患者女,68岁,福建农民,头顶部片状脱发3个月。体检：头顶部形状不规则暗红斑片,少量脱屑。红斑区毛发根部紧贴头皮脱落,呈黑点状,脱发区毛囊轻度红肿,皮损区头皮局部有轻度波动感。直接镜检可见断发内大量孢子集聚沿发干呈链状分布,真...患者女,68岁,福建农民,头顶部片状脱发3个月。体检：头顶部形状不规则暗红斑片,少量脱屑。红斑区毛发根部紧贴头皮脱落,呈黑点状,脱发区毛囊轻度红肿,皮损区头皮局部有轻度波动感。直接镜检可见断发内大量孢子集聚沿发干呈链状分布,真菌培养分离黄白色绒毛状菌落,小培养镜下可见棒形,梨形小分生孢子,尿素酶试验阳性。临床分离株进行r DNA ITS扩增测序,BLAST比对与Gen Bank中断发毛癣菌序列同源性100%。诊断：断发毛癣菌所致黑点癣。治疗采用伊曲康唑0.2~0.4/d口服及酮康唑洗剂、曲安奈德益康唑乳膏及酮康唑乳膏等外用,总疗程2个月,皮损完全消退,断发重新长出,无瘢痕秃发形成。停药后随访半年无复发。展开更多
Introduction. In March 2001 a school and family survey was conducted in a nursery school in the Southern suburbs of Paris, during an epidemic of Trichophyton tondsurans tinea. Patients and methods. One hundred twenty-...Introduction. In March 2001 a school and family survey was conducted in a nursery school in the Southern suburbs of Paris, during an epidemic of Trichophyton tondsurans tinea. Patients and methods. One hundred twenty-nine children aged 3 to 6 were examined as well as 15 adults working in the school. A survey of the contaminated children or asymptomatic carriers was performed. All the children and adults concerned were treated at the same time, without eviction from school. Results. T. tonsurans was detected in 10 cases of tinea (7.7 p.cent of the persons examined), in 18 cases of cutaneous lesions (13.9 p.cent) and in 25 asymptomatic carriers on the scalp (19.4 p.cent). The majority of the positive cases came from the same school class as the original case:23 of the 26 children (88 p.cent), with 6 tinea, 14 asymptomatic carriers and 13 cutaneous lesions. Only one of the 15 adults exhibited a T. tonsurans cutaneous lesion. Among the 13 families studied, 2 had several members involved, the first being that of the original case (3 tinea and 2 asymptomatic carriers). Discussion. Several important points are underlined by this study:1) the high contagiousness of T. tonsurans; 2) the detection of 2 mechanisms of indirect contamination (rag doll mascot in the class and the family hair-clipper); 3) the one-year time lapse between the arrival of the contaminating child in the class and the survey, explaining the extent of the contamination; 4) the underestimation of the epidemic due to the lack of mycological examinations; 5) the identification of several dermatophytes in the same school:M. corn’s, Tsoudanense and T. tonsurans, and 7) the futility of eviction from school when all the children can be treated.展开更多
‘ Tinea corporis gladiatorum’ describes a dermatophytosis transmitted mainly from close skin contact among wrestlers. Although tinea corporis is well recognized, no data are available for tinea capitis infections in...‘ Tinea corporis gladiatorum’ describes a dermatophytosis transmitted mainly from close skin contact among wrestlers. Although tinea corporis is well recognized, no data are available for tinea capitis infections in wrestlers. After finding tinea capitis infection in a student wrestler, we aimed to search for possible ringworm infections among wrestlers in a wrestling boarding-school. Of the 32 wrestlers, 29, aged 12-18 years, were affected, of whom 22 had scalp involvement. Trichophyton tonsurans was isolated from 20 of the patients, and T. mentagrophytes from the remaining two. Isolated strains of dermatophytes were susceptible to terbinafine and itraconazole. The patients with tinea capitis received oral terbinafine for 4 weeks, and patients with more than two lesions but without scalp involvement received oral terbinafine for 2 weeks. Overall clinical and mycological cure rate was 72.4% and 70% , respectively, at assessment at week 6. The asymptomatic dermatophyte carrier rate was negative 1 year after control of the epidemic. Terbinafine seems to be an alternative drug for the treatment of tinea capitis caused by T. tonsurans; however, control of an outbreak may be very difficult and effective preventive measures should be considered.展开更多
文摘患者女,68岁,福建农民,头顶部片状脱发3个月。体检：头顶部形状不规则暗红斑片,少量脱屑。红斑区毛发根部紧贴头皮脱落,呈黑点状,脱发区毛囊轻度红肿,皮损区头皮局部有轻度波动感。直接镜检可见断发内大量孢子集聚沿发干呈链状分布,真菌培养分离黄白色绒毛状菌落,小培养镜下可见棒形,梨形小分生孢子,尿素酶试验阳性。临床分离株进行r DNA ITS扩增测序,BLAST比对与Gen Bank中断发毛癣菌序列同源性100%。诊断：断发毛癣菌所致黑点癣。治疗采用伊曲康唑0.2~0.4/d口服及酮康唑洗剂、曲安奈德益康唑乳膏及酮康唑乳膏等外用,总疗程2个月,皮损完全消退,断发重新长出,无瘢痕秃发形成。停药后随访半年无复发。
文摘Introduction. In March 2001 a school and family survey was conducted in a nursery school in the Southern suburbs of Paris, during an epidemic of Trichophyton tondsurans tinea. Patients and methods. One hundred twenty-nine children aged 3 to 6 were examined as well as 15 adults working in the school. A survey of the contaminated children or asymptomatic carriers was performed. All the children and adults concerned were treated at the same time, without eviction from school. Results. T. tonsurans was detected in 10 cases of tinea (7.7 p.cent of the persons examined), in 18 cases of cutaneous lesions (13.9 p.cent) and in 25 asymptomatic carriers on the scalp (19.4 p.cent). The majority of the positive cases came from the same school class as the original case:23 of the 26 children (88 p.cent), with 6 tinea, 14 asymptomatic carriers and 13 cutaneous lesions. Only one of the 15 adults exhibited a T. tonsurans cutaneous lesion. Among the 13 families studied, 2 had several members involved, the first being that of the original case (3 tinea and 2 asymptomatic carriers). Discussion. Several important points are underlined by this study:1) the high contagiousness of T. tonsurans; 2) the detection of 2 mechanisms of indirect contamination (rag doll mascot in the class and the family hair-clipper); 3) the one-year time lapse between the arrival of the contaminating child in the class and the survey, explaining the extent of the contamination; 4) the underestimation of the epidemic due to the lack of mycological examinations; 5) the identification of several dermatophytes in the same school:M. corn’s, Tsoudanense and T. tonsurans, and 7) the futility of eviction from school when all the children can be treated.
文摘‘ Tinea corporis gladiatorum’ describes a dermatophytosis transmitted mainly from close skin contact among wrestlers. Although tinea corporis is well recognized, no data are available for tinea capitis infections in wrestlers. After finding tinea capitis infection in a student wrestler, we aimed to search for possible ringworm infections among wrestlers in a wrestling boarding-school. Of the 32 wrestlers, 29, aged 12-18 years, were affected, of whom 22 had scalp involvement. Trichophyton tonsurans was isolated from 20 of the patients, and T. mentagrophytes from the remaining two. Isolated strains of dermatophytes were susceptible to terbinafine and itraconazole. The patients with tinea capitis received oral terbinafine for 4 weeks, and patients with more than two lesions but without scalp involvement received oral terbinafine for 2 weeks. Overall clinical and mycological cure rate was 72.4% and 70% , respectively, at assessment at week 6. The asymptomatic dermatophyte carrier rate was negative 1 year after control of the epidemic. Terbinafine seems to be an alternative drug for the treatment of tinea capitis caused by T. tonsurans; however, control of an outbreak may be very difficult and effective preventive measures should be considered.
