Department of Dermatology, Tokyo Dental College Ichikawa General Hospital.
Department of Dermatology, Keio University School of Medicine.
Med Mycol J. 2022;63(2):37-41. doi: 10.3314/mmj.21-00022.
We herein report a case of kerion celsi of the scalp and tinea corporis due to Trichophyton tonsurans. A 17-year-old Japanese male high school student who practiced judo had alopecic patches with severe inflammation on the scalp. We performed a fungal culture and identified the causative fungus as T. tonsurans. A plate culture of T. tonsurans showed lemon-yellow colonies with yellow-green fluorescence under UVA light, which are typical findings for Microsporum canis. However, genetic analysis of the ribosomal RNA gene of the isolate facilitated differential diagnosis of T. tonsurans.In contrast to dermatophytosis due to other dermatophytes, the clinical features of infection caused by T. tonsurans, an anthropophilic dermatophyte, are initially not very apparent and, thus, are frequently overlooked. We herein present a case of a severe type of kerion celsi caused by T. tonsurans with a fluorescence pattern mimicking M. canis colonies under UVA light. We suspect that yellow pigment metabolites, such as riboflavin, which are fluorescent under UV when secreted into the culture medium, are the virulence factors for not only M. canis, but also T. tonsurans, as shown in the present case.
我们在此报告一例由须癣毛癣菌引起的头皮脓癣和体癣。一名 17 岁的日本男性高中生,练习柔道,头皮出现脱发斑伴严重炎症。我们进行了真菌培养,鉴定致病真菌为须癣毛癣菌。须癣毛癣菌的平板培养显示柠檬黄色菌落,在 UVA 光下呈黄绿色荧光,这是犬小孢子菌的典型表现。然而,该分离株核糖体 RNA 基因的遗传分析有助于鉴别诊断须癣毛癣菌。与其他亲动物性皮肤癣菌引起的皮肤癣病不同,亲人性皮肤癣菌须癣毛癣菌感染的临床特征起初并不十分明显,因此经常被忽视。我们在此报告一例由须癣毛癣菌引起的严重脓癣病例,其在 UVA 光下的荧光模式类似于犬小孢子菌的菌落。我们怀疑,当分泌到培养基中时,黄色色素代谢物,如核黄素,不仅是犬小孢子菌,也是须癣毛癣菌的毒力因子,正如本病例所示。