• 文章类型: Case Reports
    头癣,主要由毛癣菌和小孢子菌等皮肤癣菌引起,是一种影响头皮和头发的浅表真菌感染,常见于青春期前儿童,但罕见于成人。在这里,我们报告了一个成年女性头癣的独特病例,表现为头皮尖部弥漫性脱发和红斑炎症,模仿脂溢性皮炎.使用荧光显微镜和真菌培养物检查头发和头皮,确定了球形马拉色菌菌丝的存在,糠马拉色菌和犬小孢子菌。患者接受口服抗真菌药物治疗3个月,导致皮疹和随后的头发再生的解决,6个月随访期间无复发。犬小孢子菌和马拉色菌(球形马拉色菌和糠马拉色菌)的体外共培养实验表明,马拉色菌似乎促进犬小孢子菌的生长,而没有观察到相反的情况。这些数据表明,马拉色菌使用长链脂肪酸可能会降低其抗菌作用,可能有助于犬小孢子菌引起的成人头癣的发展。
    Tinea capitis, primarily caused by dermatophytes such as Trichophyton and Microsporum species, is a superficial fungal infection affecting the scalp and hair, commonly observed in prepubertal children but rare in adults. Here we report a unique case of an adult female with tinea capitis presenting as diffused alopecia and erythema inflammation on the scalp\'s apex, mimicking seborrheic dermatitis. Examination of the hair and scalp using fluorescence microscopy and fungal culture identified the presence of hyphae from Malassezia globosa, Malassezia furfur and Microsporum canis. The patient underwent with oral antifungal treatment for 3 months, resulting in the resolution of the rash and subsequent hair regrowth, with no recurrence during 6-month follow-up. In vitro co-culture experiments of Microsporum canis and Malassezia (both Malassezia globose and Malassezia furfur) revealed that Malassezia appears to facilitate Microsporum canis growth, while the reverse was not observed. This data suggests that Malassezia\'s use of long-chain fatty acids by might reduce its antibacterial effect, potentially aiding adult tinea capitis development caused by Microsporum canis.
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  • 文章类型: Journal Article
    背景:头癣,主要影响儿童的常见头皮感染,是由皮肤角质化真菌引起的,特别是小孢子菌和毛癣菌。犬小孢子菌,主要从猫和狗传播给人类,在像印度这样的非流行地区很少报道。我们报告了一个涉及三个来自德里的家庭成员的案件,印度,诊断为犬小孢子菌引起的头癣。索引案例,一个五岁的男孩,通过与猫接触感染,而他的弟弟和妹妹是通过家庭内的人传人获得的。
    方法:临床检查,微观分析,和分子鉴定技术证实了诊断。抗真菌药敏试验显示对伊曲康唑和特比萘芬敏感,但对灰黄霉素耐药。
    结果:口服特比萘芬和外用酮康唑乳膏治疗3例患者均取得了成功的结果。分子分型证实了分离株的克隆性,表明人与人之间的传播。
    结论:本案例研究强调了在非流行地区犬小孢子虫引起的头癣的诊断和治疗中考虑非典型感染源和人与人之间传播的重要性。它强调了彻底的接触史评估和适当的抗真菌治疗以有效控制感染的必要性。
    BACKGROUND: Tinea capitis, a common scalp infection primarily affecting children, is caused by keratinophilic dermatophytic fungi, notably Microsporum and Trichophyton species. Microsporum canis, primarily transmitted from cats and dogs to humans, is rarely reported in non-endemic regions like India. We report a cases involving three family members from Delhi, India, diagnosed with tinea capitis caused by Microsporum canis. The index case, a five-year-old boy, contracted the infection through contact with a cat, while his younger brother and sister acquired it through human-to-human transmission within the family.
    METHODS: Clinical examination, microscopic analysis, and molecular identification techniques confirmed the diagnosis. Antifungal susceptibility testing revealed sensitivity to itraconazole and terbinafine but resistance to griseofulvin.
    RESULTS: Treatment with oral terbinafine and topical ketoconazole cream led to successful outcomes for all three patients. Molecular typing confirmed clonality of the isolates, indicating human-to-human transmission.
    CONCLUSIONS: This case study underscores the significance of considering atypical sources of infection and human-to-human transmission in the diagnosis and management of tinea capitis caused by Microsporum canis in non-endemic regions. It emphasizes the necessity of thorough contact history assessment and appropriate antifungal therapy for effective control of the infection.
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  • 文章类型: Journal Article
    头癣(TC)的流行病学数据,皮肤癣菌对头皮的感染,在喀麦隆是稀缺的。这项研究旨在确定Dschang分区的学童中TC的患病率,喀麦隆西部。2021年6月在Dschang进行了一项横断面研究,其中包括5-13岁的学生。首先,我们对参与者进行了标准化问卷,以收集社会人口统计学数据.然后,收集样品并在Sabouraud-氯霉素-庆大霉素琼脂上培养。根据其形态特征和MALDI-TOF质谱鉴定病原体。共有1070名儿童接受了临床检查,108名(10.1%)儿童出现TC病变。1070名参与者的平均年龄为8.3±2.6岁(范围:5-13岁);772(72.2%)为男性。钻孔水的使用(OR=0.01,95CI[0.001-0.03]),泉水(OR=0.2,95CI[0.08-0.50]),雨水(OR=0.004,95CI[0.001-0.016]),和美发沙龙访问(OR=0.413,95CI[0.196-0.872])在多变量逻辑回归分析中与TC风险降低相关.相比之下,与兄弟姐妹同床(OR=4.48,95CI[2.095-9.60])与儿童TC风险增加相关.在培养中分离出的32种皮肤癣菌中,audouinii小孢子菌最常见(43.8%),其次是红色毛癣菌(25.0%)和T.soudanense(25.0%)。犬小孢子菌和紫菜均很少分离。需要进一步的研究来评估TC与本研究中强调的生活用水的关联。
    Data on the epidemiology of tinea capitis (TC), an infection of the scalp by dermatophytes, are scarce in Cameroon. This study aimed to determine the prevalence of TC among school-children in the Dschang Subdivision, Western Cameroon. A cross-sectional study was carried out in June 2021 in Dschang including pupils aged 5-13. First, a standardized questionnaire was administered to participant for the collection of sociodemographic data. Then, samples were collected and cultured onto Sabouraud-Chloramphenicol-Gentamicin Agar. The etiological agents were identified based on their morphological features and with MALDI-TOF mass spectrometry. A total of 1070 children were clinically examined and 108 (10.1%) children presented with TC lesions. The mean age of the 1070 participants was 8.3 ± 2.6 years (range: 5-13 years); 772 (72.2%) were males. The use of borehole water (OR = 0.01, 95%CI[0.001-0.03]), spring water (OR = 0.2, 95%CI[0.08-0.50]), rainwater (OR = 0.004, 95%CI[0.001-0.016]), and hairdressing salons visits (OR = 0.413, 95%CI[0.196-0.872]) were associated with a decreased TC risk in the multivariate logistic regression analysis. In contrast, sharing bed with siblings (OR = 4.48, 95%CI[2.095-9.60]) was associated with an increased TC risk in children. Among the 32 dermatophytes isolated in culture, Microsporum audouinii was the most frequent (43.8%), followed by Trichophyton rubrum (25.0%) and T. soudanense (25.0%). Microsporum canis and T. violaceum were both rarely isolated. Further studies are warranted to assess the association of TC with domestic water usage that has been highlighted in this study.
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  • 文章类型: Journal Article
    头癣(TC)是一种常见的头皮真菌感染,尤其是儿童。毛管镜检查是一种非侵入性技术,可以在体内快速和放大地观察头发,并可视化肉眼通常无法察觉的形态特征。
    本研究旨在评估内窥镜在临床诊断中的有用性,并研究TC的各种临床形态学模式。
    这个横截面,观察性研究包括在1年期间(2021年4月至2022年3月)发现的140例TC临床诊断病例.所有患者均使用皮肤镜进行评估(DermliteDL4Multispectrical3Gen,圣胡安·卡皮斯特拉诺,CA,美国,10×)。
    本研究中TC的患病率为每千人2.69。最常见的临床变异是灰色斑块,其次是kerion和黑点,最常见的病因是扁桃体毛癣菌。特征性的毛发特征如下:逗号毛(80%),其次是开瓶器毛(68.6%),弯曲的头发(54.2%),之字形毛发(35.7%),和类似摩尔斯电码的毛发(15%)。其他发现包括缩放(89.2%),其次是黑点(67.1%),断发(42.8%),结痂和脓疱(各32.1%)。逗号和开瓶器形状的头发在黑点类型中最常见,而锯齿形,弯曲的头发,莫尔斯电码毛在TC的灰色斑块类型中很常见。三镜检查结果与TC类型之间存在显着关联。
    毛管镜检查可以被认为是一种新颖的工具,用于快速诊断和选择适当的治疗方法以及监测TC的治疗效果。
    UNASSIGNED: Tinea capitis (TC) is a common fungal infection of the scalp, especially in children. Trichoscopy is a noninvasive technique that allows rapid and magnified in vivo observation of the hair with the visualization of morphologic features that are often imperceptible to the naked eye.
    UNASSIGNED: This study aimed to evaluate the usefulness of trichoscopy in clinical diagnosis and to study various clinico-morphological patterns of TC.
    UNASSIGNED: This cross-sectional, observational study included 140 clinically diagnosed cases of TC seen during a period of 1 year (April 2021 to March 2022). All patients were evaluated using a dermoscope (DermLite DL4 Multispectral 3 Gen, San Juan Capistrano, CA, USA,10×).
    UNASSIGNED: The prevalence rate of TC in this study was 2.69 per thousand population. The most common clinical variant was gray patch followed by kerion and black dot, and the most common etiological agent was Trichophyton tonsurans. The characteristic trichoscopic features were as follows: comma hairs (80%), followed by corkscrew hairs (68.6%), bent hairs (54.2%), zigzag hairs (35.7%), and morse code-like hairs (15%). Other findings included scaling (89.2%), followed by black dot (67.1%), broken hairs (42.8%), and crusting and pustules (32.1% each). Comma and corkscrew-shaped hairs were most common in the black dot type, whereas zigzag, bent hairs, and morse code hairs were common in the gray patch type of TC. There was a significant association between trichoscopic findings and type of TC.
    UNASSIGNED: Trichoscopy can be considered a novel tool for rapid diagnosis and selection of the appropriate therapy and in the monitoring of treatment efficacy in TC.
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  • 文章类型: Journal Article
    简介头癣,通常被称为头皮癣,是一种影响头皮的真菌感染,睫毛,和眉毛。它通常是由毛癣菌和小孢子菌属的皮肤癣菌引起的。扁桃体毛癣菌和犬小孢子菌是全球大多数头癣病例的主要病因。头癣通常表现为瘙痒,脱发的鳞片状斑块。头癣是全球儿童中普遍存在的皮肤癣菌疾病。方法进行了一项体外评估研究,以评估印度的乙醇提取物的抗真菌特性以及桉树和丁尼红的油。无论是单独还是组合。采用琼脂扩散法和M38-A2微量肉汤稀释法评价了对致病性皮肤癣菌的抗真菌功效,即犬小孢子菌和沙端毛癣菌。将完全成熟的绿叶用乙醇处理,以制备印em叶提取物。此外,进行高效液相色谱分析以确定萜类化合物的含量。氟康唑,一种抗真菌药物,被用作标准。结果研究结果表明,在187.5和375μg/ml的最小抑制浓度下,对于所选草药油,皮肤癣菌的生长总体抑制作用为0.625至2.5μl/ml。而对犬小孢子菌和扁桃体毛癣菌的阳性对照为0.25μg/ml和0.50μg/ml,分别。结论通过对苦参叶中乙醇提取物的植物化学研究发现,萜类化合物的存在。以其显著的生物活性而闻名。该研究的发现证明了印eem叶提取物与桉树和Cymbogon马提尼油组合用于治疗头癣感染的治疗能力。当将印度的叶提取物和油混合时,可以看到更广泛和改善的抗真菌谱。因此,它可以发展成为治疗头癣的合适配方。
    Introduction Tinea capitis, often known as ringworm of the scalp, is a fungal infection that affects the scalp, eyelashes, and eyebrows. It is generally caused by dermatophytes from the genera Trichophyton and Microsporum. Trichophyton tonsurans and Microsporum canis are the main etiological agents responsible for most of the cases of tinea capitis globally. Tinea capitis commonly manifests as itchy, scaly patches of hair loss. Tinea capitis is the prevailing dermatophyte illness among children globally. Methods An in-vitroevaluation study was conducted to assess the antifungal properties of ethanolic extracts of neem leaves and the oils of Eucalyptus citriodora and Cymbopogon martini, both individually and in combination. The agar-well diffusion method and the M38-A2 microbroth dilution method were employed to evaluate the antifungal efficacy against pathogenic dermatophyte strains, namely Microsporum canis and Trichophyton tonsurans. The fully mature green leaves were treated with ethanol to make the neem leaf extract. Additionally, high-performance liquid chromatographic analysis was carried out to determine the contents of the terpenoids. Fluconazole, an antifungal drug, is used as a standard. Results The findings demonstrated an overall inhibition of the growth of dermatophytes at a minimal inhibitory concentration of 187.5 and 375 μg/ml for neem leaf extract and 0.625 to 2.5 μl/ml for selected herbal oils, whereas it was 0.25 μg/ml and 0.50 μg/ml for positive control against Microsporum canis and Trichophyton tonsurans, respectively. Conclusion The phytochemical investigation of the ethanolic extracts in neem leaves revealed the presence of terpenoids, which are known for their significant biological activity. The study\'s findings demonstrated the therapeutic capabilities of neem leaf extract in combination with the oils of Eucalyptus citriodora and Cymbopogon martini for managing the tinea capitis infection. A broader and improved antifungal spectrum was seen when neem leaf extract and oils were combined. Therefore, it can be developed into a suitable formulation for the management of tinea capitis.
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  • 文章类型: Journal Article
    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。
    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.
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  • 文章类型: Journal Article
    头癣(T.capitis),俗称头皮癣,是影响头皮和头发的真菌感染。在病原体中,犬小孢子菌(M.Canis)脱颖而出,经常从猫传播给人类(人畜共患疾病)。在这项研究中,我们调查了番木瓜的功效(C.木瓜),对皮肤癣菌的水果提取物,尤其是M.canis,在体外和体内。此外,我们旨在确定抑制真菌生长的活性化合物,并评估木瓜对人细胞的毒性。
    它分两个部分进行。首先,体外研究包括以甲醇为溶剂制备木瓜果实提取物,植物提取物的化学分析包括气相色谱-质谱(GC-MS)和傅里叶变换红外光谱(FTIR),使用HUH-7细胞进行细胞毒性测定,采用MTT测定(1-(3-(4,5-二甲基噻唑-2-基)-2,5-二苯基四唑溴化物),对犬分枝杆菌的抗菌活性进行了评估,包括:抑制区(ZI),最小抑制浓度(MIC),最小杀菌浓度(MFC),使用扫描电子显微镜(SEM)和透射电子显微镜(TEM)观察犬M.canis细胞的改变。第二,在Vivo,包括白化病Wistar雄性大鼠。
    木瓜甲醇提取物的植物化学分析揭示了几个官能团,包括羟基,氨,烷烃,碳酸盐,和酒精。此外,GC-MS分析确定了15种化合物,黄嘌呤和癸酸是主要成分。木瓜果实的甲醇提取物表现出有效的抗真菌活性:ZI=37毫米,MIC=1,000μg/mL,MFC=1900μg/mL,MTT结果表明,在20μg/mL的浓度下,水果提取物的细胞毒性较低,50μg/mL,100μg/mL,150μg/mL,和200μg/mL,IC50显示细胞活力随着提取物浓度的增加而显著降低。值得注意的是,木瓜提取物引起犬分枝杆菌菌丝和孢子形态的明显改变。在动物组织中,在用木瓜提取物治疗的大鼠组中观察到改善。这项研究强调了木瓜果实作为天然抗真菌剂的潜力,保证临床应用的进一步探索。
    UNASSIGNED: Tinea capitis (T. capitis), commonly known as scalp ringworm, is a fungal infection affecting the scalp and hair. Among the causative agents, Microsporum canis (M. canis) stands out, often transmitted from cats to humans (zoonotic disease). In this study, we investigated the efficacy of Carica papaya (C. papaya), fruit extract against dermatophytes, particularly M. canis, both in vitro and in vivo. Additionally, we aimed to identify the active compounds responsible for suppressing fungal growth and assess the toxicity of C. papaya on human cells.
    UNASSIGNED: It conducted in two parts. First, In Vitro Study include the preparation of C. papaya fruit extract using methanol as the solvent, Phytochemical analysis of the plant extract including Gas chromatography-mass spectrometry (GC-MS) and Fourier-transform infrared spectroscopy (FTIR) was conducted, Cytotoxicity assays were performed using HUH-7 cells, employing the MTT assay (1-(3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide), Antimicrobial activity against M. canis was evaluated, including: Zone of inhibition (ZI), Minimum inhibitory concentration (MIC), Minimum fungicidal concentration (MFC), M. canis cell alterations were observed using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Second, In Vivo, Albino Wistar male rats were included.
    UNASSIGNED: The phytochemical analysis of the methanolic extract from papaya revealed several functional groups, including hydroxyl, ammonia, alkane, carbonate, and alcohol. Additionally, the GC-MS analysis identified 15 compounds, with xanthosine and decanoic acid being the predominant components. The methanolic extract of papaya fruits demonstrated potent antifungal activity: ZI = 37 mm, MIC = 1,000 μg/mL, MFC = 1900 μg/mL, MTT results indicated lower cytotoxicity of the fruit extract at concentrations of 20 μg/mL, 50 μg/mL, 100 μg/mL, 150 μg/mL, and 200 μg/mL, The IC50 revealed a significant decrease in cell viability with increasing extract concentration. Notably, papaya extract induced considerable alterations in the morphology of M. canis hyphae and spores. In animal tissue, improvements were observed among the group of rats which treated with Papaya extract. This study highlights the potential of C. papaya fruits as a natural antifungal agent, warranting further exploration for clinical applications.
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  • 文章类型: Journal Article
    头癣是由皮肤癣菌引起的头皮和头发的真菌感染,最常影响儿童,也可能影响成人。以前的估计表明,全世界所有头癣病例中有3%至11%发生在成人中,尽管需要最新的流行病学研究来重新评估成人人群中头癣的患病率.绝经后成年女性最常受到头癣的影响,非洲裔美国人或黑人女性尤其处于危险之中。经历拥挤生活条件的成年人,住在动物附近,免疫抑制的人,和/或居住在有受影响儿童的家庭中的人感染的风险最大。头癣可以是非炎性或炎性的,亚型影响临床症状的范围和严重程度。真菌培养和氢氧化钾制剂是最常用的诊断工具。显微镜检查,定义为头皮和头发的皮肤镜成像,是体检的有用辅助手段。治疗的主要手段是口服抗真菌药物,和局部治疗单独不推荐。由于头癣感染在成人中并不常见,目前尚无广泛接受的治疗指南.相反,儿童头癣感染的相同药物建议成人使用不同剂量,包括灰黄霉素,还有特比萘芬,and,不太常见,伊曲康唑和氟康唑。如果给予及时和充分的治疗,成人头癣的预后通常很好;然而,诊断延迟或治疗不当可导致瘢痕性脱发。在过去的十年里,已经出现了对局部和口服抗真菌药物治疗具有抗性的皮肤癣菌感染。虽然迄今为止很少报道对抗真菌治疗耐药的头癣感染,抗真菌耐药性在浅表真菌感染中总体上升,和抗真菌管理是必要的,以确保对治疗的耐药性不会在引起头癣的皮肤癣菌中发展。
    Tinea capitis is a fungal infection of the scalp and hair caused by dermatophyte molds, that most often affects children and may also affect adults. Previous estimates suggest that between 3% and 11% of all tinea capitis cases worldwide occur in adults, although updated epidemiological studies are needed to reassess the prevalence of tinea capitis in adult populations specifically. Postmenopausal adult women are most often affected by tinea capitis, with African American or Black women particularly at risk. Adults who experience crowded living conditions, who live in close proximity to animals, who are immunosuppressed, and/or who live in households with affected children are at greatest risk of infection. Tinea capitis can be non-inflammatory or inflammatory in nature, and the subtype affects the extent and severity of clinical symptoms. Fungal culture and potassium hydroxide preparations are the most commonly used diagnostic tools. Trichoscopy, defined as dermoscopic imaging of the scalp and hair, is a useful adjunct to the physical examination. The mainstay of therapy is oral antifungal therapy, and topical therapy alone is not recommended. Since tinea capitis infection is uncommon in adults, there are no widely accepted treatment guidelines. Rather, the same medications used for tinea capitis infection among children are recommended for adults at varying doses, including griseofulvin, and terbinafine, and, less commonly, itraconazole and fluconazole. The prognosis for tinea capitis in adults is typically excellent when prompt and adequate treatment is administered; however, delayed diagnosis or inadequate treatment can result in scarring alopecia. Over the past decade, dermatophyte infections resistant to treatment with topical and oral antifungal agents have emerged. While tinea capitis infections resistant to antifungal therapy have been rarely reported to date, antifungal resistance is rising among superficial fungal infections in general, and antifungal stewardship is necessary to ensure that resistance to treatment does not develop among dermatophytes that cause tinea capitis.
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  • 文章类型: Letter
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  • 文章类型: Case Reports
    Kerioncelsi(KC),称为头皮癣,是儿童中最常见的皮肤癣菌病。在墨西哥,它在皮肤癣菌中排名第四,频率为4%-10%。KC是头癣(TC)的炎性品种,最常见的病原体是犬小孢子菌和毛癣菌。我们介绍了一名6岁男性被诊断患有KC的临床病例。直接检查用氯唑黑染色,并进行培养,产生负面结果。组织病理学研究显示,毛干内部和周围有孢子和短菌丝。伊曲康唑治疗是基于对小孢子菌的怀疑而开始的。从内窥镜检查的结果。我们提出了一种用于kerioncelsi的诊断和治疗算法。
    Kerion celsi (KC), known as scalp ringworm, is the most common dermatophytosis in children. In Mexico, it ranks fourth among dermatophytoses, with a frequency of 4%-10%. KC is the inflammatory variety of tinea capitis (TC), with the most common causative agents being Microsporum canis and Trichophyton mentagrophytes. We present the clinical case of a six-year-old male diagnosed with KC. Direct examination stained with chlorazol black and cultures were performed, yielding negative results. Histopathological study revealed spores and short hyphae within and surrounding the hair shaft. Treatment with itraconazole was initiated based on suspicion of Microsporum spp. from the trichoscopy findings. We propose a diagnostic and therapeutic algorithm for kerion celsi.
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