Tinea Capitis in Adults

Objective: To determine the epidemiology and the aetiology of tinea capitis in the elderly in Turin (Italy). Methods: We prospectively collected all cases of adult tinea capitis in the Dermatology Clinic of the University of Turin from January 1997 to December 2012. Results: 13 patients (4 males and 9 females) with a mean age of 56.5 years were found to be affected by tinea capitis among a total number of 508 (2.6%). Diagnosis was made on clinical appearance and mycological examination. Culture identified M. canis in 7 patients (53.8%), T. mentagrophytes in 3 patients (23.1%), T. rubrum in 2 patients (15.4%) and T. violaceum in 1 patient (7.7%). 6 cases reported contact with animals. Treatment consisted in administration of Griseofulvin at the dose of 500 mg/d or Terbinafine at the dose of 250 mg/d for at least 8 weeks. A complete recovery was observed in 10 patients, whereas 3 of them suffered from cicatritial alopecia. Conclusion: This study wants to highlight the importance of considering tinea capitis as a differential diagnosis in elderly patients with scaly scalp lesions, even though it is considered to be rare in adults.

Tinea capitis caused by Microsporum Canis in a child:a case report

We report a tinea capitis caused by Microsporun Canis.A 6-year-old girl who had a history contact with dogs and cats in rural area.The girl suffered from scalp mass,pustules and itching for 2 months.There were two round patches in right scalp which the several pustules scattered on it.The morphology of the colony on the culture medium,the morphological characteristics under the microscope and the results of molecular sequencing confirmed that the girl’s tinea capitis was caused by Microsporun Canis.The girl was cured with the treatment of oral administration of itraconazole and ketoconazole ointment for external use for ten days.

Epidemiology of pediculosis capitis among schoolchildren in the eastern area of Bangkok,Thailand

Objective:To determine the prevalence of infestation with head lice in primary schoolchildren in the eastern area of Bangkok,Thailand.Methods:The present study was to determine the head lice infestation(Pediculosis) levels in primary schoolchildren,during May,2011 to July, 2011,A total of 3747 schoolchildren aged 5-12 years old from 12 selected primary school of Ladkrabang district,the eastern area of Bangkok were examined for head lice.Pediculosis was defined as the presence of at least on living adult,nymph and viable egg.Results:The overall head lice infestation rate was 23.32%and infestation rate was higher in girls(47.12%) than in boys(0%).The infestation rate among schoolchildren varied from 12.62%to 29.76%.The infestation rate among girls varied from 26.07%(12 years old group) to 55.89%(8 years old group).Conclusions: Pediculosis is a common public healtli problem affecting primary schoolchildren in eastern area of Bangkok and those levels are epidemic importance.

Tinea faciei in a newborn due toTrichophyton tonsurans

We report here the first case of neonatal tinea faciei caused by Trichophyton tonsurans in China's Mainland. The mother of the infant had tinea corpris and tinea capitis while the father had tinea incongnito. The infections in the parents were mycologically confirmed to be due to Trichophyton tonsurans. Ttinea faciei in the infant was cured after two-week topical use of amorolfine cream. The mother ceased breastfeeding and took oral terbinafine for 4 weeks. No recurrence was observed in the infant during 12 months of follow-up.

New Thai herbal shampoos as pediculicides for killing head louse, Pediculus humanus capitis De Geer(Phthiraptera)

Objective: To evaluate the efficacy of Thai herbal shampoos [Cartoxylum formosum(C.formosum) + eucalyptus essential oil(EO), C. formosum + citrus EO, Solanum trilobatum+ eucalyptus EO, Solanum trilobatum + citrus EO, Moringa oleifera + eucalyptus EO and Moringa oleifera + citrus EO] for killing all stages of Pediculus humanus capitis(Phthiraptera).Methods: A filter paper contact method was applied with three concentrations(0.05, 0.10 and 0.20 mL/cm^2) of each Thai herbal shampoo as well as permethrin pediculicide(positive control) and drinking water(negative control) against eggs, nymphs and adults of Pediculus humanus capitis. Mortality rates of the eggs were recorded after 7 days of incubation while those of nymphs and adults were recorded after 5 minutes of contact. Results: All herbal shampoos at the high concentration were highly effective against nymphs and adults, but not effective against the eggs. C. formosum + eucalyptus EO and C. formosum + citrus EO shampoos at all concentrations exhibited the highest efficacy against nymphs and adults with100% mortality rate at 5 min and LC_(50) values of 0.004 and 0.005 mL/cm^2, respectively. All formulation of Solanum trilobatum and Moringa oleifera shampoos added with eucalyptus EO showed mortality rates against nymphs at 92.0%-100.0% and 76.0%-100.0% and against adults at 84.0%-100.0% and 20.0%-32.0%, respectively. Permethrin pediculicide was not effective against the eggs, but showed 68.0%-92.0% and 28.0%-60.0% mortality rates against nymphs and adults. Conclusions: These results indicate that C. formosum + eucalyptus EO shampoo can be used as an effective nymphicide and adulticide against Pediculus humanus capitis.

Tinea incognito due tomicrosporum gypseum

A 41-year-old woman presented with a pruritic rash on the face that was of 3 months duration. During that time, it had been successively misdiagnosed as psoriasis vulgaris, systemic lupus erythematosus, facial dermatitis at other hospitals, and had been treated with agents that included acitretin and prednisone. Finally, fungi were found in the lesions by optical microscopy, and the fungal culture was positive for Microsporum gypseum, and was diagnosed as a Microsporum gypseum infection. The lesions eventually cleared completely after 8 weeks of antifungal treatment.

Inflammatory Tinea Manuum due to <i>Trichophyton erinacei</i>from an African Hedgehog

The zoophylic dermatophytes, as Trichophyton erinacei, frequently cause very inflammatory tineas in the human host. This dermatophyte is carried by some pets, particularly by the terrestrial hedgehog. Herein, we present the case of a 22-year-old male student with an exudative erythematous scaly plaque on his right fifth finger for 1 month. He had a pet African hedgehog (Atelerix albiventris). KOH examination demonstrated hyphae compatible with dermatophytes. The culture revealed a white, radiated dusty colony. PCR sequencing of the region ITS1-5.8S-ITS2 identified T. erinacei. The final diagnosis was inflammatory tinea manuum due to T. erinacei. Clinical and mycological cure was achieved after treatment with oral terbinafine 250 mg/day × 1 month.

Ginkgo paste improves tinea corporis in a guinea pig model

To investigate the effects of Ginkgo paste for external use on tinea corporis in a guinea pig model.The guinea pig tinea corporis model were induced by infection with Trichophyton mentagrophytes strains.And then,high and low doses of Ginkgo water-paste and alcohol-paste were administrated to the animals.The symptom,tinea corporis skin lesions and histopathological aspects of guinea pig were analyzed.High and low doses of Ginkgo alcohol-paste and Ginkgo water-paste could significantly reduced the tinea corporis symptom(P<0.01),increased negative rate of strain culture(P<0.01),and improved pathological changes of tinea corporis(P<0.01).The best efficacy was observed in high dose ginkgo alcohol paste group.These results suggest that Ginkgo paste exhibits the efficacy to treat tinea corporis in a guinea pig model.

Topical 5-aminolevulinic acid photodynamic therapy improved refractory acne conglobata and perifolliculitis capitis abscedens et suffodiens rather than hidradenitis suppurativa

Acne conglobata(AC),perifolliculitis capitis abscedens et suffodiens(PCAS)and hidradenitis suppurativa(HS)are uncommon refractory chronic,inflammatory,scarring diseases but cause serious damage to the quality of life.These three diseases are associated with follicular occlusion.Several studies indicated topical 5-aminolevulinic acid photodynamic therapy(ALA-PDT)improved follicular occlusion besides acne treatment.So we attempted to apply ALA-PDT to medicine resistant AC,PCAS and HS.Topical ALA-PDT was applied to 10 patients with AC,seven patients with PCAS and three patients with HS for more than three sessions.All the patients completed the dermatology life quality index(DLQI)questionnaire and were assessed for the efficacy at the baseline and on two weeks after each treatment.Adverse effects were recorded at each visit.The results showed 25.5%(5/20,two cases of AC and three cases of PCAS)of patients achieved excellent improvement after three sessions of PDT and another 60.0%(12/20,eight cases of AC and four cases of PCAS)of patients achieved good improvement.15.0%(3/20,three cases of HS)got poor response(<20%lesions clearance).Anotherfive cases(three cases of AC and two cases of PCAS)also achieved excellent response after 5–7 sessions of PDT.We also found that papular/nodular,cyst/abscess showed higher clearance rate than sinus/¯stula(88.5%,86.1%versus 11.1%).DLQI was reduced after three sessions of PDT in AC and PCAS patients rather than HS patients.5-ALA-PDT could improve refractory AC and PCAS but could not lead to improvement in late stage of HS.The e±cacy increased with more treatment sessions.

A Prospective Single-Arm Investigation Assessing Performance of a Multifunctional Foot Cream in Subjects with Tinea Pedis Interdigitalis and Heel Cracks, Calluses and/or Dry Feet

This prospective, open-label, single-arm investigation evaluated the performance of a multifunctional foot cream used twice daily for 8 weeks in the combined treatment of mild/moderate tinea pedis interdigitalis (TPI) and heel cracks, calluses and/or dry feet in 46 adult subjects. All subjects showed reductions in the severity of symptoms of both TPI (53.7% reduction) and heel cracks, calluses and/or dry feet (51.6% reduction), beginning already after 2 weeks of treatment, with reduction continuation and improvement after 4 and 8 weeks of treatment. Negative mycological cultures were obtained post-treatment in 85.7% of subjects, while 35.7% of subjects also obtained mycological cure (negative mycological culture + negative KOH test). Post-treatment questionnaires showed improved quality of life, good treatment tolerability, easy use, and that 69% of subjects would recommend the product. The results reveal that the foot cream is safe and effective in the combined treatment of TPI and heel cracks, calluses and/or dry feet.

Tinea of Vellus Hair Caused by Trichophyton violaceum in a Child:A Case Report

Introduction:Tinea of vellus hair is a rare dermatophytosis,caused by dermatophyte infection in the vellus hair.The clinical symptoms of tinea of vellus hair are more serious and the conventional topical treatment are often ineffective.Here,we report a case of tinea of vellus hair caused by Trichophyton violaceum in a child.Case presentation:A 7-year-old boy presented with a localized,scaly,and itchy erythema on his left cheek for two months.He once used a topical corticosteroid but without any clinical improvement,the erythema was progressively enlarging and spread to the left eyebrow.He denied any contact with animals.Direct microscopy found abundant spores and hyphae on the vellus hair;T.violaceum was identified by culture and PCR examination.The patient was diagnosed with tinea of vellus hair and cured after treating with oral terbinafine 125 mg/day and topical treatment for two weeks.There was no recurrence during the follow-up period.Discussion:The clinical symptoms of tinea of vellus hair are often atypical and easy to be misdiagnosed.Timely fungal examination is necessary for suspicious patients and confirmed patients should be treated with oral antifungal drugs.Conclusion:The diagnosis and treatment of tinea of vellus hair need to be paid more attention in clinical works.

Clinical and Experimental Studies on Composite Divitriol Infusion in Treating Tinea Manum

Objective: To investigate the effect of Composite Divitriol Infusion (CDI) in treating tinea manum and study its antimycotic action.Methods: CDI was used to treat 139 patients with tinea manum and compared with Tinea Unguium Infusion in treating 77 cases as control. The experimental study in vivo was done, and electron microscopy (EM) was used to observe the therapeutical effect of CDI.Results: Among the 139 patients of the CDI group, 104 were cured, 21 markedly effective, 10 improved and 4 ineffective, the cure and markedly effective rate being 89.9%. The difference of effect between the CDI group and the control group was significant statistically (X 2>12.84,P < 0.005). The antimycotic action of CDI was studied in vitro. The minimum inhibitory concentration (MIC) of CDI were about 0.25% for Trichophyton rubrum and 0.5% for Trichophyton gypseum and Microsporum gypseum. Trichophyton rubrum immersed with CDI showed that the mycelia became roughened, deformed, and macroconidium became smaller under EM.Conclusion: CDI is valuable in treating tinea manum.

手术联合光动力治疗头部脓肿性穿掘性毛囊周围炎的临床疗效观察

目的:观察手术联合光动力治疗头部脓肿性穿掘性毛囊周围炎的临床疗效。方法:回顾性分析2021年1月-2022年6月笔者医院给予手术联合光动力治疗的24例头部脓肿性穿掘性毛囊周围炎患者临床资料。观察所有患者的临床治疗效果、不良反应和复发情况。结果:纳入治疗的患者痊愈13例(54.17%),显效6例(25.00%),有效3例(12.50%),无效2例(8.33%),总有效率91.67%。伤口均甲级愈合,未出现术后感染、皮瓣坏死、溃疡等并发症。随访0.5~2年,复发4例,复发率16.67%。大部分患者术后瘢痕不明显,患者满意度高。结论:手术联合光动力治疗头部脓肿性穿掘性毛囊周围炎疗效良好,可提高患者生活质量,且安全性好,复发率低。

中国南京及周边地区301例头癣临床流行病学特征及病原谱研究

目的分析南京及周边地区头癣患者的流行病学特征及病原谱。方法回顾性分析2013年1月至2022年12月期间301例头癣患者的临床及真菌检测等资料,真菌鉴定采用形态学、时间飞行质谱及分子生物学方法。结果301例患者中,儿童及未成年头癣286例(95%),其中以4~7岁学龄前儿童的分布最多(46.5%),性别分布以男童居多(56.3%)。成人头癣仅15例(5%),成人头癣性别分布以女性居多(66.7%)。所有头癣患者的真菌鉴定结果统计显示,犬小孢子菌(164例,54.5%)、须癣毛癣菌(57例,18.9%)和紫色毛癣菌(44例,14.6%)是最常见的菌种,须癣毛癣菌和犬小孢子菌各年龄段之间病原菌种检出率差异具有统计学意义(P<0.01),石膏样小孢子菌、断发毛癣菌、紫色毛癣菌和红色毛癣菌在不同年龄组检出率差异无统计学意义(P>0.05)。结论4~7岁的男童是最常见的头癣患病群体,过去10年犬小孢子菌已取代须癣毛癣菌成为南京及周边地区头癣感染的优势致病菌,这些结果为头癣的治疗和预防提供了有用的信息。

自拟槿柏洗方外洗联合萘替芬酮康唑乳膏治疗小儿头癣美学效果观察

目的:研究自拟槿柏洗方外洗联合萘替芬酮康唑乳膏治疗小儿头癣的美学效果。方法:选取2021年5月-2023年4月在秦皇岛市中医医院中医皮肤科收治的82例头癣患儿,根据随机数表法将其分为联合组和对照组,各41例。对照组单纯采用抗真菌药膏外涂治疗,2次/天,持续治疗4周;联合组在对照组基础上联合自拟槿柏洗方外洗治疗,2次/天,持续治疗4周。观察比较两组患儿治疗开始时、结束时及停药后4周患儿头部的靶皮损(皮损面积最大处)状况[皮损面积、红斑、鳞屑(脓疱/黄痂)、瘙痒]评分和头皮严重指数(PSSI)评分,患儿治疗结束时的疗效,患儿治疗结束4周后复发情况和家长美观满意度,患儿治疗期间的不良反应发生情况。结果:联合组患儿总有效率高于对照组(P<0.05);治疗后,两组患儿靶皮损状况评分和PSSI评分均低于治疗前,且联合组患儿靶皮损状况评分和PSSI评分均低于对照组(P<0.05)。治疗期间,联合组患儿总不良反应发生率低于对照组(P<0.05);治疗结束4周后,联合组家长美观满意度高于对照组(P<0.05);联合组复发率与对照组比较,差异无统计学意义(P>0.05)。结论:相比于单纯使用抗真菌药膏外涂治疗小儿头癣,自拟槿柏洗方外洗联合萘替芬酮康唑乳膏对头皮的损伤程度更小,疗效更佳,家长美观满意度更高,治疗后不良反应发生率更低。

72例头癣患儿真菌荧光染色与皮肤镜特征分析

目的研究拟通过真菌荧光染色镜检技术结合皮肤镜分析不同临床类型头癣的特点,为临床提供准确、快速诊断头癣的依据。方法收集72例头癣患儿,使用荧光染色法结合皮肤镜观察头癣病发的主要特征;观察随访患儿治疗后荧光染色法及皮肤镜特殊表征是否同时转阴。结果根据临床特征,72例头癣患儿以白癣为主,占58.33%(42/72);荧光染色法阳性率100%,发外孢子占比最高,为62.50%(45/72);皮肤镜诊断的阳性率100%,皮肤镜检查白癣以断发(90.48%)为主、脓癣以脓疱(100%)为主,以逗号发/螺旋发/条码样发为特殊的表征;随访率为59.72%(43/72)。结论真菌荧光染色法结合皮肤镜特征能对头癣疾病及其临床类型做出快速且准确的诊断。

易被忽视及误诊的癣病——毳毛癣

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。

1008例皮肤浅部真菌感染及其病原菌分析

目的分析皮肤浅部真菌感染病种及致病菌种的种类和分布特点。方法收集2021年7月—2022年7月在青岛大学附属医院皮肤科就诊后拟诊断为皮肤真菌感染的患者皮肤标本,共1008例。取镜检阳性的标本接种于沙氏葡萄糖琼脂(SDA)平板或马铃薯葡萄糖琼脂(PDA)平板上进行真菌培养和鉴定,对培养结果为酵母菌属的真菌采用科马嘉(CHROMagar)显色培养基进行分离鉴定,对于无法直接鉴定的菌落采用VITEK ATB自动细菌鉴定和药敏分析系统进行分析鉴定。取镜检阳性或培养为阳性的结果进行统计分析。结果1008例皮肤浅部真菌感染标本中,病种前三位为甲真菌病244例(24.21%)、花斑糠疹184例(18.25%)、足癣182例(18.06%);致病菌种前三位为红色毛癣菌307株(30.46%)、马拉色菌255株(25.30%)、须癣毛癣菌187株(18.55%);甲真菌病女性多于男性(χ^(2)=8.02,P<0.001),股癣男性多于女性(χ^(2)=29.12,P<0.001),差异有统计学意义。致病菌种在性别构成上均无统计学差异(均P>0.05)。结论本地区皮肤浅部真菌感染主要病种为甲真菌病、花斑糠疹和足癣,主要致病菌种为红色毛癣菌、马拉色菌和癣毛癣菌。临床治疗时应加以重视。

温通化瘀散结法联合箍围-火针法治疗头部脓肿性穿掘性毛囊炎5例

目的分析头部脓肿性穿掘性毛囊炎的临床特征及中医证候特点,提高对本病的诊断及中医辨证水平。方法对5例头部脓肿性穿掘性毛囊炎的临床表现、中医证候、中医治则、方药、预后进行回顾性分析。结果5例患者均为青年男性,年龄为19~26岁,平均年龄22.62岁,5例患者皮损以头皮大量结节、囊肿、融合性脓肿为主,伴有明显脓性分泌物、压痛、脱发明显等临床特点。5例患者中2例肥胖(BMI≥30.0 kg/m 2)。5例患者皮疹辨证均符合痰瘀互结证。中医内治均采用温通化瘀散结之法,局部红肿者仙方活命饮加减。外治采用箍围-火针法,箍围使用自制消炎膏配合冲和散,火针针刺后按压排脓。中医药治疗时间为56~180 d,平均时间为101.20 d,5例中3例结节、囊肿完全消退,脓性分泌物消失,遗留色减斑及瘢痕(病例1~3);1例结节消失,囊肿变平,硬化性囊肿缩小(病例4);1例硬化性囊肿略缩小(病例5)。随访6个月后,2例肥胖患者均有复发,继续治疗后复发皮损消失。结论温通化瘀散结法联合箍围-火针法治疗头部脓肿性穿掘性毛囊炎临床疗效较好,值得进一步研究和推广。

“Z”字形拨针治疗神经根型颈椎病急性加重期(气滞血瘀证)的临床观察

目的观察“Z”字形拨针治疗对神经根型颈椎病急性加重期(气滞血瘀证)的疗效及炎性因子的影响。方法选取120例患者,随机分为拨针组和针刺组,分别给予“Z”字形拨针联合常规护理宣教和针刺联合常规护理宣教。比较两组治疗前后的颈椎功能、疼痛程度、生活质量和血清炎性因子水平、头夹肌及头半棘肌E值的变化和1个月、3个月、6个月的复发率。结果两组治疗后症状及功能评价均有明显改善,但拨针组优于针刺组(P<0.05);两组治疗后血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平均显著降低(P<0.05),拨针组明显低于针刺组(P<0.05);两组治疗后的头夹肌及头半棘肌E值均下降,拨针组明显低于针刺组(P<0.05);治疗后6个月的复发率比较,拨针组明显低于针刺组(P<0.05)。结论“Z”字形拨针治疗能有效改善神经根型颈椎病急性加重期(气滞血瘀证)患者的颈椎功能、疼痛程度和生活质量,降低相关肌肉的E值,且可能通过抑制炎性因子的释放发挥治疗作用,降低复发率。