背景:毛癣菌(T.)赤耳是一种罕见但正在出现的人畜共患皮肤癣菌,很少被分离为人类病原体,只有少数案例在文献中广泛描述。
方法:我们进行了系统的搜索,以识别报告人口统计的合格文章,临床特征,以及关于人类木耳弧菌感染的治疗方法。
结果:在开始至2023年11月之间的国际文献中报道了168例受紫锥菊影响的患者。只有56例(32.1%)被完全描述。诊断时的中位年龄为26岁,女性/男性比例约为2:1。该病的主要来源是刺猬。感染表现为红斑的组合,鳞状斑块,脓疱,丘疹,囊泡,水肿,和侵蚀;最常见的位置是手和头部。最常进行的检查是真菌培养,但是基因测序和质谱在最近的诊断过程中提高了速度和精度。局部克霉唑和全身特比萘芬是选择最多的治疗方法。
结论:对于有红斑鳞片和最近接触刺猬的患者,应考虑使用毛癣菌。特比萘芬应该被认为是一线有效的治疗方法,灰黄霉素和唑类药物可以被认为是有效的替代品。
BACKGROUND: Trichophyton (T.) erinacei is a rare but emerging zoonotic dermatophyte that is rarely isolated as a human pathogen, with only a few cases extensively described in the literature.
METHODS: We conducted a systematic search to identify eligible articles reporting demographics, clinical characteristics, and the therapeutic approach regarding T. erinacei infection in humans.
RESULTS: 168 patients affected by T. erinacei were reported in the international literature between inception and November 2023. Only 56 cases (32.1%) were fully described. The median age at diagnosis was 26 years, the female/male ratio was around 2:1. The main source of the disease was the
hedgehog. The infection presented with a combination of erythema, scaly plaques, pustules, papules, vesicles, oedema, and erosion; the most common locations were the hands and the head. The most frequently conducted examination was fungal culture, but gene sequencing and mass spectrometry improved both speed and precision in the most recent diagnostic course. Topical clotrimazole and systemic terbinafine were the most chosen treatment.
CONCLUSIONS: Trichophyton erinacei should be considered in patients with erythematous scaly patches and recent contact with hedgehogs. Terbinafine should be considered as a first-line effective treatment, griseofulvin and azoles could be considered valid alternatives.