Department of Dermatology, University Hospitals of Schleswig-Holstein, Kiel, Germany.
Unitat de Micologia, Facultat de Medicina i Ciències de la Salut and IISPV, Universitat Rovira i Virgili, Reus, Spain.
Mycoses. 2019 Feb;62(2):157-164. doi: 10.1111/myc.12861. Epub 2018 Nov 13.
A 60-year-old woman presented with a nodular granulomatous skin lesion on her right thumb. It had developed after inoculation of a splinter of wood. Because it was resistant to various therapies, the nodule was finally excised. Complete healing followed this surgery and a melanised filamentous fungus with scopulariopsis-like morphology was recovered from the dermal tissue. Fitting with no known species, the fungus was subjected to extensive morphological, physiological and genetic investigations. It was characterised by resistance to cycloheximide, growth at 37°C, branched conidiophores with cylindrical annellides in brush-like groups producing dark conidia in basipetal chains, and cleistothecia with ellipsoidal to slightly reniform ascospores. Genetically it clustered in a well-supported clade together with Microascus (M.) brunneosporus, Microascus chinensis, Microascus intricatus, Microascus longicollis, Microascus micronesiensis and Microascus onychoides, but formed an independent branch distant from the other Microascus species. Based on its unique genetic characteristics and morphological findings, the isolate is proposed as a new species, Microascus ennothomasiorum. Morphologically it differs from its phylogenetically closest species by its branched conidiophores and ascomata with a peridium of textura intricata. Our observation once again emphasises that dermal granulomas can be caused by uncommon fungi; diagnostics should therefore include appropriate mycological investigations.
一位 60 岁女性，右手拇指出现结节状肉芽肿性皮损。皮损是在扎入木刺后出现的。由于各种治疗方法均无效，最终进行了结节切除术。术后完全愈合，从皮肤组织中分离出一种形态似枝孢霉的黑曲霉属丝状真菌。由于与已知菌种均不相符，对该真菌进行了广泛的形态学、生理学和遗传学研究。该菌具有抗环己酰亚胺、37°C 生长、具圆柱状环痕的分枝分生孢子梗，在毛刷状丛中产生暗褐色的分生孢子，闭囊壳内具椭圆形至稍肾形的子囊孢子等特征。遗传学上，它与 Microascus（M.）brunneosporus、Microascus chinensis、Microascus intricatus、Microascus longicollis、Microascus micronesiensis 和 Microascus onychoides 聚为一个支持度高的分支，但与其他 Microascus 种相距较远。基于其独特的遗传特征和形态学发现，该分离株被提议为一个新种，即 Microascus ennothomasiorum。与亲缘关系最近的种相比，其形态学特征为分枝的分生孢子梗和具网状纹饰的子囊壳。我们的观察结果再次强调，皮肤肉芽肿可由罕见的真菌引起；因此，诊断应包括适当的真菌学研究。
