Abstract：
BACKGROUND: Kerion is a severe type of tinea capitis that is difficult to treat and remains a public health problem.
OBJECTIVE: To evaluate the epidemiologic features and efficacy of different treatment schemes from real-world experience.
METHODS: From 2019 to 2021, 316 patients diagnosed with kerion at 32 tertiary Chinese hospitals were enrolled. We analysed the data of each patient, including clinical characteristics, causative pathogens, treatments and outcomes.
RESULTS: Preschool children were predominantly affected and were more likely to have zoophilic infection. The most common pathogen in China was Microsporum canis. Atopic dermatitis (AD), animal contact, endothrix infection and geophilic pathogens were linked with kerion occurrence. In terms of treatment, itraconazole was the most applied antifungal agent and reduced the time to mycological cure. A total of 22.5% of patients received systemic glucocorticoids simultaneously, which reduced the time to complete symptom relief. Furthermore, glucocorticoids combined with itraconazole had better treatment efficacy, with a higher rate and shorter time to achieving mycological cure.
CONCLUSIONS: Kerion often affects preschoolers and leads to serious sequelae, with AD, animal contact, and endothrix infection as potential risk factors. Glucocorticoids, especially those combined with itraconazole, had better treatment efficacy.
OBJECTIVE: To evaluate the epidemiologic features and efficacy of different treatment schemes from real-world experience.
METHODS: From 2019 to 2021, 316 patients diagnosed with kerion at 32 tertiary Chinese hospitals were enrolled. We analysed the data of each patient, including clinical characteristics, causative pathogens, treatments and outcomes.
RESULTS: Preschool children were predominantly affected and were more likely to have zoophilic infection. The most common pathogen in China was Microsporum canis. Atopic dermatitis (AD), animal contact, endothrix infection and geophilic pathogens were linked with kerion occurrence. In terms of treatment, itraconazole was the most applied antifungal agent and reduced the time to mycological cure. A total of 22.5% of patients received systemic glucocorticoids simultaneously, which reduced the time to complete symptom relief. Furthermore, glucocorticoids combined with itraconazole had better treatment efficacy, with a higher rate and shorter time to achieving mycological cure.
CONCLUSIONS: Kerion often affects preschoolers and leads to serious sequelae, with AD, animal contact, and endothrix infection as potential risk factors. Glucocorticoids, especially those combined with itraconazole, had better treatment efficacy.
摘要：
背景：Kerion是一种严重的头癣，难以治疗，仍然是一个公共卫生问题。
目的：从实际经验中评估不同治疗方案的流行病学特征和疗效。
方法：从2019年至2021年，在32家三级中国医院确诊的316例患者中纳入。我们分析了每个病人的数据,包括临床特征，致病性病原体，治疗和结果。
结果：学龄前儿童主要受到影响，并且更有可能发生嗜血杆菌感染。中国最常见的病原体是犬小孢子菌。特应性皮炎(AD),动物接触,内皮感染和嗜地病原体与角质发生有关。在治疗方面,伊曲康唑是应用最多的抗真菌药，缩短了真菌学治愈的时间。共有22.5%的患者同时接受全身性糖皮质激素,缩短了症状缓解的时间.此外，糖皮质激素联合伊曲康唑治疗效果较好,以更高的速度和更短的时间来实现真菌学治愈。
结论：Kerion经常影响学龄前儿童并导致严重的后遗症，AD,动物接触,和内皮组织感染是潜在的危险因素。糖皮质激素,尤其是那些与伊曲康唑合用的，有较好的治疗效果。
目的：从实际经验中评估不同治疗方案的流行病学特征和疗效。
方法：从2019年至2021年，在32家三级中国医院确诊的316例患者中纳入。我们分析了每个病人的数据,包括临床特征，致病性病原体，治疗和结果。
结果：学龄前儿童主要受到影响，并且更有可能发生嗜血杆菌感染。中国最常见的病原体是犬小孢子菌。特应性皮炎(AD),动物接触,内皮感染和嗜地病原体与角质发生有关。在治疗方面,伊曲康唑是应用最多的抗真菌药，缩短了真菌学治愈的时间。共有22.5%的患者同时接受全身性糖皮质激素,缩短了症状缓解的时间.此外，糖皮质激素联合伊曲康唑治疗效果较好,以更高的速度和更短的时间来实现真菌学治愈。
结论：Kerion经常影响学龄前儿童并导致严重的后遗症，AD,动物接触,和内皮组织感染是潜在的危险因素。糖皮质激素,尤其是那些与伊曲康唑合用的，有较好的治疗效果。
