Rouzaud Claire, Hay Roderick, Chosidow Olivier, Dupin Nicolas, Puel Anne, Lortholary Olivier, Lanternier Fanny
Centre d'Infectiologie Necker-Pasteur, Hôpital Necker Enfants Malades et Institut Imagine, APHP, Université Paris Descartes, Sorbonne Paris Cité, 75015 Paris, France.
Dermatology Department, King's College Hospital NHS Trust, London SE5 9RS, UK.
J Fungi (Basel). 2015 Dec 31;2(1):4. doi: 10.3390/jof2010004.
Dermatophytes are keratinophilic fungi responsible for benign and common forms of infection worldwide. However, they can lead to rare and severe diseases in immunocompromised patients. Severe forms include extensive and/or invasive dermatophytosis, , deep dermatophytosis and Majocchi's granuloma. They are reported in immunocompromised hosts with primary (autosomal recessive CARD9 deficiency) or acquired (solid organ transplantation, autoimmune diseases requiring immunosuppressive treatments, HIV infection) immunodeficiencies. The clinical manifestations of the infection are not specific. Lymph node and organ involvement may also occur. Diagnosis requires both mycological and histological findings. There is no consensus on treatment. Systemic antifungal agents such as terbinafine and azoles (itraconazole or posaconazole) are effective. However, long-term outcome and treatment management depend on the site and extent of the infection and the nature of the underlying immunodeficiency.
皮肤癣菌是嗜角质真菌，在全球范围内引发良性和常见的感染形式。然而，它们可在免疫功能低下的患者中导致罕见且严重的疾病。严重形式包括广泛性和/或侵袭性皮肤癣菌病、深部皮肤癣菌病和Majocchi肉芽肿。在原发性（常染色体隐性CARD9缺陷）或获得性（实体器官移植、需要免疫抑制治疗的自身免疫性疾病、HIV感染）免疫缺陷的免疫功能低下宿主中报告有这些疾病。感染的临床表现不具有特异性。也可能发生淋巴结和器官受累。诊断需要真菌学和组织学检查结果。治疗尚无共识。特比萘芬和唑类（伊曲康唑或泊沙康唑）等全身性抗真菌药物有效。然而，长期预后和治疗管理取决于感染的部位和范围以及潜在免疫缺陷的性质。
