原发性皮肤毛霉病

报告1例原发性皮肤毛霉病.患者男,57岁.右前臂埋置静脉套管针17 d后局部出现红肿,迅速坏死并扩大.患者患2型糖尿病及慢性肾功能不全.皮肤科检查示右前臂大片坏死区,上覆黑色焦痂及渗出.取黑痂及渗液行真菌镜检,镜下可见大量粗大、无分隔、垂直分枝的菌丝,培养第2天即有棉花糖样菌落生长,初步诊断为皮肤毛霉病.皮损行组织病理检查,PAS染色示真皮及皮下组织可见较多粗大、无分隔菌丝,确诊为皮肤毛霉病.给予两性霉素B脂质体泵入、坏死组织清创术、术后外敷两性霉素B脂质体溶液及外用人成纤维细胞生长因子.患者伤口愈合良好,随访4个月无复发.

Primary cutaneous mucormycosis: a case report

A case of primary cutaneous mucormycosis is reported.A 59-year-old male patient presented with erythema on his right forearm for 17 days at the site of detained intravenous cannula needle,followed by rapid enlargement of the lesions and necrosis.He had Type Ⅱ diabetes and chronic renal insufficiency.Dermatological examinations showed large area of necrosis on his right forearm,covered with black eschar and exudation.Fungal examination of both eschar and secretion showed broad hyphae with branches at right angles.PAS staining of biopsied specimens revealed plenty of broad hyphae without septum in the dermis and subcutaneous tissues.Fungal culture of the eschar showed cotton candy-like colony.The patient wag diagnosed as primary cutaneous mucormycosis.Complete excision of total necrotic tissue was performed,and intraveneous liposomal amphotericin B was given.Topical solution of liposomal amphotericin B and basic fibroblast growth factor was used after debridement.The disease of the patient was well controlled.No recurrence was found after 4-month follow-up.