Erythroderma combined with deeper dermal dermatophytosis due to Trichophyton rubrum in a patient with myasthenia gravis: first case report and literature review

The dataset includes the following content:Patient's skin lesion photos, pathological tissue examination photos, and strain morphology photos. Figure 1 shows the clinical presentation of the patient. a-h Erythema accompanied by scales covered the patient’s body, and multiple disseminated, firm and dusky red to purple nodules and plaques were distributed over his trunk (a, b), arms (c, d , g) and lower extremities (e, f), presenting with crusts and erosions. (h) All toenails were thickened, dystrophic and showed yellowish discoloration. Figure 2 provides histological descriptions of the erythema and nodules.Histological description of the erythema and nodules. a, b Histological examination of the erythema revealed epidermal hyperplasia and hypertrophy, infectious granuloma in the dermis, and dense inflammatory infiltrate consisting of epithelioid cells, lymphocytes, plasma cells, neutrophils, and scattered multinucleated giant cells. Hematoxylin and eosin (HE) ×100 (a), HE ×200 (b). c, d Histopathology of the nodules revealed pseudoepitheliomatous epidermal hyperplasia, inflammatory granulomatous infiltration, and dense inflammatory infiltration in the dermis, with infiltrating cells identical to those of the erythema. HE, ×20 (c), HE, ×100 (d). e-g Hyphae (white arrow) and conidia (red arrow) in the corneum (e) and dermis (f, g). Periodic acid-Schiff stain, ×200.Scale bar, 20 µm. Figure 3 presents the fungal examination results.a KOH wet mount and direct microscopic examination of the scrapings from the patient’s trunk showing abundant septate hyphae. ×200. b Small white fluffy and creamy yellow colonies were observed on potato dextrose agar plate after 1 week of culturing at 28°C. c Macroconidia (black arrow) and microconidia (red arrow) were observed under lactate phenol medan staining with an optical microscope. Scale bar, 20 µm. Figure 4 depicts the clinical presentation of the patient after treatment. a–c After receiving antifungal treatment for 14 days, the patient's erythema and scales partially subsided. ITS sequences of the clinical strain.Table 1 summarizes a published paper titled "Characterization of patients with dermatophyte-related erythroderma" Abbreviations: M: male; F: female; DM: diabetes mellitus; ITR: itraconazole; KCZ: ketoconazole; GSF: griseofulvin; AMB: amphotericin B; IV: intravenous injection; m: mounth; CR: complete response.ND: not described; Table 2 summarizes a published paper titled "Characterization of patients with deeper dermal dermatophytosis caused by T. rubrum" Abbreviations: M: male; F: female; ND: not described; y: year; d: day; tx: transplantation; DM: diabetes mellitus; Y: yes; N: no; ITR: itraconazole; POS: posaconazole; VOR: voriconazole TER: terbinafine; KCZ: ketoconazole; GSF: griseofulvin; EX: excisional surgery; AMB: amphotericin B; IV: intravenous injection; m: mounth; w: week; CR: complete response; UK: unknow

数据集包含以下内容：患者皮肤病变照片、病理组织检查照片及菌株形态照片。图1展示了患者的临床表现：a-h 患者全身覆盖红斑伴鳞屑，躯干（a、b）、手臂（c、d、g）及下肢（e、f）分布有多枚弥漫性、质地坚硬的暗红至紫色结节和斑块，表面可见痂皮与糜烂；h 所有趾甲增厚、营养不良并呈黄色变色。图2提供了红斑和结节的组织学描述：红斑的组织学检查显示表皮增生肥厚，真皮内可见感染性肉芽肿，以及由上皮样细胞、淋巴细胞、浆细胞、中性粒细胞和散在多核巨细胞组成的密集炎症浸润（苏木精-伊红染色（HE）×100（a）、HE×200（b））；结节的组织病理学检查显示假上皮瘤样表皮增生、炎症性肉芽肿浸润及真皮内密集炎症浸润，浸润细胞与红斑一致（HE×20（c）、HE×100（d））；e-g 角质层（e）及真皮（f、g）中可见菌丝（白色箭头）和分生孢子（红色箭头）（过碘酸-雪夫染色×200，标尺20μm）。图3呈现真菌检查结果：a 患者躯干刮取物的氢氧化钾湿片法直接镜检显示大量有隔菌丝（×200）；b 28℃培养1周后，马铃薯葡萄糖琼脂平板上可见白色绒毛状及乳黄色菌落；c 光学显微镜下经乳酸酚棉蓝染色观察到大分生孢子（黑色箭头）和小分生孢子（红色箭头）（标尺20μm）。图4描绘了患者治疗后的临床表现：a–c 接受抗真菌治疗14天后，患者红斑和鳞屑部分消退。临床菌株的内部转录间隔区序列（ITS sequences）。表1总结了一篇题为《皮肤癣菌相关红皮病患者的特征分析》的已发表论文，缩写说明：M（男性）、F（女性）、DM（糖尿病，diabetes mellitus）、ITR（伊曲康唑，itraconazole）、KCZ（酮康唑，ketoconazole）、GSF（灰黄霉素，griseofulvin）、AMB（两性霉素B，amphotericin B）、IV（静脉注射，intravenous injection）、m（月，month）、CR（完全缓解，complete response）、ND（未描述，not described）。表2总结了一篇题为《红色毛癣菌（T. rubrum）所致深部皮肤癣菌病患者的特征分析》的已发表论文，缩写说明：M（男性）、F（女性）、ND（未描述）、y（年，year）、d（天，day）、tx（移植，transplantation）、DM（糖尿病）、Y（是）、N（否）、ITR（伊曲康唑）、POS（泊沙康唑，posaconazole）、VOR（伏立康唑，voriconazole）、TER（特比萘芬，terbinafine）、KCZ（酮康唑）、GSF（灰黄霉素）、EX（切除手术，excisional surgery）、AMB（两性霉素B）、IV（静脉注射）、m（月）、w（周，week）、CR（完全缓解）、UK（未知，unknown）