Chaisuwannarak Kornkanok, Chularojanamontri Leena, Junsuwan Natachaya, Eimpunth Sasima
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Dermatol. 2022 Jan;49(1):168-172. doi: 10.1111/1346-8138.16197. Epub 2021 Oct 15.
Talaromyces (formerly Penicillium) marneffei is a dimorphic fungus that causes talaromycosis (formerly penicilliosis). The condition is predominantly found in patients with HIV. Important diagnostic clues are a history of living or travelling in endemic areas, and central umbilicated skin lesions. Dermoscopy is particularly useful for providing rapid bedside information, with a round, whitish, amorphous structure being the most common finding. Immune reconstitution inflammatory syndrome (IRIS) may occur. Driven by the initiation of antiretroviral therapy, IRIS is an exaggerated response of T cells to pathogens. Although mycobacterial and cryptococcal opportunistic infections are common with IRIS, a linkage between T. marneffei and IRIS has rarely been reported. Here, we report on a literature review of patients with HIV who developed IRIS associated with talaromycosis. Dermatologists should be aware of the cutaneous and dermoscopic findings of talaromycosis as they provide important clues that enable its early diagnosis and treatment.
马尔尼菲篮状菌（曾称马尔尼菲青霉）是一种双相真菌，可引起马尔尼菲篮状菌病（曾称青霉病）。这种疾病主要见于艾滋病患者。重要的诊断线索包括在流行地区生活或旅行史以及中央脐凹状皮肤损害。皮肤镜检查对于提供快速的床边信息特别有用，最常见的表现是圆形、白色、无定形结构。免疫重建炎症综合征（IRIS）可能会发生。IRIS由抗逆转录病毒治疗引发，是T细胞对病原体的过度反应。虽然分枝杆菌和隐球菌机会性感染在IRIS中很常见，但马尔尼菲篮状菌与IRIS之间的关联鲜有报道。在此，我们报告了一项关于艾滋病患者发生与马尔尼菲篮状菌病相关的IRIS的文献综述。皮肤科医生应了解马尔尼菲篮状菌病的皮肤和皮肤镜表现，因为它们提供了有助于早期诊断和治疗的重要线索。
