PDF(Pubmed)
Abstract：
Impetigo, commonly caused by bacteria, is characterized by lesions of pustules, bullae or golden yellow crusts; it is seldom caused by fungi. Here, we report one case of a 17-year-old female patient with a 1-month history of erythematous pustules on her left cheek. She was clinically diagnosed with \"impetigo\", but did not respond to 1 week of treatment with topical mupirocin cream (antibacterial agent). We then saw that a fungal colony grew on the culture, which was identified as T. mentagrophytes based on the morphological and molecular characteristics. The patient was then diagnosed with tinea faciei and was topically treated with 0.2% ketoconazole cream twice per day for 7 days. Through a literature review, we found another 18 cases of impetigo-like tinea faciei with similar clinical manifestations and pathogenic characteristics. Among these, the most common causative agent was T. mentagrophytes complex, which frequently occurs in children and adolescents and exhibits no gender preferences. Systemic and topical antifungals such as terbinafine or itraconazole are effective for impetigo-like tinea faciei caused by T. mentagrophytes complex. However, prolonged course of impetigo in more than 50% cases highlights the importance of mycological examination when dealing with apparent antibiotic-resistant impetigo cases in clinical settings.
摘要：
Impetigo,通常由细菌引起，以脓疱病变为特征，大疱或金黄色结皮；很少由真菌引起。这里,我们报告一例17岁的女性患者，她的左脸颊有1个月的红斑脓疱病史。她被临床诊断为“脓疱病”但对局部莫匹罗星乳膏（抗菌剂）治疗1周没有反应。然后我们看到培养物上生长了一个真菌菌落，根据形态和分子特征，将其鉴定为T.然后将患者诊断为面癣,并用0.2%酮康唑乳膏每天局部治疗两次,持续7天。通过文献综述,我们又发现了18例脓疱疮样面癣，其临床表现和致病特征相似。其中,最常见的病原体是T.mentagrosphytes复合体，这种情况经常发生在儿童和青少年中，没有性别偏好。全身性和外用抗真菌药物如特比萘芬或伊曲康唑可有效治疗由T.mentagrosphytes复合体引起的脓疱疮样面癣。然而,在超过50%的病例中,脓疱病病程延长凸显了在临床环境中处理明显的抗生素耐药脓疱病病例时,真菌学检查的重要性.
