Esposto M C, Lazzarini C, Prigitano A, Olivi A, Monti M, Tortorano A M
Department of Biomedical Sciences, Università degli Studi di Milano, Milan, Italy -
G Ital Dermatol Venereol. 2015 Oct;150(5):491-4.
Aim of the paper was to report cases of Tinea imbricata, a mycosis caused by the anthropophilic dermatophyte Trichophyton concentricum, observed in 2012 in Guadalcanal, the largest of the Salomon islands.
During 2012, several cases of Tinea imbricata, called bakwa by local people, were observed in the Little Samaritan Hospital in Guadalcanal. Skin scrapings collected from three young patients were examined in Italy to confirm the clinical diagnosis. The fungus grown on culture was morphologically identified and submitted to sequencing of the ITS1-ITS2 region.
The diagnosis obtained by visual inspection of the skin lesions, characterised by concentric and lamellar plaques of scale often involving large part of the body, was confirmed mycological investigations. A prevalence of 15% of Tinea imbricata in this population was hypothesized. The fungus grown on culture was morphologically identified as Trichophyton concentricum and identification was confirmed sequencing the ITS1-ITS2 region. Patients were treated with potassium permanganate solution soaked gauze followed by colloidal sulfur and salicylic acid cream application. However, the efficacy of the antifungal treatment was difficult to evaluate due to the poor compliance of the patients and the remoteness of the villages.
Italian clinicians and mycologists should be aware of this fungal infection because the increased number of international travels and of migration rise the spread of infections previously restricted to limited geographical areas.
本文旨在报告2012年在所罗门群岛最大的瓜达尔卡纳尔岛观察到的叠瓦癣病例,该病是由亲人性皮肤癣菌同心毛癣菌引起的一种真菌病。
2012年期间,在瓜达尔卡纳尔岛的小撒玛利亚医院观察到几例叠瓦癣病例,当地人称为“bakwa”。从三名年轻患者身上采集的皮肤刮屑在意大利进行检查,以确诊临床诊断。对培养出的真菌进行形态学鉴定,并对其ITS1-ITS2区域进行测序。
通过目视检查皮肤病变获得的诊断得到真菌学调查的证实,皮肤病变特征为同心和层状鳞屑斑块,常累及身体大部分部位。据推测,该人群中叠瓦癣的患病率为15%。培养出的真菌在形态学上被鉴定为同心毛癣菌,通过对ITS1-ITS2区域进行测序确认了鉴定结果。患者先用高锰酸钾溶液浸泡纱布治疗,随后涂抹胶体硫和水杨酸乳膏。然而,由于患者依从性差以及村庄偏远,抗真菌治疗的疗效难以评估。
意大利临床医生和真菌学家应了解这种真菌感染,因为国际旅行和移民人数的增加导致以前局限于有限地理区域的感染得以传播。