カンジダ性痤瘡の1例

A CASE OF CANDIDAL FOLLICULITIS

はじめに

　皮膚カンジダ症は間擦疹の形をとることが多く^1），毛包炎の形を示すことはきわめてまれである。これまでにカンジダによる毛包炎の報告は散見されるが^2）〜5），毛包内に菌要素を証明した例はほとんどない。最近，堀口・石津^6）によりカンジダ性痤瘡の報告がなされたが，著者らも臨床的には尋常性痤瘡の像を示し，組織学的にはカンジダ性毛包炎と考えられる症例を経験した。自験例について報告するとともに，カンジダ性毛包炎について若干の考察を試みた。

A 22-year-old Japanese woman had been troubled with eruptions of the face for several months. The lesions were recalcitrant to the treatment, a combined therapy of oral antibiotics and topi-cally applied corticosteroid, given by a dermatologist under a diagnosis of acne vulgaris. On the first visit of the patient, a number of tender reddish follicular papules and pustules were grouped on the chin and lower cheeks. Follicular scales which were plucked separately from the cheeks and chin with pointed forceps, were examined by "Parker Quink-KOH" method. Large numbers of fungi were found in materials taken from the face. Fungi were isolated from pustules and identified as species of Candida. Skin biopsy showed a large follicular cyst with perifollicular inflammatory cellular infiltration. Massive PAS-positive oval round spores were detected in the cyst. On the basis of the above mentioned data, the diagnosis of "Candidal folli-culitis" was made. Several cases of "Candidal folliculitis" have been reported, however fungi were found only on the surface of lesions in those cases, except for a case of Horiguchi and Ishizu in which the fungal elements were found within the follicles. A literature says that cutaneous candidiasis is "a biological contact dermatitis of the primary irriant type". In general. candidiasis is a superficial infection, and the fungus inhabits and grows on the surface of the skin, unless it was granulomatous or systemic. Thus, the presented case is considered to be an additional case of "Candidal folliculitis" in a true sense. The iatrogenic causes were suspected.