CAJ | 학술논문

患者女,68岁,福建农民,头顶部片状脱发3个月. 体检:头顶部形状不规则暗红斑片,少量脱屑. 红斑区毛发根部紧贴头皮脱落,呈黑点状,脱发区毛囊轻度红肿,皮损区头皮局部有轻度波动感. 直接镜检可见断发内大量孢子集聚沿发干呈链状分布,真菌培养分离黄白色绒毛状菌落,小培养镜下可见棒形,梨形小分生孢子,尿素酶试验阳性. 临床分离株进行rDNA ITS扩增测序,BLAST比对与GenBank中断发毛癣菌序列同源性100%. 诊断:断发毛癣菌所致黑点癣. 治疗采用伊曲康唑0.2~0.4/d口服及酮康唑洗剂、曲安奈德益康唑乳膏及酮康唑乳膏等外用,总疗程2个月,皮损完全消退,断发重新长出,无瘢痕秃发形成. 停药后随访半年无复发.
환자녀,68세,복건농민,두정부편상탈발3개월. 체검:두정부형상불규칙암홍반편,소량탈설. 홍반구모발근부긴첩두피탈락,정흑점상,탈발구모낭경도홍종,피손구두피국부유경도파동감. 직접경검가견단발내대량포자집취연발간정련상분포,진균배양분리황백색융모상균락,소배양경하가견봉형,리형소분생포자,뇨소매시험양성. 림상분리주진행rDNA ITS확증측서,BLAST비대여GenBank중단발모선균서렬동원성100%. 진단:단발모선균소치흑점선. 치료채용이곡강서0.2~0.4/d구복급동강서세제、곡안내덕익강서유고급동강서유고등외용,총료정2개월,피손완전소퇴,단발중신장출,무반흔독발형성. 정약후수방반년무복발.
A 68?year old female farmer presented with hair loss for 3 months. Physical examination showed irregularly dark red patch with a little amount of scales.The hairs in the red lesion broke off from the scalp presented with black dotted like,while the hair follicles showed swollen with mild fluctuation. Direct fungal microscopic examination presented a large amount of chain?like spores distribution along the inside of hair shaft. Fungal culture isolated yellow?white woolly colony presented with short rod?like or pear?shaped microconidiain by slide culture and positive urease test. Molecular identification by BLAST based on rDNA ITS sequencing confirmed as Trichophyton tonsurans.The diagnosis was confirmed as black?dot ringworm caused by Trichophyton tonsurans.Therapeu?tic drugs included oral itraconazole, 0. 2?0. 4 per day, external ketoconazole lotion, triamcinolone acetonide and econazole nitrate cream,and ketoconazole cream.After 2 months treatment,skin lesions completely faded and broken hair grew back without scarring al?opecia.No recurrence after treatment was observed in 6?month follow?up.