• 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: Journal Article
    Kerion,由皮肤癣菌引起的头癣的严重表现,是一种主要影响儿童的真菌性皮肤病。本报告讨论了6例成功采用光动力疗法(PDT)和抗真菌药联合治疗的小儿鹿鱼。此外,我们进行了文献综述,鉴定和分析六份已发表的关于角膜炎和头癣的报告。总结了这些病例的特点和疗效。总之,早期联合治疗和积极的治疗前干预措施被证明可以最大限度地提高治疗效果,减少疾病持续时间和减少不良反应,如瘢痕性脱发。这种方法已成为治疗kerion的有利选择。
    Kerion, a severe manifestation of tinea capitis caused by dermatophytes, is a fungal skin disease primarily affecting children. This report discusses six cases of pediatric kerion that were successfully treated with a combination of photodynamic therapy (PDT) and antifungal agents. Additionally, we conducted a literature review, identifying and analyzing six published reports on kerion and tinea capitis. The characteristics and efficacies of these cases are summarized. In summary, early combination therapy and proactive pre-treatment interventions proved effective in maximizing therapeutic outcomes, reducing disease duration and minimizing adverse reactions such as cicatricial alopecia. This approach has emerged as a favorable choice for the treatment of kerion.
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  • 文章类型: Systematic Review
    对用于治疗皮肤病的天然和可持续产品的需求日益增加。本系统评价旨在批判性地分析已发表的随机对照试验(RCT),并为姜黄素治疗各种皮肤病提供循证建议。2023年7月18日,使用PRISMA姜黄或姜黄素治疗皮肤病的指南,对已发表的文献进行了系统的搜索。根据牛津循证医学中心指南提出临床建议。我们确定了18项使用姜黄或姜黄素治疗牛皮癣的原始随机对照试验,放射性皮炎,口腔扁平苔藓,瘙痒,白癜风,头癣,面部红斑,和疤痕。牛皮癣,剖宫产瘢痕,瘙痒接受B级建议的放射性皮炎,口腔扁平苔藓,白癜风,头癣,并且面部红肿获得了建议C或D的等级。在所有分析的临床试验中,姜黄素被证明具有优异的安全性。需要进一步的研究来确定姜黄的最佳剂量和治疗参数。额外,较大,应进行RCT和非RCT,以进一步研究姜黄素作为皮肤病治疗选择的安全性和有效性。
    There is increasing demand for natural and sustainable products for the treatment of dermatologic conditions. This systematic review aims to critically analyze published randomized controlled trials (RCTs) and provide evidence-based recommendations on the therapeutic use of curcumin for a variety of dermatological diseases. A systematic search of published literature was performed on July 18, 2023 using PRISMA guidelines for turmeric or curcumin for the treatment of skin diseases. Clinical recommendations were made based on the Oxford Centre for Evidence-Based Medicine guidelines. We identified 18 original randomized controlled trials for use of turmeric or curcumin for psoriasis, radiation dermatitis, oral lichen planus, pruritis, vitiligo, tinea capitis, facial erythema, and scarring. Psoriasis, cesarean section scar, and pruritus received grade of recommendation B. Radiation dermatitis, oral lichen planus, vitiligo, tinea capitis, and facial redness received grade of recommendation C or D. Curcumin was demonstrated to have an excellent safety profile in all clinical trials analyzed. Further research is required to determine optimal dosing and treatment parameters of turmeric. Additional, larger, RCTs and non-RCTs should be conducted to further investigate the safety and efficacy of curcumin as a treatment option for dermatological diseases.
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  • 文章类型: Case Reports
    头癣是儿童头皮常见的皮肤癣菌感染。它在成人中是一种罕见的感染,通常影响绝经后妇女和免疫功能低下的患者。我们报告了一名具有免疫能力的老年女性,患有由紫毛毛癣菌引起的炎症性头癣,并回顾了过去5年的文献来描述这种疾病。其流行病学特征,涉及的皮肤癣菌物种和使用的治疗方案。病例总数为11例,其中女性8例,男性3例,平均年龄48.36岁.最常见的分离的皮肤癣菌是沙端毛癣菌,大多数病例口服特比萘芬治疗成功,无副作用。在我们的案例中,诊断是通过直接检查确定的,培养和组织学检查。伊曲康唑和泼尼松龙的补救措施非常成功。成人头癣的早期诊断对于提供早期治疗和减少疾病的后遗症是必要的。
    Tinea capitis is a common dermatophyte infection of the scalp in children. It is an uncommon infection in adults and usually affects postmenopausal women and immunocompromised patients. We report an immunocompetent elderly female with inflammatory tinea capitis caused by Trichophyton violaceum and review the literature for the past 5 years to describe the disease, its epidemiologic characteristics, dermatophyte species involved and treatment options used. The total number of cases was 11, including 8 women and 3 men, with an average age of 48.36. The most commonly isolated dermatophyte was Trichophyton tonsurans, and most cases were treated successfully with oral terbinafine with no side effects. In our case, the diagnosis was established by direct examination, culture and histological examination. Remedy with itraconazole and prednisolone was very successful. Early diagnosis of tinea capitis in adults is necessary to provide early treatment and minimize sequelae of the disease.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    KerionCelsi是一种炎症,头皮深部真菌感染。它在新生儿中很少见,但在3岁及以上的儿童中更常见。它代表肿胀,沼泽病变,疼痛,脱发和脓性分泌物。浸渍后继发细菌感染并不罕见。皮外表现包括局部淋巴结病,发烧和非常罕见的真菌血症。可以发生Id反应。诊断是基于临床怀疑,临床检查和病史。诊断应通过显微镜确认,真菌培养和分子程序。最常见的分离真菌物种是嗜人毛癣菌(T。)小苏兰和亲虫小孢子菌(M.)canis,而嗜地性物种和霉菌很少引起KerionCelsi。治疗是医学上的全身性和局部抗真菌药,必要时补充全身性抗生素,而手术需要避免。早期和充分的治疗可防止瘢痕性脱发。最重要的鉴别诊断是细菌性皮肤和软组织感染。
    Kerion Celsi is an inflammatory, deep fungal infection of the scalp. It is rare in neonates but gets more common in children about 3 years and older. It represents with swelling, boggy lesions, pain, alopecia and purulent secretions. Secondary bacterial infection is not unusual after maceration. Extracutaneous manifestations include regional lymphadenopathy, fever and very rare fungemia. Id-reactions can occur. Diagnosis is based on clinical suspicion, clinical examination and medical history. Diagnosis should be confirmed by microscopy, fungal culture and molecular procedures. The most common isolated fungal species are anthropophilic Trichophyton (T.) tonsurans and zoophilic Microsporum (M.) canis, while geophilic species and moulds rarely cause Kerion Celsi. Treatment is medical with systemic and topical antifungals supplemented by systemic antibiotics when necessary, while surgery needs to be avoided. Early and sufficient treatment prevents scarring alopecia. The most important differential diagnosis is bacterial skin and soft tissue infections.
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  • 文章类型: Case Reports
    头癣是儿童的常见疾病,但在1个月以下的新生儿中很少见。从1990年至今,索引文献中仅描述了29例新生儿头癣。虽然抗真菌剂可以局部和全身使用,由于局部药物进入毛囊的渗透有限,全身抗真菌治疗通常被认为是头癣的首选治疗方法。然而,缺乏新生儿使用全身抗真菌药物的数据,并且有报道仅使用局部疗法成功治疗新生儿头癣。在本文中,我们介绍了一例29日龄女婴的头癣病例,并回顾了此前29例报道的病例.
    Tinea capitis is a common disease in children but rare in newborns younger than 1 month of age. Only 29 cases of tinea capitis in newborns have been described in indexed literature from 1990 until now. While antifungal agents can be used topically and systemically, systemic antifungal therapy is generally accepted as the treatment of choice for tinea capitis due to limited penetration of topical agents into the hair follicle. However, there is a lack of data on the use of systemic antifungal agents in newborns, and there are reports of successful treatment of tinea capitis in newborns using only topical therapy. In this paper, we present a case of tinea capitis in a 29-day-old female baby and review the previous 29 reported cases.
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  • 文章类型: Journal Article
    大规模的人口流动改变了接收难民的国家头癣(TC)的流行病学。定期监测局部病原体谱可以作为选择适当的经验性抗真菌治疗和实施预防措施的基础。因此,我们调查了自2015年以来希腊前所未有的移民潮对TC流行病学趋势的影响.所有在2012-2019年期间在雅典的皮肤科疾病转诊学术医院确诊的微生物确诊的TC病例,希腊,进行回顾性审查。共记录583例患者,348(60%)是男性,547(94%)是儿童,160(27%)是来自巴尔干的移民,中东,亚洲和非洲国家。TC的总体年发病率为0.49,多年来显著增加(p=0.007)。犬分枝杆菌是主要的病原体(74%),其次是紫罗兰(12%),T.tonsurans(7%)和其他稀有皮肤癣菌(7%)。犬分枝杆菌患病率从2014年到2019年下降(84%到67%,p=0.021)与紫罗兰草率增加三倍(10%至32%,p=0.002)。随着向嗜人性毛癣菌的转移,TC的发病率增加。在希腊,可能与来自不同社会经济背景的移民流有关。
    Mass population movements have altered the epidemiology of tinea capitis (TC) in countries receiving refugees. Periodic monitoring of the local pathogen profiles may serve as a basis for both the selection of appropriate empirical antifungal therapy and the implementation of preventive actions. Therefore, we investigated the impact of an unprecedented immigration wave occurring in Greece since 2015 on the epidemiological trends of TC. All microbiologically confirmed TC cases diagnosed during the period 2012-2019 in a referral academic hospital for dermatological disorders in Athens, Greece, were retrospectively reviewed. A total of 583 patients were recorded, where 348 (60%) were male, 547 (94%) were children and 160 (27%) were immigrants from Balkan, Middle Eastern, Asian as well as African countries. The overall annual incidence of TC was 0.49, with a significant increase over the years (p = 0.007). M. canis was the predominant causative agent (74%), followed by T. violaceum (12%), T. tonsurans (7%) and other rare dermatophyte species (7%). M. canis prevalence decreased from 2014 to 2019 (84% to 67%, p = 0.021) in parallel with a three-fold increase in T. violaceum plus T. tonsurans rates (10% to 32%, p = 0.002). An increasing incidence of TC with a shift towards anthropophilic Trichophyton spp. in Greece could be linked to the immigration flows from different socioeconomic backgrounds.
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  • 文章类型: Journal Article
    头癣是一种广泛的浅表真菌感染,主要影响儿童。显微镜检查和真菌培养是诊断的常规金标准,但它们既不敏感又耗时。近年来,已经开发了新的诊断方法来促进病原体的诊断和鉴定。毛镜检查对诊断有逗号毛发特征的头癣具有较高的敏感性和特异性,开瓶器的头发,条形码状的头发和锯齿形的头发。在多项研究中,反射共聚焦显微镜也已用于头癣的快速诊断。诸如聚合酶链反应和基质辅助解吸/电离飞行时间质谱的分子测定被广泛用于快速和准确地鉴定病原体。早期诊断和治疗有助于疾病控制和减少疤痕。
    Tinea capitis is a widespread superficial fungal infection that affects children predominately. Microscopic examination and fungal culture are the conventional gold standards for diagnosis, but they are insensitive and time-consuming. In recent years, new diagnostic methods have been developed to facilitate the diagnosis and identification of causative pathogens. Trichoscopy examination showed high sensitivity and specificity for diagnosing tinea capitis with the characteristic signs of comma hairs, corkscrew hairs, bar code-like hairs and zigzag hairs. Reflectance confocal microscopy has also been used in the rapid diagnosis of tinea capitis in several studies. Molecular assays such as polymerase chain reaction and matrix-assisted desorption/ionization time to flight mass spectrometry are extensively utilized for rapid and accurate identification of the pathogens. Early diagnosis and treatment can aid in disease control and scarring reduction.
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  • 文章类型: Meta-Analysis
    背景:头癣占所有真菌感染的25%至30%,但它经常被忽视,因为它在本质上不会危及生命。这在学童中更为常见,特别是在发展中国家。由于先前研究中存在显著的变异性,本研究旨在提供埃塞俄比亚学童头癣的合并患病率和相关因素.
    方法:我们在五个主要数据库中进行了系统的搜索,以查找与我们主题类似的文章。这篇综述包括以英语为基础的学校横断面研究,这些研究从2006年到2022年进行。使用MicrosoftExcel提取数据,并使用StataTM版本17.0统计软件进行进一步分析。森林地块用于以95%的置信区间评估异质性的存在。随机效应元分析模型用于汇集初步估计。宣布是否存在关联,使用具有比值比的95%置信区间。
    结果:共纳入了14项研究,共有9465名学童。合并患病率为29.03%(95CI:15.37-42.71)。观察到异质性,这可以用发表偏倚来解释(P=0.04)。头癣家族史(OR:9.18,95CI:3.5-24.02),10岁以下(OR:1.65,95CI:1.17~2.33)是增加学龄儿童和每周至少洗头一次的学龄儿童发生头癣的因素(OR:0.31,95CI:0.24~0.42)与头癣风险降低显著相关.
    结论:埃塞俄比亚最普遍的儿童健康状况之一是头癣,影响超过四分之一的学童。有头癣家族史且年龄在10岁以下的学童是确定的危险因素,但他们每周至少洗头一次是学童头癣的保护因素。需要临床和公众参与活动来克服疾病的负担。
    Tinea capitis accounts for25 to 30% of all fungal infections, but it is often ignored because it is not life threatening in nature. It is more common among schoolchildren particularly in developing countries. Due to the presence of significant variability among the previous studies, this study was conducted to provide a pooled prevalence and associated factors of tinea capitis in Ethiopian schoolchildren.
    We conducted a systematic search in five major databases for articles similar to our topic. This review included school-based cross-sectional studies that were reported in English and conducted from 2006 through 2022. The data were extracted using Microsoft Excel and further analysis was done using StataTM Version 17.0 statistical software. Forest plots were used to assess the presence of heterogeneity with 95% confidence intervals. A random effects meta- analysis model was used to pool primary estimates. To declare the presence or absence of association, 95% confidence interval with odds ratio was used.
    Fourteen studies with a total of 9465 schoolchildren were included. The pooled prevalence was 29.03% (95%CI: 15.37-42.71). There was observed heterogeneity, which could be explained by publication bias (P = 0.04). Family history of tinea capitis (OR: 9.18, 95%CI: 3.5-24.02), under the age of 10 years (OR: 1.65, 95%CI: 1.17-2.33) were factors increasing the development of tinea capitis among schoolchildren and schoolchildren who had hair wash at least once a week (OR: 0.31, 95%CI: 0.24-0.42) was significantly associated with reduced risk for tinea capitis.
    One of the most prevalent childhood health condition in Ethiopia is tinea capitis, which affects over one in every four schoolchildren. Schoolchildren who had family history of tinea capitis and under the age of 10 years were the identified risk factors but they had hair wash at least once a week was the protective factor of tinea capitis among schoolchildren. Clinical and public engagement activities are needed to overcome the burden of the disease.
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