Abstract:
A 20-year-old man had developed dermatitis on his scalp and facial hair between his lower lip and chin, his \'soul patch\', for one month. He initially presented to urgent care, where the dermatitis was attributed to Herpes simplex infection, for which he was treated with both oral valacyclovir and topical acyclovir. When no change was observed, he consulted his pediatrician, who prescribed oral clindamycin and referred him to dermatology. Physical examination revealed a crusted plaque on an erythematous and edematous base at the lower cutaneous border of the lower lip (Figure 1). Examination additionally revealed an erythematous scaling plaque on the left temporal area with associated flaking, tenderness, and hair loss and left-sided cervical lymphadenopathy. A fungal culture grew Trichophyton mentagrophytes, but a bacterial culture did not grow. Further investigation revealed that he had a dog; however, no other animal contact to account for a fungal reservoir was present. He was successfully treated with oral terbinafine for 6 weeks, plus ketoconazole 2% shampoo and ketoconazole 2% cream with complete reso-lution (Figure 2).
摘要:
一名20岁男子的头皮和下唇和下巴之间的面部毛发出现皮炎,他的“灵魂补丁”,一个月。他最初接受了紧急护理,皮炎归因于单纯疱疹感染,为此,他接受了口服伐昔洛韦和外用阿昔洛韦的治疗。当没有观察到变化时,他咨询了他的儿科医生,他开了口服克林霉素并转诊到皮肤科。体格检查显示,下唇下皮肤边缘的红斑和水肿基底上有结痂斑块(图1)。检查还发现左侧颞区有红斑鳞屑斑块,并伴有剥落,压痛,脱发和左侧颈部淋巴结肿大。真菌培养物生长了毛癣菌,但是细菌培养物没有生长。进一步调查显示他有一只狗;然而,没有其他动物接触,以解释真菌库的存在。他成功口服特比萘芬治疗6周,加上酮康唑2%洗发水和酮康唑2%乳膏与完全反应(图2)。