拇指爪甲下に生じたAspergillus nigerによる皮膚アスペルギルス症

・爪甲下に膿瘍を形成したAspergillus niger（A. niger）による原発性膿皮症様アスペルギルス症の1例を経験した．

・爪甲内には直接鏡検および病理組織学的に菌要素を認めなかった．

・爪甲下に激しい疼痛を認めたが，指尖部や後爪郭部の炎症所見は認めなかった．

・爪甲の部分的除去による排膿，局所洗浄と抗真菌剤外用のみで治癒した．

（「症例のポイント」より）

　

A case of subungual abscess caused by Aspergillus niger

　

Miyamori, Mutsuki1）Futatsuya, Taketoshi1）Hatta, Junko1）Ushigami, Tsuyoshi1）Anzawa, Kazushi1）Mochizuki, Takashi1）

1）Department of Dermatology, Kanazawa Medical University

　

A 70-year-old Japanese healthy woman with severe pain of the right thumb for 9 days visited our clinic. The nail plate was discolored purplish yellow. Partial removal of the plate revealed abscess formation with an ulcer reaching the dorsal aspect of the phalanx. Histopathological examination showed septate hyphae with calcium oxalate crystals accompanied by marked inflammatory cells with a granulomatous reaction in the dermis. Fungal elements were not observed in the nail plate. Primary cutaneous aspergillosis with Aspergillus niger was diagnosed and the infection was successfully treated by thorough washing of the nail bed and topical application of luliconazole ointment.