A 62-year-old female patient,whose scalp developed pruritus erythema for 1 month,exacerbated to pustules for 3 weeks,formed scabs for 1 week.KOH direct microscopic examination finds typical hyphae on scalp scales.Culture on Sabo uraud Dextrose Agar (SDA),with 25 ℃ for 25 days,shows purple colonies with reddish periphery.The pathogen's DNA was extracted for PCR amplification and the products was sequenced and identified as Trichophyton violaceum,which confirmed the patient's diagnose of tinea capitis.She was administrated itraconazole 200 mg twice a day taken with milk,combine with 1％ naftifine-0.25 ％ ketoconazole cream,after wash with 2％ ketoconazole shampoo.Her scalp scales are improved 3 weeks later.However,band clustery tension blisters appeared on right scalp,right ear,right cheek,lips and underjaw,which was diagnosed as herpes zoster.The lesion was controlled after we prescribed brivudine 125 mg daily for 9 days.%患者女,62岁,头皮红斑、丘疹、鳞屑1个月,加重伴脓疱3周,结痂1周.取痂壳直接镜检发现真菌菌丝,将痂壳接种沙堡弱培养基25℃培养25 d见紫色菌落生长,周围有红色色素.提取菌落DNA做PCR扩增后测序为紫色毛癣菌,诊断为老年头癣.经牛奶送服伊曲康唑联合2％酮康唑洗剂洗头后外用萘替芬酮康唑治疗3周后患者头皮痂壳消退,但于右侧头面部出现带状分布簇集张力性水疱,诊断为带状疱疹.服用溴夫定片125 mg/d治疗9d后水疱消退.
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