Squeo R F, Beer R, Silvers D, Weitzman I, Grossman M
Department of Dermatology, Columbia Presbyterian Medical Center, New York, New York, USA.
J Am Acad Dermatol. 1998 Aug;39(2 Pt 2):379-80. doi: 10.1016/s0190-9622(98)70396-2.
A 55-year-old renal transplant recipient with onychomycosis and chronic tinea pedis presented with tender nodules on his left medial heel. He then developed papules and nodules on his right foot and calf. A skin biopsy demonstrated periodic acid-Schiff (PAS) positive, thick walled round cells, 2 to 6 microm in diameter, in the dermis. Skin biopsy culture grew Trichophyton rubrum. T. rubrum has been described as an invasive pathogen in immunocompromised hosts. The clinical presentation, histopathology, and early fungal culture growth suggested Blastomyces dermititidis in the differential diagnosis before the final identification of T. rubrum.
一名55岁的肾移植受者，患有甲癣和慢性足癣，其左内侧足跟出现压痛性结节。随后，他的右脚和小腿出现丘疹和结节。皮肤活检显示真皮内有直径2至6微米、过碘酸希夫（PAS）染色阳性的厚壁圆形细胞。皮肤活检培养物培养出红色毛癣菌。红色毛癣菌在免疫功能低下的宿主中被描述为一种侵袭性病原体。在最终鉴定出红色毛癣菌之前，临床表现、组织病理学和早期真菌培养生长提示在鉴别诊断中有皮炎芽生菌。
