伊曲康唑治疗着色芽生菌病后出现暂时性增生性皮疹一例

患者，男，67岁。鼻部增生性斑块4个月，有外伤史。实验室检查：组织病理可见真菌孢子，真菌镜检可见硬壳小体，真菌培养与菌种鉴定为卡氏枝孢瓶霉。予伊曲康唑、热敷治疗，患者治疗第1个月后原皮损部位出现的增生性皮疹，继续原治疗方案3个月，增生性皮疹萎缩，基本痊愈。出现增生性皮疹的原因猜测为伊曲康唑治疗后，皮损部位的真菌细胞膜功能受损，大量异种蛋白被机体识别，加重了局部的炎症反应，具体原因还需要进一步研究。

Hyperplastic rash occurred in a patient with chromoblastomycosis after treatment with itraconazole

A 67-year-old male presented with plaque on nose for 4 months and has a history of injuries. Histologic examination showed spores. Brown sclerotic cells were found under microscope. Chladophialophora carrionii was identified by culture and ITS sequencing. Itraconazol and hot compress were given. The patient had hyperplastic rash at the original site after the 1st month of treatment. After continuing the original treatment for 3 months, the hyperplastic rash atrophied and basically recovered. The reason for the occurrence of hyperplastic rash is speculated to be that after itraconazole treatment, the function of fungal cell membrane in the lesion site is impaired, a large number of xenogeneic proteins are recognized, and the local inflammatory reaction is aggravated. The real reason needs to be further studied.