Abstract：
Candidal granuloma is an uncommon type of deep chronic cutaneous candidiasis. Candida albican is the most common causative pathogen for candidal granuloma. We report herein the original case of a 69-year-old Chinese woman presented with a 3-year of painful cutaneous lesion on the back of left hand. Physical examination revealed a 4 × 5 cm large infiltrative reddish plaque with unclear boundaries. The yellow-white crusts were observed on the uneven surface of plaque. Histopathological examination of biopsy tissue revealed that yeast cells and the horizontal section of hyphae in the dermis by hematoxylin eosin staining and periodic acid-Schiff staining. Finally, the pathogen was identified as Candida parapsilosis by mycological examination and molecular identification. The patient was treated with itraconazole oral 200 mg twice daily combined with topical terbinafine hydrochloride cream for 2 months. The lesions were fully resolved and no recurrence was observed. Since the cutaneous infection caused by C. parasilosis were rarely reported, we also reviewed all 11 cases of cutaneous infection caused by C. parapsilosis in the PubMed. Our study highlighted that chronic unilateral infiltrated plaques or ulcers should be aware of the occurrence of fungal granuloma including candidal granuloma especially in immunocompromised patients.
摘要：
念珠菌肉芽肿是一种罕见的深部慢性皮肤念珠菌病。白色念珠菌是念珠菌肉芽肿最常见的病原体。我们在此报告了一名69岁的中国妇女的原始病例，其左手背部有3年的疼痛性皮肤病变。体格检查发现一个4×5厘米大的浸润性红色斑块，边界不清。在斑块的不平坦表面上观察到黄白色的结皮。活检组织的组织病理学检查显示，通过苏木精伊红染色和高碘酸希夫染色，真皮中的酵母细胞和菌丝水平切片。最后,通过真菌学检查和分子鉴定，将病原体鉴定为近叶念珠菌。患者口服伊曲康唑200mg，每日2次，并外用盐酸特比萘芬乳膏治疗2个月。病变完全消退，未观察到复发。由于由寄生虫病引起的皮肤感染很少报道，我们还回顾了PubMed中所有11例近apsilosis引起的皮肤感染病例。我们的研究强调，慢性单侧浸润斑块或溃疡应意识到真菌肉芽肿的发生，包括念珠菌肉芽肿，尤其是在免疫功能低下的患者中。
