Ohno Sayoko, Tanabe Hiroshi, Kawasaki Masako, Horiguchi Yuji
Ohno Dermatological Clinic, Nara, Japan.
J Dermatol. 2008 Sep;35(9):590-3. doi: 10.1111/j.1346-8138.2008.00528.x.
A 13-year-old Japanese boy presented with acute skin inflammation on the extremities. He belonged to a judo club of a junior high school in which club tinea capitis and tinea corporis seemed to be prevalent. Vesicles and pustules appeared on his right forearm and right leg. They increased in numbers and formed annular lesions. Pruritic erythema appeared surrounding these lesions. Direct microscopic examination of the lesions detected hyphae, and culture for the fungi yielded yellowish colonies. The result of culture from pustules revealed Staphylococcus aureus. At first, a topical antifungal drug and systemic antibiotics seemed to cure annular lesions, but pustules arose again. A large surrounding erythema was cured by topical treatment with a steroid agent. A biopsy specimen from a pustule showed hyphae of fungi within a hair shaft and in the bulb. The restriction fragment length polymorphism in the internal transcribed spacer regions of the ribosomal gene (polymerase chain reaction restriction fragment length polymorphism) revealed a banding pattern compatible with Trichophyton tonsurans. Treatment with systemic itraconazole was begun and lesions disappeared immediately. Systemic antifungal therapy was needed in our case. Tinea corporis with inflammation necessitates systemic antifungal therapy.
一名13岁的日本男孩出现四肢急性皮肤炎症。他隶属于一所初中的柔道俱乐部，该俱乐部似乎头癣和体癣流行。水疱和脓疱出现在他的右前臂和右腿上。数量增多并形成环状皮损。在这些皮损周围出现瘙痒性红斑。对皮损进行直接显微镜检查发现了菌丝，真菌培养产生淡黄色菌落。脓疱培养结果显示为金黄色葡萄球菌。起初，局部抗真菌药物和全身性抗生素似乎治愈了环状皮损，但脓疱再次出现。大的周围红斑通过局部使用类固醇药物治愈。脓疱的活检标本显示毛发干和毛球内有真菌菌丝。核糖体基因内部转录间隔区的限制性片段长度多态性（聚合酶链反应限制性片段长度多态性）显示出与断发毛癣菌相符的条带模式。开始使用全身性伊曲康唑治疗，皮损立即消失。我们的病例需要全身性抗真菌治疗。伴有炎症的体癣需要全身性抗真菌治疗。
