PMC9109911_01
Images of the lesions before treatment (A-C). Image of the lesions on her right cheek (A). Image of the lesions on her chin (B). Image of the lesions on her left cheek (C).
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Most of erythematous lesions were eventually covered with golden-yellow scales or crusts which were readily removed as shown in Figure 1A-C.
The strain was cultured on SDA at 28  C for 1 week. The images of colony showing white colonies peripherally radiating, centrally raised, and powdery margins (A), and the reverse side showed yellow to brown colonies (B). The strain staining with lactophenol cotton blue was observed under light microscope showing filamentous and spiral hyphae, microconidia and macroconidia (original magnification x 200) (C), and a grape-like arrangement of microconidia laterally and terminally inserting at the hyphae (original magnification x 400) (D).
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Agar with Chloramphenicol (SDA) (Hope Bio-Technology Co., Ltd., Qingdao, Shandong, China) for fungal growth and Columbia Blood Agar (CBA) (Hope Bio-Technology Co., Ltd., Qingdao, Shandong, China) for bacterial growth, respectively. A white fungal colony was evident after 1 week, which was peripherally radiating but centrally raised with powdery margins (Figure 2A) and a yellow to brown color on the reverse side of the plate (Figure 2B). Under microscopy, a grape-like arrangement of the microconidia was observed laterally and terminally distributed along filamentous and spiral hyphae (Figure 2C and D).
Maximum likelihood phylogenetic tree created from ITS and beta-Tubulin sequences of 31 Trichophyton species including CCJNMM-1678 and 30 representative type strains sequences with bootstrap above 70% are shown. The phylogenetic tree was rooted with Microsporum gypseum (actually Nannizzia gypsea) CBS 146.66.
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A phylogenetic tree in Figure 3 was constructed based on the results of BLAST searches through GenBank with ITS and beta-tubulin sequences using the maximum-likelihood method in MEGA 7.0.
The lesions completely disappeared after one week of treatment with 0.2% ketoconazole cream (twice daily) (A-C). Images of the patient's right cheek (A), chin (B) and left cheek (C) after the treatment.
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The patient was given 0.2% ketoconazole cream twice a day. The lesions completely ceased to be visible after 1 week (Figure 4A-C).