鲁比切克毛癣菌致体癣一例

【摘要】 患者男，54岁，右侧臀部红斑伴瘙痒半年，皮损逐渐扩大，出现脱屑。体检见右侧臀部红色斑片，覆散在鳞屑，边界清楚，边缘略高于皮面，鳞屑明显。真菌学检查：取皮屑行10% KOH直接镜检，见带有折光性的透明菌丝。皮屑真菌培养，培养物在形态学、生理学和遗传学上有以下几个方面特征：①沙氏葡萄糖琼脂培养基上菌落呈绒毛状，马铃薯葡萄糖培养基培养产红色色素，中央有紫红色色素颗粒形成；②小培养见梨形或棒状小分生孢子，圆柱状大分生孢子，丰富的节孢子；③尿素酶试验阳性，毛发穿孔试验阴性。取培养菌落提取DNA进行分子生物学鉴定，扩增菌株rDNA的ITS1-4区，测序结果与已知的鲁比切克毛癣菌或红色毛癣菌ITS1-ITS4片段序列进行比对，显示完全一致。分离菌株鉴定为鲁比切克毛癣菌。诊断：鲁比切克毛癣菌所致体癣。治疗：口服特比萘芬片0.25 g·kg-1·d-1，2周后皮损消退。

Tinea corporis caused by Trichophyton raubitschekii:the first report in China

A 54-year-old man presented with a pruritic erythematous patch on the buttock that had been expanding over a periond of half a year. Physical examination disclosed a weU-marginated erythematous patch measuring 7 cm×12 cm;there were scattered scales on the surface,and the border was elevated.Microscopic examination of the scales with potassium hydroxide exhibited refractive hyaline hypha. Fungal culture showed velvety colony which developed on Sabouraud's dextrose agar (SDA) plate. The fungus purified from potato dextrose agar (PDA) plate was found to have abundant rod-shaped microconidia and pear-shaped macroconidia by microscopy. The isolate was positive for urease reaction but negative for hair perforation test. The sequence of rDNA ITS region of the isolate was assessed and compared against Genbank database. A full consistence was observed between the ITS sequence of the fungal strain and the referrence sequence of ITS of T. rubrum. The isolate was identified as T. raubitschekii according to the above findings. The lesion completely healed after 2 weeks of treatment with oral terbinafine.