A 53-year-old landscaper presented to the dermatology clinic with a 4-month history of red, raised, itchy skin lesions on his left lower back and buttock. Physical examination showed numerous verrucous nodules and plaques with overlying crusting and surrounding erythema on the left lower back and buttock. Grocott-Gomori methenamine silver staining showed broad-based budding organisms. Chest imaging showed no abnormalities.
Which of the following is the best treatment?
A. Clarithromycin and amikacin
B. Itraconazole
C. Penicillin
D. Rifampicin, isoniazid, pyrazinamide, and ethambutol
E. Trimethoprim-sulfamethoxazole
答案解析：
诊断为原发性皮肤芽生菌病。尿芽生菌抗原检测结果也为阳性。原发性皮肤芽生菌病是由芽生菌属引起的，芽生菌属是在美国东部发现的二型真菌，通常生长在土壤中，并从林区碎屑中生长。皮肤表现通常提示播散性疾病，但很少通过初次接种发生，如本例。处方伊曲康唑治疗，6个月后皮肤病变消退。
正确答案：B
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