A Case of Superficial Hyperkeratotic Candidiasis of Palm Complicated with Nail Candidiasis.

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  • 爪カンジダ症を合併した手掌の角質増殖型皮膚カンジダ症の１例

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We report the case of a 38-year-old man with superficial hyperkeratotic candidiasis of palm with nail involvement. He visited our hospital because he developed scaly erythema with hyperkeratosis on his left palm with pachonychia of his left thumb and middle finger. Direct examination of the nail using the Parker-KOH method revealed numerous fungal elements, including both hyphae and grape-shaped spores, however, examination of the palm showed numerous hyphae but no spores. Candida tropicalis and C. parapsilosis were isolated and identified from both palm and nail. One week after treatment with oral itraconazole and topical antifungal reagent, same positive results were obtained with the Parker-KOH method. Cultures of the nail with Sabouraud dextrose agar were positive in both candida species, but those of scales from palm were negative. Observations of the culture with BHI broth with thiamin and inositol were the same as the culture with Sabouraud dextrose agar. However, Candida-elements on the palm were detectable by both PAP method with polyclonal anti-candida antibodies and PAS staining.

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