Abstract: Objective　To diagnose a case of chromoblastomycosis（CBM） due to Fonsecaea monophora with a molecular biological method and to observe the patient response to the treatment with itraconazole plus terbinafine.Methods　We retrospectively analyzed the clinical data（including laboratory findings such as fungal culture，results of microscopy，pathological examination，DNA sequencing and antifungal susceptibility testing） of a case of CBM due to Fonsecaea monophora admitted to Department of Dermatology，Guangdong General Hospital at March 22，2015 receiving treatment with oral administration of itraconazole combined with terbinafine with reviewing the relevant studies.Results　A proliferative verrucous leukoplakia（PVL） was observed on the patient's left jaws of death which appeared after a trauma for over 11 years.Fungal culture produced dark brown or olivaceous to black colonies．Cladosporium-type and rhinocladiella-typeconidiogenous cells were observed on slide culture，which morphologically indicated the identification of Fonsecaea monophora.Histopathology of the skin biopsy showed brown sclerenchyma.Molecular identification of the isolated strain by ITS region sequencing confirmed the causative agent to be Fonsecaea monophora.The patient was diagnosed as CBM due to Fonsecaea monophora according to clinical features and laboratory findings．The results of antifungal susceptibility testing indicated that the isolated strain was sensitive to itraconazole and terbinafine.The patient was cured with a 9-month therapy of oral administration of itraconazole （200 mg/d） and terbinafine （250 mg/d）.No recurrence was found showed by a 6-month follow-up.During the treatment，the liver and renal functions were normal.Conclusion　This case of CBM due to Fonsecaea monophora was cured successfully with combination therapy of itraconazole plus terbinafine.

Key words: Chromoblastomycosis, Fonsecaea monophora, Itraconazole, Terbinafine, Case reports

摘要： 目的　利用分子生物学方法鉴定1例Fonsecaea monophora致着色芽生菌病（CBM），观察伊曲康唑联合特比萘芬治疗的效果。方法　回顾性分析2015-03-22广东省人民医院皮肤科收治的1例Fonsecaea monophora致CBM患者的临床资料。观察真菌培养、镜检、病理检查、DNA测序、体外药敏试验情况以及口服伊曲康唑联合特比萘芬治疗情况。复习相关文献并进行讨论。结果　患者左手虎口部位创伤后引发疣状增生斑块长达11年。沙氏葡萄糖琼脂培养基（SDA）上可见暗棕色、橄榄色至黑色菌落，镜下可见枝孢型和喙枝孢型分生孢子，病理结果显示可见棕色厚壁孢子。ITS区序列分析鉴定为Fonsecaea monophora，结合临床特征及实验室检查确诊为Fonsecaea monophora致CBM，体外抗真菌药敏结果提示该Fonsecaea monophora菌株对伊曲康唑和特比萘芬敏感。口服伊曲康唑（200 mg/d）联合特比萘芬（250 mg/d），共治疗9个月，病情痊愈，随访6个月未见复发。治疗过程中全程检测肝、肾功能，未发生异常。结论　伊曲康唑联合特比萘芬成功治愈1例Fonsecaea monophora致CBM，并取得满意的治疗效果。

关键词: 着色芽生菌病, Fonsecaea monophora, 伊曲康唑, 特比萘芬, 病例报告