Ueno Takashi, Kume Hikaru, Mitsuishi Tsuyoshi, Morimoto Kensuke, Kikuchi Izumi, Kawana Seiji
Department of Dermatology, Nippon Medical School, Tokyo, Japan.
J Dermatol. 2008 Dec;35(12):778-81. doi: 10.1111/j.1346-8138.2008.00568.x.
We describe a case of systemic lupus erythematosus (SLE)-associated cutaneous cryptococcosis. A 32-year-old woman with SLE and lupus nephritis presented with the erythematous maculae on the chest and the extremities, in which encapsulated yeasts were revealed, and was diagnosed with secondary cutaneous cryptococcosis. We administered fluconazole (FLCZ) and then itraconazole (ITCZ) instead of amphotericin B (AMPH-B) to avoid the risk of renal toxicity of AMPH-B in the patient. While treatment with FLCZ was not particularly effective, repeated intermittent administration of ITCZ on a "3-day on/off cycle" (i.e. medication on 3 consecutive days and suspension for the next 3 days in turn) achieved complete remission of the cryptococcosis.
我们描述了一例系统性红斑狼疮（SLE）相关的皮肤隐球菌病病例。一名患有SLE和狼疮性肾炎的32岁女性，胸部和四肢出现红斑性斑疹，从中发现了有荚膜的酵母，被诊断为继发性皮肤隐球菌病。为避免两性霉素B（AMPH - B）对该患者产生肾毒性风险，我们先给予氟康唑（FLCZ），之后改用伊曲康唑（ITCZ）。虽然使用FLCZ治疗效果不佳，但采用“3天用药/停药周期”（即连续3天用药，接下来3天停药，依次交替）反复间歇性给予ITCZ，使隐球菌病完全缓解。
