Department of Dermatology, Tenri Hospital.
Med Mycol J. 2024;65(4):93-98. doi: 10.3314/mmj.24-00018.
I report a case of tinea barbae presenting as a tumor in the philtrum of a man in his thirties with comorbid alcoholic liver disease. The patient also had tinea on the auricles, neck, and feet, with direct microscopy confirming the presence of dermatophytes at all sites. A history of multiple pet ownership was noted. The causative organism in the philtrum was identified as the zoophilic fungus Trichophyton mentagrophytes, while the tinea on the feet was caused by the anthropophilic fungus Trichophyton interdigitale ITS genotype II. Despite abnormal liver enzymes, the patient was cured after a three-month course of oral terbinafine following cessation of alcohol intake. This case, encountered by the author approximately 20 years ago, was initially identified as Arthroderma vanbreuseghemii using PCR-RFLP analysis of the ITS region of rRNA genes. Recent sequencing analysis of preserved strains reidentified the organism as T. mentagrophytes. The alignment of this strain showed a query cover of 100% and a percent identity (Per.ident) of 99.84%, matching with T. mentagrophytes ITS genotype VII. As a dermatologist, it is crucial to continuously monitor the evolving taxonomy of fungi and its clinical implications.
我报告了一例发生于 30 多岁伴有酒精性肝病的男性人中部位的癣菌病，表现为肿瘤。该患者还患有耳部、颈部和足部的癣病，所有部位的直接显微镜检查均证实存在真菌。患者有饲养多只宠物的病史。人中部位的致病微生物被鉴定为亲动物性真菌须毛癣菌，而足部的癣病是由亲人性真菌红色毛癣菌 ITS 基因型 II 引起的。尽管肝功能酶异常，但在停止饮酒并接受三个月的口服特比萘芬治疗后，患者痊愈。作者大约 20 年前遇到的这例病例，最初使用 rRNA 基因 ITS 区的 PCR-RFLP 分析鉴定为 Arthroderma vanbreuseghemii。最近对保存菌株的测序分析重新鉴定为须毛癣菌。该菌株的比对显示查询覆盖率为 100%，同一性百分比（Per.ident）为 99.84%，与 T. mentagrophytes ITS 基因型 VII 匹配。作为一名皮肤科医生，持续监测真菌的不断演变的分类及其临床意义至关重要。
