Department of Dermatology, Chang Gung Memorial Hospital, Linkou and Taipei, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Dermatol. 2023 Aug;50(8):1088-1092. doi: 10.1111/1346-8138.16806. Epub 2023 Apr 20.
Hyalohyphomycosis is a rare infection caused by a group of fungi that are devoid of pigments in their cell walls. As one of the main pathogens of hyalohyphomycosis, Purpureocillium lilacinum (former Paecilomyces lilacinus) is known for its intrinsic resistance to various antifungal agents. Here, we report three cases that coincide with a history of farming and all of them suffered from cutaneous hyalohyphomycosis caused by P. lilacinum. They shared a clinical presentation consisting of erythematous-to-violaceous painful plaques with overlying pustules on one of their forearms. Hyphae and fungal elements were highlighted by periodic acid Schiff or Gomori methenamine silver staining in their skin biopsies. Fungal cultures of their skin tissues yielded P. lilacinum, which was confirmed by both morphological and molecular characteristics. All patients responded well to oral terbinafine or itraconazole treatment. In this report, we also reviewed previously reported cases associated with either P. lilacinum or other Paecilomyces spp. infections in Taiwan.
着色芽生菌病是一种由一群细胞壁缺乏色素的真菌引起的罕见感染。作为着色芽生菌病的主要病原体之一,淡紫拟青霉(原拟青霉)对各种抗真菌药物具有固有耐药性。在这里,我们报告了三例与农业史相符的病例,所有这些病例均由淡紫拟青霉引起的皮肤着色芽生菌病。它们具有相同的临床表现,即前臂之一处出现红斑至紫蓝色疼痛斑块,其上覆盖脓疱。在皮肤活检中,过碘酸雪夫或 Gomori 六胺银染色突出显示了菌丝和真菌成分。皮肤组织的真菌培养产生了淡紫拟青霉,这通过形态学和分子特征得到了证实。所有患者均对口服特比萘芬或伊曲康唑治疗反应良好。在本报告中,我们还回顾了台湾地区以前报道的与淡紫拟青霉或其他拟青霉属感染相关的病例。