毛癣菌（34.3％）.14个养兔组、6个养猫组、2个养狗组均培养出指（趾）间毛癣菌,34个养猫组、8个养狗组培养出犬小孢子菌.有明显临床症状（红斑脱屑、脱毛等）的宠物54只（75.0％）,无明显症状的18只（25.0％,全部是猫）.18只无症状猫中,14只培养出犬小孢子菌,4只培养出指（趾）间毛癣菌.ITS序列测定和RAPD显示组内病原菌间具有高度同源性.结论 犬小孢子菌和指（趾）间毛癣菌是人畜共患皮肤癣菌病的主要病原菌,两者具有宿主特异性,人畜传播是人畜共患皮肤癣菌病的传播途径,应重视无临床症状动物（携带者）.     

690例浅部真菌病及其病原菌分析

目的：了解本所浅部真菌病发病情况及其病原菌菌种分布特点。方法：对拟诊为浅部真菌病的I临床标本行镜检、分离培养及菌种鉴定。结果：在培养阳性的690例浅部真菌病患者中，甲真菌病375例（54．3％）、手足癣112例（16．2％）、体癣29例（4．2％）、股癣51例（7．4％）、头癣32例（4．6％）、糠枇孢子菌毛囊炎52例（7．5％）、花斑癣39例（5．7％）；镜检阳性率为61．1％。分离的690株真菌中，皮肤癣菌共365株（52．9％），以红色毛癣菌最多，为321株（46．5％），犬小孢子菌次之，为29株（4．2％），须癣毛癣菌7株（1．0％）；此外，念珠菌与酵母菌305株（44．2％），霉菌20株。结论：在本组浅部真菌病中，甲真菌病最常见，其致病菌仍以红色毛癣菌占主导地位，念珠菌与酵母样真菌所占比例较往年有大幅增多。     

1%盐酸布替萘芬乳膏治疗体股癣、足癣疗效观察

目的：评价1％盐酸布替萘芬乳膏治疗体股癣、足癣的临床疗效和安全性。方法：采用多中心、随机、双盲、平行对照的方法．试验组外用1％盐酸布替萘芬乳膏,对照组外用1％联苯苄唑乳膏。结果：体股癣患者停药时试验组与对照组痊愈率分别为32．76％和38．98％。有效率分别为93．10％和94．92％;停药2周时,试验组与对照组痊愈率分别为62．07％和64．41％,有效率分别为93．10％和96．61％。足癣患者停药时．试验组与对照组痊愈率分别为29．31％和30．00％．有效率分别为89．66％和85．00％;停药2周时,试验组与对照组痊愈率分别为48．28％和43．33％．有效率分别为91．38％和86．67％。局部不良反应发生率,两试验组为5．13％;两对照组为4．17％。上述各项指标,两组比较差异无统计学意义。结论：1％盐酸布替萘芬乳膏治疗体股癣、足癣安全有效。     

Once-weekly oral doses of fluconazole 150 mg in the treatment of tinea corporis/cruris and cutaneous candidiasis

Ninety-five adult out-patients with tinea corporis and/or tinea cruris participated in a multicentre open non-comparative study investigating the safety and efficacy of 1-4 once-weekly doses of oral fluconazole 150 mg. Trichophyton rubrum was isolated most frequently (67 of 86 mycologically evaluable patients). A mean of 2.6 doses of fluconazole was administered; patients infected with Candida albicans or Epidermophyton floccosum required an average of 2 doses compared to 3-4 doses in patients infected with other organisms. Clinical cure was obtained in 85 of 92 (92%) patients at the last post-treatment evaluation, with the remaining seven patients being substantially improved. At long-term follow-up, 28-30 days after the last dose, 80 of 91 (88%) patients were assessed as clinically cured, three (3%) patients were improved and eight (9%) patients failed. Among the long-term clinical failures, there was one diagnosis of tinea corporis (3% failure rate) and seven diagnoses of tinea cruris (12% failure rate). Mycological evidence of infection occurred in only 1 of 86 patients assessed at the last post-treatment follow-up. Mycological relapse occurred in nine (11%) patients at long-term follow-up; one patient was infected with Trichophyton mentagrophytes and eight patients were infected with T. rubrum. Relapse occurred in 2 of 29 (7%) patients with tinea corporis and eight of 57 (14%) patients with tinea cruris (one patient who relapsed had both tinea corporis and cruris). There was no correlation between the number of doses received and the mycological response or relapse rates at long-term follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)     

Clinicomicrobiological aspects of tinea cruris in madras

A total of 242 patients with clinically diagnosed tinea cruris were screened and 181 (74.7 %) were found to be positive in culture for dermatophytes. 93.9% of infections were caused by Trichophyton spp., of which 58.4% were Trichophyton rubrum, 5.5% were Epidermophyton floccosum, 3.8% were Trichophyton tonsurans and we had a single isolate of Microsporum gypseum complex. Incidence of tinea cruris was higher in males (95.6%) than in females (4.4%). 45% of the cases were recurrent and 38% of cases were chronic tinea cruris. Three patients had granulomatous lesion. Zoophilic T mentagrophytes was the major aetiologic agent isolated from all the 3 cases of granulomatous tinea cruris.     

136例股癣发病情况及菌种分析

目的：分析兰州一综合医院分离的股癣病原菌种方法：对临床拟诊为股癣的患者，取标本行10％KOH涂片镜检、分离培养及菌种鉴定：结果：临床拟诊为股癣的169例患者（同时合并足癣者56例）真菌镜检阳性136例（80．47％）；培养分离菌株125株，红色毛癣菌112株（89．60％）、念珠菌9株（7．20％），其中包括白念珠菌8株（6．40％）、近平滑念珠菌1株（0．80％），行膏样毛癣菌4株（3．20％）：结论：肥胖成年男性易患股癣；足癣是股癣的重要传染源；兰州地区股癣主要致病菌为红色毛癣菌。     

美克治疗体股癣、手足癣、花斑癣和皮肤念珠菌病疗效观察

目的评价美克(1%联苯苄唑乳膏)治疗体股癣、手足癣、花斑癣和皮肤念珠菌病的临床疗效和安全性。方法采用多中心、随机、平行对照的方法,试验组外用美克,对照组外用欣欣(1%盐酸布替萘芬乳膏)。结果体股癣患者停药时试验组与对照组痊愈率分别为42.20%和39.45%,有效率分别为94.49%和91.74%;停药2w时,试验组与对照组痊愈率分别为85.32%和82.56%,有效率分别为97.24%和96.33%。手足癣停药时试验组与对照组痊愈率分别为39.87%和37.34%,有效率分别为85.54%和84.81%;停药2w时,试验组与对照组痊愈率分别为59.49%和58.22%,有效率分别为89.24%和86.70%。花斑癣患者停药时试验组与对照组痊愈率分别为50.72%和52.17%,有效率分别为79.71%和76.81%;停药2w时,试验组与对照组痊愈率分别为66.67%和63.76%,有效率分别为84.05%和81.16%。皮肤念珠菌病患者停药时试验组与对照组痊愈率分别为34.88%和39.53%,有效率分别为72.09%和76.74%;停药2w时,试验组与对照组痊愈率分别为65.11%和67.44%,有效率分别为88.37%和86.04%。局部不良反应发生率各试验组合计为5.27%;各对照组合计为5.54%。上述各项指标,各病种试验组与对照组比较差异均无统计学意义。结论美克治疗体股癣、手足癣、花斑癣和皮肤念珠菌病安全有效。     

One-week therapy with oral terbinafine in cases of tinea cruris/corporis

The use of oral terbinafine in the treatment of superficial dermatophyte infections has been extensively studied, using different treatment regimens. To evaluate the efficacy of short-term therapy with oral terbinafine in cases of tinea cruris/corporis. 22 patients (21 male and one female) with mycologically proven tinea cruris/corporis, were included in the present study. Each patient received one tablet of terbinafine 250 mg daily for 1 week. Patients were followed-up for 6 weeks after completion of treatment. Clinical and mycological assessments were performed at the end of treatment, and at the end of the follow-up period. The mean sum of scores of signs and symptoms in all patients decreased significantly from 12-36 before treatment to 0 at the end of the follow-up period, and mycological investigations were negative in all patients at the end of the follow-up period. Our results show that 1-week therapy with oral terbinafine is highly effective in the treatment of tinea cruris/corporis.     

Study of Dermatomycoses

ABSTRACT: 555 clinically suspected cases of dermatomycoses were studied for causative fungi and their detailed clinical manifestations. The fungi were demonstrated on routine KOH mount and/or by culture in 464 cases (83.6%). Tinea corporis was the predominant fungal infection (30.6%) and T. rubrum was the main etiologic agent. Favus (T. schoenleini) was found only in cases from Jammu and Kashmir valleys. There was a high incidence of tinea capitis among children. Trichophyton tonsurans was isolated in cases of tinea corporis, tinea cruris, and tinea pedis. Trichophyton ferrugineum and T. verrucosum were isolated from cases of tinea capitis; and Microsporum gypseum was isolated from tinea cruris infections.     

Recalcitrant tinea corporis as the presenting manifestation of patch-stage mycosis fungoides

Mycosis fungoides is a cutaneous T-cell lymphoma. Its presence, which denotes an altered immune system, may make treatment of otherwise simple cutaneous infections difficult. In the case presented here, a patient with widespread tinea corporis poorly responsive to several oral antifungals was noted as having a background poikilodermatous slightly scaly eruption. Results of a skin biopsy during therapy with oral antifungal medications showed evidence of tinea corporis; atrophy of the epidermis; a superficial, perivascular, and interstitial lymphocytic infiltrate with numerous atypical lymphocytes; and exocytosis of atypical lymphocytes into the epidermis with formation of microabscesses-findings consistent with the diagnosis of mycosis fungoides. Treatment with PUVA (oral psoralen and UVA light) and oral itraconazole led to long-term remission of the mycosis fungoides and the associated tinea corporis. Immune suppression may have contributed to the recalcitrant nature of our patient's dermatophyte infection. Underlying cutaneous, systemic, or iatrogenic disorders associated with immune dysfunction should be considered in patients with recalcitrant dermatophyte infections.     

浅部真菌病2600例病原菌分析

目的了解昆明地区浅部致病真菌的分布情况。方法对本科2010年1月-2011年6月拟诊为浅部真菌病患者的临床标本再次进行镜检和分离培养及菌种鉴定,并对结果进行统计学分析。结果 7944份临床送验标本中,直接涂片镜检阳性率29.39%,培养阳性率19.70%,而镜检和(或)培养的阳性率为32.73%,显著高于单一的镜检或培养。上述3种方法的真菌检出率差异均有统计学意义(P均<0.005)。分离的1565株浅部致病真菌中,红色毛癣菌1088株(69.52%),马拉色菌216株(13.80%),须癣毛癣菌118株(7.54%)。镜检和(或)培养阳性的2600例浅部真菌病患者中,足癣803例(30.88%),甲真菌病424例(16.31%),股癣386例(14.85%),体癣364例(14.00%),花斑癣259例(9.96%),手癣194例(7.46%),马拉色菌毛囊炎83例(3.19%)和头癣46例(1.77%),同时患有手癣和足癣41例(1.58%)。结论镜检结合培养法的阳性率显著高于单一镜检或培养法,昆明地区浅部真菌的病种以足癣、甲真菌病、股癣较多见,浅部致病真菌以红色毛癣菌和马拉色菌为主。     

利拉萘酯乳膏治疗体股癣及足癣的多中心随机双盲对照观察

目的 探讨2%利拉萘酯乳膏治疗体股癣、足癣的临床疗效和安全性。方法 采用多中心随机双盲阳性药平行对照法，分别在3个中心进行，入选288例患者，2%利拉萘酯乳膏试验组144例，1% 联苯苄唑乳膏对照组144例；每组中体股癣患者各72例，足癣患者各72例。每日涂药1次，足癣疗程4周，每2周复诊1次；体股癣疗程2周，每周复诊1次；停药后2周均再复诊1次。结果 试验组体股癣患者中有１例脱落。停药时体股癣试验组的痊愈率和有效率分别为59.2%和94.4%，足癣试验组分别为41.7%和81.9%，与对照组比较，差异均无统计学意义（P ＞ 0.05）。在用药结束后2周时，体股癣试验组的痊愈率和有效率分别为67.6%和94.4%，足癣试验组分别为54.2%和81.9%，与对照组比较，差异无统计学意义（P ＞ 0.05）。在用药结束后2周，体股癣和足癣试验组符合方案分析集真菌学清除率分别为97.18%和90.28%，试验组和对照组差异均无统计学意义（P ＞ 0.05）。用药后发生的不良反应表现为用药部位红肿、疼痛，其中体股癣试验组不良反应发生率为2.78%。结论 2%利拉萘酯乳膏治疗体股癣、足癣有良好的疗效和安全性。