易被忽视及误诊的癣病——毳毛癣

Tinea of vellus hair:an easily overlooked and misdiagnosed tinea

本文报告2例儿童面部毳毛癣。例1.女,3岁。面部红斑、丘疹、脱屑及瘙痒1个月余。皮肤科检查:左眼眶周圆形红斑及丘疹,境界较清晰,皮损边缘轻微隆起,伴少许脱屑,轻微红肿,鼻尖处少许类似皮损。真菌学检查:毳毛真菌荧光镜检阳性,真菌培养示须癣毛癣菌生长,真菌药敏实验示特比萘芬和伊曲康唑敏感。诊断:毳毛癣。治疗:予口服特比萘芬及泼尼松,外用维生素E乳膏。例2.女,4岁。面部红斑、丘疹、脱屑及瘙痒2个月余。皮肤科检查:左颊部圆形红斑,境界尚清晰,可见散在丘疹及轻微脱屑,少许毛细血管扩张及色素沉着。真菌学检查:毳毛真菌荧光镜检阳性,真菌培养未生长。诊断:毳毛癣。治疗:予口服特比萘芬,外用维生素E乳膏。

Two cases of facial tinea of vellus hair in children were reported.Case 1 was a 3-year-old girl presented with facial erythema,papules,peeling,and itching for over a month.Dermatological examination showed circular erythema and papules around the left orbit,with a clear boundary.The edge of the rash was slightly raised,with slight peeling and swelling.The tip of the nose was also involved.Examination using fluorescence microscopy was positive for fungal organisms,and the fungal culture showed the growth of Trichophyton mentagrophytes.The fungal susceptibility test showed that both terbinafine and itraconazole were sensitive.A diagnosis of tinea of vellus hair was made.The patient was treated with oral terbinafine and prednisone,and topical vitamin E cream.Case 2 was a 4-year-old girl presented with facial erythema,papules,peeling,and pruritus for over 2 months.Dermatological examination showed round erythema on the left cheek with clear boundaries,a few papules and slight peeling,capillary dilation,and pigmentation.Examination using fluorescence microscopy was positive for fungal organisms.However,the fungal culture was negative.A diagnosis of tinea of vellus hair was made.The patient was treated with oral terbinafine and topical vitamin E cream.