Chiou C B, Huang F Y, Hsu C H, Hung H Y, Chen S C
Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1990 Nov-Dec;31(6):396-401.
Congenital cutaneous candidiasis is a very rare disease. We reported two newborn infants in whom generalized skin eruption was noted at birth, characteristics of erythematous papules and pustules. The eruption involved head, face, neck, trunk and extremities. Candida albicans was demonstrated on direct KOH smear, by surface fungal cultures and skin biopsy. The disease implies a congenital intrauterine infection and is different from neonatal candidiasis which manifests as thrush, diaper dermatitis. The route of infection is ascending in congenital cutaneous candidiasis. The skin eruption is usually noted at birth or within 12 hours after delivery as a diffuse erythematous maculopapula, with pustules or vesicles distributed over head, face, neck, trunk and extremities. There is no fever; other constitutional signs are lacking. No evidence of impaired immunological responsiveness has been noted in previous study. Clinical features, direct smear examination of specimen and appropriate cultures are useful in differentiating the lesions from other more common dermatoses of the neonatal period. Topical antifungal therapy is sufficient unless systemic candidiasis is present. Prognosis for congenital cutaneous candidiasis is good.
先天性皮肤念珠菌病是一种非常罕见的疾病。我们报告了两名新生儿，他们出生时即出现全身性皮疹，表现为红斑丘疹和脓疱。皮疹累及头部、面部、颈部、躯干和四肢。直接氢氧化钾涂片、表面真菌培养及皮肤活检均证实有白色念珠菌。该病提示先天性宫内感染，与表现为鹅口疮、尿布皮炎的新生儿念珠菌病不同。先天性皮肤念珠菌病的感染途径为上行性。皮疹通常在出生时或出生后12小时内出现，为弥漫性红斑丘疹，脓疱或水疱分布于头部、面部、颈部、躯干和四肢。无发热，也无其他全身症状。既往研究未发现免疫反应受损的证据。临床特征、标本直接涂片检查及适当的培养有助于将病变与新生儿期其他更常见的皮肤病相鉴别。除非存在系统性念珠菌病，局部抗真菌治疗就足够了。先天性皮肤念珠菌病的预后良好。
