Chen Yu-Ting, Lin Hao-Chiung, Huang Chieh-Chen, Lo Yuan-Hsin
Department of Dermatology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Int J Dermatol. 2006 Apr;45(4):429-32. doi: 10.1111/j.1365-4632.2006.02619.x.
Although the dematiaceous fungus Veronaea botryosa is rarely encountered clinically, it can be pathogenic.
A patient with a history of diabetes mellitus, coronary artery disease, and Cushing's syndrome had recurrent multifocal, crusted, brownish-red noduloplaques on the right forearm, left upper limb, and right knee. A skin biopsy was obtained for histopathology and fungal cultures.
The histopathology showed brownish hyphae and yeast-like cells scattered in granulomatous infiltrates. Slide cultures revealed erect and straight conidiophores with two-celled cylindrical conidia, which have round tops and truncated bases. The fungus was identified as Veronaea botryosa. The disease slowly progressed despite a 6-month itraconazole regimen (200 mg daily). Subsequent use of Amphoterecin B produced only mild clinical improvements. Susceptibility tests showed resistance to both agents.
Cutaneous phaeohyphomycosis caused by V. botryosa is extremely rare. Antifungal susceptibility tests are important for choosing the appropriate drug and predicting the clinical outcome.
尽管皮肤癣菌 Veronaea botryosa 在临床上很少见，但它可能具有致病性。
一名有糖尿病、冠状动脉疾病和库欣综合征病史的患者，其右前臂、左上肢和右膝出现反复发作的多灶性、结痂的棕红色结节斑块。取皮肤活检进行组织病理学检查和真菌培养。
组织病理学显示棕色菌丝和酵母样细胞散在于肉芽肿性浸润中。玻片培养显示直立且直的分生孢子梗，带有双细胞圆柱形分生孢子，其顶部圆形，基部截形。该真菌被鉴定为 Veronaea botryosa。尽管进行了为期6个月的伊曲康唑治疗方案（每日200毫克），病情仍缓慢进展。随后使用两性霉素B仅产生了轻微的临床改善。药敏试验显示对这两种药物均耐药。
由 Veronaea botryosa 引起的皮肤暗色丝孢霉病极为罕见。真菌药敏试验对于选择合适的药物和预测临床结果很重要。
