CAJ | 학술논문

患者女,53岁.右下肢条带状排列损害,反复起疹30余年.损害由结节和暗红色浸润斑块覆污秽色痂组成,部分损害表面有黑点.直接镜检和组织病理可见褐色厚壁孢子,真菌培养及分子生物学鉴定病原菌为裴氏着色芽生菌.体外真菌药敏试验显示对特比萘芬及伊曲康唑敏感.联合应用特比萘芬和伊曲康唑治疗,辅以手术切除和局部热疗.治疗10个月后,脓性分泌物消失,皮损面积缩小,治愈部位留下色素沉着.对着色芽生菌病联合特比萘芬和伊曲康唑口服,辅以红光热疗及手术切除,综合疗效较好.
환자녀,53세.우하지조대상배렬손해,반복기진30여년.손해유결절화암홍색침윤반괴복오예색가조성,부분손해표면유흑점.직접경검화조직병리가견갈색후벽포자,진균배양급분자생물학감정병원균위배씨착색아생균.체외진균약민시험현시대특비내분급이곡강서민감.연합응용특비내분화이곡강서치료,보이수술절제화국부열료.치료10개월후,농성분비물소실,피손면적축소,치유부위류하색소침착.대착색아생균병연합특비내분화이곡강서구복,보이홍광열료급수술절제,종합료효교호.
A 53-year-old female patient presented with bandlike lesions on the right lower limb for 30 years.Physical examination revealed a chain of nodules and dull erythematous infihrative plaques covered with dirty crusts.Black dots were observed on the surface of some lesions.Direct microscopic examination and histopathology showed brown chlamydospores.The pathogenic strain was identified as Fonsecaea pedrosoi by fungal culture and molecular biology.Drug sensitivity test in vitro showed that the F.pedrosoi strain was sensitive to itraconazole and terbinafine.The patient was managed with oral itraconazole and terbinafine plus surgical excision and local hyperthermia treatment.After 10-month treatment,purulent discharge disappeared and skin lesions diminished with pigmentation in the lesional sites.Oral itraconazole and terbinafine plus sursical excision and local hypeahermia therapy shows satisfactory efficacy in the management of chromoblastomycosis.