Kamalapirat Thanachote, Apichonbancha Sirin, Tonaree Warangkana
Division of Plastic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Plastic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Diagn Microbiol Infect Dis. 2025 Jul;112(3):116791. doi: 10.1016/j.diagmicrobio.2025.116791. Epub 2025 Mar 13.
A 63-year-old Thai woman, owner of 14 cats, presented with chronic skin lesions initially misdiagnosed as cellulitis. Further investigation revealed lymphocutaneous sporotrichosis caused by Sporothrix schenckii. Histopathology of one lesion unexpectedly demonstrated pseudoepitheliomatous hyperplasia (PEH), a reactive epidermal proliferation that can clinically and histopathologically mimic squamous cell carcinoma (SCC). The patient was treated with itraconazole for the fungal infection, and surgical debridement was performed due to suspicion of malignancy. Diagnostic tools included fungal culture and detailed histopathology, emphasizing the importance of thorough evaluation of persistent cutaneous lesions, especially in individuals with animal exposure. This case highlights the rarity of hyperplastic or verrucous variants in chronic fungal infections and underscores the need to distinguish benign PEH from true malignancy. Timely intervention with antifungal therapy and appropriate surgical management resulted in a favorable outcome.
一名63岁的泰国女性，养了14只猫，因慢性皮肤病变前来就诊，最初被误诊为蜂窝织炎。进一步检查发现由申克孢子丝菌引起的皮肤淋巴管型孢子丝菌病。其中一个病变的组织病理学检查意外显示为假上皮瘤样增生（PEH），这是一种反应性表皮增生，在临床和组织病理学上可模仿鳞状细胞癌（SCC）。该患者因真菌感染接受伊曲康唑治疗，因怀疑恶性肿瘤而进行了手术清创。诊断工具包括真菌培养和详细的组织病理学检查，强调了对持续性皮肤病变进行全面评估的重要性，特别是在有动物接触史的个体中。该病例突出了慢性真菌感染中增生性或疣状变体的罕见性，并强调了区分良性PEH与真正恶性肿瘤的必要性。及时进行抗真菌治疗和适当的手术管理取得了良好的效果。
