Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Mycoses. 2012 Nov;55(6):501-6. doi: 10.1111/j.1439-0507.2012.02191.x. Epub 2012 Apr 5.
Deep cutaneous mycoses can cause significant morbidity and mortality, especially in immunocompromised patients. There have been few studies focusing on deep cutaneous mycoses and there are no data from Asian countries. This study aimed to investigate clinical characteristics, underlying predisposing factors, aetiological organisms and outcomes in patients with deep cutaneous mycoses. A retrospective medical record review of patients with deep cutaneous mycoses treated at a tertiary referral centre in Korea from 1999 to 2010. Forty-one cases of deep cutaneous mycosis were identified (median age: 49). Most patients (32/41) had impaired immunological status, and seven of the remaining nine had a history of physical trauma. Neutropenia and long-term use of antibiotics were detected in 13 and 12 patients respectively. Nodular skin lesions were the most common type (17/41) and the morphology of the lesions varied. Fungal organisms were identified by culture and histopathology of skin specimens. Candida (16/41) was the most common organism, followed by Aspergillus, Alternaria, Fusarium (4/41 each). Systemic antifungal treatment was successful in 28 patients, while nine patients died from the fungal infection. Our study may lead to improved insights into deep cutaneous mycoses as their incidence is increasing and they vary in different clinical settings.
深部真菌病可导致严重的发病率和死亡率，尤其是在免疫功能低下的患者中。目前针对深部真菌病的研究较少，也没有来自亚洲国家的数据。本研究旨在调查深部真菌病患者的临床特征、潜在的诱发因素、病原体和预后。对韩国一家三级转诊中心 1999 年至 2010 年期间治疗的深部真菌病患者进行回顾性病历审查。共确定了 41 例深部皮肤真菌感染（中位数年龄：49 岁）。大多数患者（32/41）免疫功能受损，其余 9 例中有 7 例有外伤史。13 例患者存在中性粒细胞减少症，12 例患者长期使用抗生素。结节性皮肤病变是最常见的类型（17/41），病变形态多样。通过皮肤标本的培养和组织病理学鉴定出真菌病原体。最常见的病原体是念珠菌（16/41），其次是曲霉属、链格孢属、镰刀菌属（各 4/41）。28 例患者接受全身抗真菌治疗后成功治愈，9 例患者因真菌感染死亡。我们的研究可能会对深部真菌病有更深入的了解，因为其发病率正在增加，而且在不同的临床环境中表现也不同。
