Ouchi Takeshi, Nagao Keisuke, Hata Yasuki, Otuka Tomoko, Inazumi Toyoko
Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
J Dermatol. 2005 Jul;32(7):565-8. doi: 10.1111/j.1346-8138.2005.tb00799.x.
We report a case of dermatophytosis in a Judo wrestler caused by Trichophyton tonsurans (T. tonsurans) with clinical features that mimicked the concentric rings of tinea imbricata. Tinea imbricata is a unique dermatophytosis caused by Trichophyton concentricum (T. concentricum), observed endemically in subtropical to torrid zones and characterized by impressive concentric rings. We found three similar cases of the dermatophytosis in the literature that were reported as tinea pseudoimbricata or tinea indecisiva. All of these cases were associated with systemic or local immunosuppression, perhaps simulating the mechanism of tinea imbricata, which is known to involve the lack of delayed type hypersensitivity to T. concentricum. These cases imply that iatrogenic immunosuppression may perhaps play an important role in the development of the unique clinical features mimicking tinea imbricata. Furthermore, three of the four cases, including the presented case, were caused by T. tonsurans. It may be necessary to consider T. tonsurans infection when multiple concentric erythemas are encountered.
我们报告一例由断发毛癣菌引起的柔道摔跤运动员皮肤癣菌病,其临床特征类似叠瓦癣的同心环。叠瓦癣是由同心毛癣菌引起的一种独特的皮肤癣菌病,在亚热带至热带地区呈地方性流行,其特征为明显的同心环。我们在文献中发现三例类似的皮肤癣菌病病例,报告为假性叠瓦癣或难断癣。所有这些病例均与全身或局部免疫抑制有关,可能模拟了叠瓦癣的发病机制,已知叠瓦癣涉及对同心毛癣菌迟发型超敏反应的缺乏。这些病例表明,医源性免疫抑制可能在模仿叠瓦癣的独特临床特征的发展中起重要作用。此外,包括本病例在内的四例病例中有三例由断发毛癣菌引起。当遇到多个同心红斑时,可能有必要考虑断发毛癣菌感染。