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一原籍牙买加外貌健康的72岁黑人主妇,患足趾甲营养缺乏、增厚、易碎已10年。就诊前到加拿大已6个月。据云两年前左足背曾被木块击伤,已痊愈。左足第三及第四趾间皮肤柔软,呈白色干酪样浸渍。曾先后用克霉唑霜、咪康唑治疗各6周未见效。病人趾间及趾甲混合刮取物镜检,见有明显粗于皮肤癣菌的有横隔的菌丝。菌丝未见有明显色素,在无放线菌酮的琼脂斜面上长出3个细丝状的白色菌落。这些菌落于7天内变为灰色至褐黑色,此时菌落已盖满整个斜面。菌丝体由分隔粗糙的菌丝组成,菌丝顶端几无色。但成熟部分则呈棕色。镜下见大的关节孢子和沿菌丝的某些部分有特殊的小球形的菌丝壁增厚。在毛癣菌琼脂培养基(Difco厂出品)上约4周后有散发出成团白色孢子的黑色分生
A native of Jamaica, a healthy 72-year-old black housewife, suffered from toenail nutritional deficiencies, thickening, fragile for 10 years. It has been six months since I came to Canada for treatment. According to the cloud two years ago left foot was wounded in wood, has been cured. The left third and fourth interphalangeal skin soft, white cheese-like impregnation. Has used clotrimazole cream, miconazole treatment for 6 weeks did not work. Patient interdental and nails mixed scraped the objective examination, see the clear rough skin dermatophytes have transeptal mycelium. No obvious hyphae pigment, no acyclobutanone agar slant grow three filamentous white colonies. These colonies turned gray to brownish black within 7 days, when the colonies covered the entire slope. Mycelium consists of rough mycelium separated, mycelial top few colorless. But the mature part is brown. Microscope to see the big joint spores and along some parts of the mycelium has a special small spherical mycelial wall thickening. About 4 weeks after the Trichophyton agar medium (Difco Plant), there are black meristems emitting white lumps