PDF(Pubmed)
Abstract：
BACKGROUND: Dermatophytes are the most common causative pathogens of mycoses worldwide and usually cause superficial infections. However, they can enter deep into the dermis lead to invasive dermatophytosis such as deeper dermal dermatophytosis on rare occasions. Erythroderma is a severe dermatological manifestation of various diseases resulting in generalized skin redness, but erythroderma due to fungi infections is barely reported. In this article, we reported the first case of erythroderma combined with deeper dermal dermatophytosis due to Trichophyton rubrum (T. rubrum) in a patient with myasthenia gravis.
METHODS: A 48-year-old man was hospitalized because of erythema with scaling and nodules covering his body for a month. The patient had a history of myasthenia gravis controlled by regularly taking prednisolone for > 10 years and accompanied by onychomycosis and tinea pedis lasting > 8 years. Based on histopathological examinations, fungal cultures, and DNA sequencing results, the patient was finally diagnosed with dermatophyte-induced erythroderma combined with deeper dermal dermatophytosis caused by T. rubrum. After 2 weeks of antifungal treatment, the patient had recovered well.
CONCLUSIONS: This case report shows that immunosuppressed patients with long histories of superficial mycoses tend to have a higher risk of developing invasive dermatophytic infections or disseminated fungal infections. Dermatologists should be alert to this condition and promptly treat the superficial dermatophytosis.
METHODS: A 48-year-old man was hospitalized because of erythema with scaling and nodules covering his body for a month. The patient had a history of myasthenia gravis controlled by regularly taking prednisolone for > 10 years and accompanied by onychomycosis and tinea pedis lasting > 8 years. Based on histopathological examinations, fungal cultures, and DNA sequencing results, the patient was finally diagnosed with dermatophyte-induced erythroderma combined with deeper dermal dermatophytosis caused by T. rubrum. After 2 weeks of antifungal treatment, the patient had recovered well.
CONCLUSIONS: This case report shows that immunosuppressed patients with long histories of superficial mycoses tend to have a higher risk of developing invasive dermatophytic infections or disseminated fungal infections. Dermatologists should be alert to this condition and promptly treat the superficial dermatophytosis.
摘要：
背景：皮肤癣菌是世界范围内最常见的真菌病病原体，通常会引起浅表感染。然而,它们可以进入真皮深处，导致侵袭性皮肤癣菌病，如在罕见情况下更深的真皮皮肤癣菌病。红皮病是各种疾病的严重皮肤病学表现，导致全身皮肤发红，但是由于真菌感染引起的红皮病几乎没有报道。在这篇文章中,我们报告了首例红皮病合并红色毛癣菌引起的深层皮肤真菌病（T。rubrum）在重症肌无力患者中。
方法：一名48岁的男子因身体上有鳞屑和结节的红斑住院一个月。该患者有重症肌无力病史，通过定期服用泼尼松龙控制超过10年，并伴有甲癣和足癣持续超过8年。根据组织病理学检查，真菌培养物,和DNA测序结果，该患者最终被诊断为皮肤癣菌引起的红皮病合并红斑T.rubrum引起的真皮深层皮肤癣菌病。抗真菌治疗2周后，病人恢复良好。
结论：本病例报告显示，具有长期浅表真菌病病史的免疫抑制患者倾向于发生侵袭性皮肤癣菌感染或播散性真菌感染的风险更高。皮肤科医生应警惕这种情况，并及时治疗浅表性皮肤癣菌病。
方法：一名48岁的男子因身体上有鳞屑和结节的红斑住院一个月。该患者有重症肌无力病史，通过定期服用泼尼松龙控制超过10年，并伴有甲癣和足癣持续超过8年。根据组织病理学检查，真菌培养物,和DNA测序结果，该患者最终被诊断为皮肤癣菌引起的红皮病合并红斑T.rubrum引起的真皮深层皮肤癣菌病。抗真菌治疗2周后，病人恢复良好。
结论：本病例报告显示，具有长期浅表真菌病病史的免疫抑制患者倾向于发生侵袭性皮肤癣菌感染或播散性真菌感染的风险更高。皮肤科医生应警惕这种情况，并及时治疗浅表性皮肤癣菌病。
