花斑糠疹和马拉色菌毛囊炎致病菌菌种分析

目的使用限制性内切酶方法鉴定临床花斑糠疹和马拉色菌毛囊炎致病菌菌种分布并比较其差异。方法收集临床花斑糠疹和马拉色菌毛囊炎标本,植于Leeming-Notman培养基。培养阳性菌株提取DNA,扩增其26srDNA片段,用CfoⅠ酶和BstF51酶切。结果共鉴定花斑糠疹阳性菌株128份,其中糠秕马拉色菌49份,合轴马拉色菌23份,球形马拉色菌26份,钝性马拉色菌6份,M.japponica 1份,斯洛菲马拉色菌1份,混合感染标本22份。共鉴定马拉色菌毛囊炎阳性标本70份,其中糠秕马拉色菌43株,合轴马拉色菌5株,球形马拉色菌9株,钝性马拉色菌1株,混合感染标本12份。两种疾病菌种分布差异存在统计学意义(P=0.009)。结论花斑糠疹和马拉色菌毛囊炎致病菌菌种存在一定差异。限制性酶切方法为一种准确、快速的马拉色菌菌种鉴定方法。     

花斑糠疹和马拉色菌毛囊炎菌种分布特点分析

目的探讨花斑糠疹和马拉色菌毛囊炎的菌种分布特点。方法从临床诊断为花斑糠疹和马拉色菌毛囊炎的患者分离培养菌种,通过形态学和生理生化学方法鉴定菌种,并比较两组患者菌种分布情况。结果共收集花斑糠疹病例161例,培养阳性121株,其中合轴马拉色菌46株,糠秕马拉色菌13株,球形马拉色菌29株,钝性马拉色菌33株;马拉色菌毛囊炎135例,培养阳性114株,其中合轴马拉色菌52株,糠秕马拉色菌43株,球形马拉色菌13株,钝性马拉色菌6株。两种疾病菌种分布差异有显著性(P<0.005)。结论花斑糠疹和马拉色菌毛囊炎菌种分布存在差异,可能为两种疾病不同临床表现的原因之一,但结果尚需慎重解释,需要分子水平的进一步研究。     

花斑癣、马拉色菌毛囊炎、脂溢性皮炎马拉色菌诱发因素分析

目的调查昆明地区花斑癣、马拉色菌毛囊炎、脂溢性皮炎马拉色菌诱发因素,并比较三种疾病的诱发因素有无差异。方法收集花斑癣、马拉色菌毛囊炎、脂溢性皮炎(头皮屑)的病例,用自制的调查表对入选病例进行诱发因素调查,比较诱发因素在三种疾病间有无差异。结果共收集158例病例,男104例,女54例,平均年龄29.4岁,多汗、油性皮肤患者所占比例均超过60%,系统或局部使用糖皮质激素是马拉色菌毛囊炎的危险因素。结论马拉色菌感染好发于男性青壮年,多汗者易发生花斑癣,油性皮肤及使用糖皮质激素易发生马拉色菌毛囊炎。     

南通和南京马拉色菌毛囊炎临床调查及致病菌种分析

目的 探讨南通和南京马拉色菌毛囊炎的易感因素及致病菌种在不同地区、不同部位马拉色菌毛囊炎中的菌种分布情况。方法 对符合病例收集纳入标准的患者进行问卷调查,取毛囊内容物进行真菌涂片、培养;并根据形态学和生理生化特征进行菌种鉴定。结果 241例临床诊断为马拉色菌毛囊炎的患者,真菌涂片204例阳性,涂片阳性率84.65%;收集标本259份,共得阳性株213株,其中马拉色菌209株,念珠菌4株（占1.54%）,真菌培养阳性率82.24%。菌种鉴定：209株马拉色菌活化菌种后,可供鉴定的马拉色菌菌株186株,共检测到6个菌种的马拉色菌,其中糠秕马拉色菌111株（59.68%）、斯洛菲马拉色菌43株（23.12%）、合轴马拉色菌17株（9.14%）、球形马拉色菌9株（4.84%）、厚皮马拉色菌4株（2.15%）、钝形马拉色菌2株（1.08%）。不同个体、不同部位的菌种分布：胸部、后背、腹部和面颈部以糠秕马拉色菌为主,上肢、肩部和头顶以斯洛菲马拉色菌为主,下肢均为球形马拉色菌。同一个体、不同发病部位存在不同的菌种,主要为糠秕马拉色菌合并合轴或斯洛菲马拉色菌。 结论 南通和南京马拉色菌毛囊炎存在6种马拉色菌致病菌种,糠秕和斯洛菲马拉色菌是主要的致病菌种。     

随机扩增多态性DNA结合微流芯片鉴定马拉色菌的初步研究

目的 探讨微流芯片在马拉色菌鉴定与分型中的应用优势.方法 收集马拉色菌标准菌株及直接镜检阳性的花斑糠疹患者皮损处皮屑及马拉色菌毛囊炎患者皮损处毛囊内容物培养出的马拉色菌菌株进行DNA测序,鉴定菌种,随机扩增多态性DNA聚合酶链反应(RAPD-PCR)电泳分析及微流芯片基因型定量分析并聚类分析树状图.结果 共分离83株马拉色菌临床菌株,其中72株分离自花斑糠疹,11株分离自马拉色菌毛囊炎.大多数菌株均可被2种随机引物(S22、S24)扩增而获得清晰条带,但以S22引物扩增的条带更为稳定、清晰,作为主要引物.不同种马拉色菌通过微流芯片基因型定量分析得到不同大小的固定阳性条带,所有菌株均可见种间和种内多态性.在DNA测序的基础上,使用RAPD结合微流芯片方法,基本可将8种马拉色菌(糠秕、合轴、球形、厚皮、斯洛菲、日本、大和及皮肤马拉色菌)区别.结论 RAPD结合微流芯片方法作为一种快速、高通量、高灵敏性的分析技术,在马拉色菌种间菌株遗传多样性、亲缘关系的分析及新种鉴定中显示出一定优越性.     

糠秕马拉色菌所致荷兰男性脂溢性皮炎一例

糠秕马拉色菌是人体皮肤表面的常驻嗜脂性酵母,可引起皮肤浅部真菌感染如花斑糠疹和马拉色菌毛囊炎.脂溢性皮炎为发生在头皮、面部和躯干上半部的慢性红斑,常伴油性鳞屑,本病的病因尚不清楚,但近年研究提示,其发病机制与马拉色菌酵母有关.     

马拉色菌外分泌物的研究进展

马拉色菌为人体皮肤常住菌,亦是条件致病菌.马拉色菌与花斑糠疹、马拉色菌毛囊炎、特应性皮炎、头皮屑、脂溢性皮炎及银屑病等多种皮肤病相关.马拉色菌在生长繁殖过程中会产生多种外分泌物,包括蛋白质及代谢产物等.近年研究多集中在马拉色菌外分泌蛋白中,其中脂肪酶、蛋白酶、磷脂酶、脂氧合酶、过氧化氢酶和酸性磷酸酶等酶类物质的种类、数量、活性可能与马拉色菌的致病相关.马拉色菌外分泌性代谢产物研究较少,malassezin、吲哚[3,2?b]咔唑、β咔啉生物碱等代谢产物与生物体的功能变化有直接的联系.马拉色菌外分泌物的研究,对阐明马拉色菌的致病机制具有指导意义,可能为治疗提供新思路.     

马拉色菌相关皮肤病患者马拉色菌临床分离株脂肪酶活性分析

目的 比较分离自马拉色菌相关皮肤病的马拉色菌与分离自健康人的马拉色菌的脂肪酶活性（LPS）。方法 选取花斑糠疹、马拉色菌毛囊炎、脂溢性皮炎3种马拉色菌相关皮肤病和健康人皮肤的马拉色菌菌株并进行比较，采用脂肪酶试剂盒进行马拉色菌脂肪酶活性（LPS）测定。结果 疾病组LPS均值为0.0201±0.01937，健康组LPS均值为0.149±0.00515，两组比较，t值=1.160,P值=0.044，差异有统计学意义。结论 实验组脂肪酶活性高于健康组脂肪酶活性。     

球形马拉色菌致难辨认花斑糠疹2例

报告2例球形马拉色菌引起的难辨认花斑糠疹。均为青年男性,临床见背部或躯干边界较清的红斑,周边鲜红,上覆少许鳞屑,表现为体癣样,但经皮损取材真菌镜检,真菌培养和电镜检查,确诊为球形马拉色菌引起的花斑糠疹。     

头皮马拉色菌毛囊炎的诊断(附1例报告)

目的:报告1例成人头皮马拉色菌毛囊炎的病例并探讨头皮马拉色菌毛囊炎的诊断标准。方法:回顾分析2007年1月我科门诊发现的1例成人头皮马拉色菌毛囊炎患者的易感因素、临床表现、实验室检查及治疗情况。结果:根据患者头皮丘疹的特点、毛囊内容物直接镜检所见的大量成团簇样聚集的厚壁孢子和马拉色菌培养的阳性结果,可诊断为头皮马拉色菌毛囊炎。长期使用抗生素、多汗、皮脂溢出及搔抓是其诱发因素。结论:对于有易感因素并且反复出现头皮毛囊性红色丘疹患者,应作皮损毛囊内容物直接镜检及马拉色菌培养。     

从花斑癣患者的皮损区及非皮损区分离和鉴定马拉色菌

目的 研究花斑癣患者皮损区及非皮损区马拉色菌菌种构成;不同解剖部位、皮损颜色及各菌种的分布情况;患者病情和年龄与菌种构成的关系。方法 用无菌胶带粘取113例花斑癣患者皮损区及非皮损区共629个部位的皮屑,分别接种于含菜子油培养基中分离马拉色菌,用生理生化及形态学方法鉴定菌种。结果 皮损区与相对应的非皮损区马拉色菌分离阳性率无差别,非皮损区额部和胸背部分离阳性率高于上、下肢。共分离到565株马拉色菌,鉴定出合轴马拉色菌(44.78%)、糠秕马拉色菌(32.94%)、球形马拉色菌(11.68%)、钝形马拉色菌(5.84%)及限制马拉色菌(4.76%)共5个种,有27处(5.01%)同时分离到两种菌。皮损区与非皮损区菌种构成无明显差别,限制马拉色菌主要从额部分离出。菌种构成与皮损面积无关,但与皮损颜色和患者年龄有关。皮损颜色与病程无关。结论 花斑癣患者皮损区与非皮损区马拉色菌分离阳性率和菌种构成基本一致,与病情无关,而不同解剖部位、皮损类型及年龄患者的菌种构成有一定差异。     

Molecular analysis of Malassezia microflora in seborrheic dermatitis patients: comparison with other diseases and healthy subjects

Malassezia species colonize the skin of normal and various pathological conditions including pityriasis versicolor (PV), seborrhoeic dermatitis (SD) and atopic dermatitis (AD). To elucidate the pathogenic role of Malassezia species in SD, Malassezia microflora of 31 Japanese SD patients was analyzed using a PCR-based, culture-independent method. Nested PCR assay using the primers in the rRNA gene indicated that the major Malassezia species in SD were M. globosa and M. restricta, found in 93 and 74% of the patients, respectively. The detection rate and number of each species varied similarly in SD, PV and healthy subjects (HSs), whereas AD showed higher values. Real-time PCR assay showed that the lesional skin harbored approximately three times the population of genus Malassezia found in nonlesional skin (P<0.05), and that M. restricta is a significantly more common species than M. globosa in SD (P<0.005). Genotypic analysis of the rRNA gene showed that the M. globosa and M. restricta from SD patients fell into specific clusters, and could be distinguished from those collected from HSs, but not from those colleted from AD patients. Our results indicate that certain strains of M. restricta occur in the lesional skin of SD patients.     

Oily skin: specific features in Chinese women

BACKGROUND/PURPOSE: Inconsistent data are available on the various types of skin, their prevalence and characterization, particularly regarding Asian skins. This observation prompted to conduct a large study in China to assess the prevalence of oily skin and identify the specific factors related to that type of skin. METHODS: The multicentre trial involved 1787 Chinese women in Shenyang, Harbin, Beijing, Chengdu and Suzhou, between 18 and 65 years of age. Data on history of acne, the presence of environmental factors and a detailed self-evaluation of the skin were collected using a standardized questionnaire. A clinical evaluation of facial skin oiliness was carried-out by a dermatologist at each centre. Sebum secretion was measured on the forehead using Sebumeter SM810. Statistical analysis (multiple correspondence analysis) of typology was conducted based on self-evaluation data. RESULTS: According to self-evaluation data, oily skin prevalence in the overall Chinese population of the study was 25.6%. Self-evaluation results were quite consistent with sebum measurements and with clinical assessment by dermatologist. Parameters associated with oily skin were (i) shiny skin and a past history of acne, (ii) irregular menstruation, and (iii) highly reactive or sensitive skin. Moreover, a clear and significant link was noted between oily skin and the ingestion of spicy or sweet food. Lastly, sebum levels were found to be twice as high in Beijing as in the other cities and were correlated to higher oily skin prevalence. CONCLUSION: The study demonstrated the capacity of women for proper self-evaluation of their skin type. It also suggests a potential link between nutritional factors such as spicy and/or sweet diets and oily skin as well as between sensitive and oily skin in this population.     

Three etiologic facets of dandruff and seborrheic dermatitis: Malassezia fungi, sebaceous lipids, and individual sensitivity

Application of new molecular and biochemical tools has greatly increased our understanding of the organisms, mechanisms, and treatments of dandruff and seborrheic dermatitis. Dandruff results from at least three etiologic factors: Malassezia fungi, sebaceous secretions, and individual sensitivity. While Malassezia (formerly P. ovale) has long been a suspected cause, implicated by its presence on skin and lipophylic nature, lack of correlation between Malassezia number and the presence and severity of dandruff has remained perplexing. We have previously identified the Malassezia species correlating to dandruff and seborrheic dermatitis. In this report, we show that dandruff is mediated by Malassezia metabolites, specifically irritating free fatty acids released from sebaceous triglycerides. Investigation of the toxic Malassezia free fatty acid metabolites (represented by oleic acid) reveals the component of individual susceptibility. Malassezia metabolism results in increased levels of scalp free fatty acids. Of the three etiologic factors implicated in dandruff, Malassezia, sebaceous triglycerides, and individual susceptibility, Malassezia are the easiest to control. Pyrithione zinc kills Malassezia and all other fungi, and is highly effective against the Malassezia species actually found on scalp. Reduction in fungi reduces free fatty acids, thereby reducing scalp flaking and itch.     

Epidemiology of pityriasis versicolor in Adana, Turkey

Pityriasis versicolor is a common superficial mycoses of the skin. It is now recognized that the causative organisms of this infection are different species of Malassezia . The aim of this study was to determine the distribution of Malassezia species in patients with pityriasis versicolor in Adana, Turkey. In total, 97 patients positive for Malassezia elements, namely, yeast cells and short hyphae in microscopic examination, were included in the study. All samples were inoculated in plates containing modified Dixon's medium. However, only 44 of the patients (45.4%) showed Malassezia spp. in culture. Malassezia globosa (47.7%) was the most commonly isolated species followed by Malassezia furfur (36.4%) and Malassezia slooffiae (15.9%). Mixed Malassezia species were not isolated. In conclusion, M. globosa was found to be the predominant PV isolate in Adana, Turkey.     

The prevalence of Malassezia yeasts in patients with atopic dermatitis, seborrhoeic dermatitis and healthy controls

Cultures for Malassezia yeasts were taken from both normal-looking skin and lesional skin in 124 patients with atopic dermatitis, 16 patients with seborrhoeic dermatitis and from normal skin of 31 healthy controls. Positive Malassezia growth was found in fewer patients with atopic dermatitis (56%) than in patients with seborrhoeic dermatitis (88%) or in healthy controls (84%, p<0.01). In the patients with atopic dermatitis, fewer positive cultures were found in lesional (28%) than in non-lesional skin (44%, p<0.05), while positive cultures were found in 75% of both lesional and non-lesional skin of patients with seborrhoeic dermatitis (not significant). M. sympodialis dominated in patients with atopic dermatitis (46%) and in healthy controls (69%). In patients with seborrhoeic dermatitis both M. sympodialis and M. obtusa were cultured in 43%. A Malassezia species extract mixture would increase the possibility of detecting IgE sensitization to Malassezia in patients with atopic dermatitis.     

寻常性痤疮严重度的影响因素分析

目的探讨寻常性痤疮严重度的影响因素。方法于2007年1～12月对本科门诊确诊为寻常性痤疮的1129例患者,由首诊医生向患者发放自制的流行病学调查问卷。调查内容包括13项:性别、年龄、皮肤类型、家族史、初发年龄、平时饮食喜好、每日洗脸次数、每日睡眠时间、平均每天使用电脑时间、有无便秘、哪些季节加重、女性患者月经初潮年龄、有无月经不规律。采用SAS Version8.1软件包进行χ2检验、单因素Logistic回归分析和多因素Logistic回归分析。结果单因素Logistic回归分析显示,与痤疮严重程度相关的5个因素依次为性别、痤疮初发年龄、每日洗脸次数、油性皮肤、季节。多因素Logistic回归分析结果显示与痤疮严重程度相关的依次是性别(P<0.0001)、初发年龄(P<0.05)、喜食咸味(P<0.05)、皮肤类型(P<0.05)。结论寻常性痤疮的严重程度与油性皮肤、喜食咸味明显相关;初发年龄越小,痤疮越严重;且男性患者皮损较女性患者更严重。