Department of Dermatology, Research Institute of Medical Science, Kanazawa Medical University, Uchinada, Japan.
J Dermatol. 2013 Aug;40(8):638-40. doi: 10.1111/1346-8138.12193. Epub 2013 Jun 5.
A 90-year-old Japanese woman, taking prednisolone (5-10 mg/day) for polyarthritis, presented to our hospital with multiple subcutaneous lesions on her left arm in 2009. Her history included excision of a phaeomycotic cyst on the left middle finger in 2007. There were three subcutaneous nodules approximately 15 mm in diameter around her left wrist and a large soft cystic lesion measuring 80 mm × 60 mm on her left elbow. A granuloma with neutrophilic infiltration was detected in the deep dermis of a biopsy specimen. Chains composed of round brown cells and short pseudomycelia were found in the granuloma. Fungal cultures from the samples confirmed Exophiala sp. to be the causative agent. Treatment with terbinafine and local hyperthermia seemed effective as all the lesions tended to subside. However, the patient died due to pneumonia approximately 1 month after commencement of therapy.
一位 90 岁的日本女性因多发性关节炎每天服用泼尼松龙（5-10mg/天），于 2009 年因左手臂多处皮下病变就诊于我院。她的病史包括 2007 年在左手中指切除了一个暗色真菌性囊肿。其左腕周围有三个直径约 15mm 的皮下结节，左肘有一个 80mm×60mm 的大软囊肿性病变。活检标本的真皮深层可见伴有中性粒细胞浸润的肉芽肿。在肉芽肿中发现了由圆形棕色细胞和短假菌丝组成的链。从样本中进行的真菌培养证实为外瓶霉属真菌引起的感染。特比萘芬和局部热疗治疗似乎有效，因为所有病变都趋于消退。然而，患者在开始治疗后大约 1 个月因肺炎去世。
