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It is only for medical professionals to read.
How to use the reference drug? How safe is it? There are many difficulties in the adult world.
Staying up late to work overtime, scratching your head and sighing, standing in front of the mirror, looking tired and moving the hairline backward
.
Everyone knows that pre-adolescent carefree children also have a hair loss crisis.
The fledgling immunity is often difficult to resist the invasion of certain microorganisms, and various fungi cliques occupy the scalp territory
.
Today we will discuss the infections caused by dermatophytes colonizing the hair and scalp, causing rashes, itching, even hair loss, and permanent scars, which have an indelible impact on children's psychology and life
.
In order to diagnose and treat tinea capitis caused by dermatophyte infection, Dr.
Huang Xiaowen from the Department of Dermatology of Nanfang Hospital explained the clinical manifestations and treatment plans of tinea capitis in detail.
Let us follow Holmes Huang to "uniform" tinea capitis in children
.
The scene of the crime-the clinical manifestations of tinea capitis Tinea capitis is a dermatophyte infection that affects the hair and scalp
.
White ringworm in tinea capitis is the most common in China, and is mainly caused by Microsporum canis and Microsporum rust; Tinea melanogaster is mainly caused by Trichophyton purple and Trichophyton rubrum, which are more common in North America
.
The way of transmission is mainly through direct contact with ringworm patients or affected animals, asymptomatic carriers, and indirectly through sharing contaminated hairdressing tools, hats, pillow covers and other items
.
According to different pathogens and clinical manifestations, tinea capitis is mainly divided into four types: white ringworm, black spot ringworm, yellow ringworm, and pus ringworm
.
(1) White ringworm: more common in school-age children, more men than women
.
At first, the skin lesions are clusters of small red papules, which can expand into a round or oval shape and cover with gray-white scales
.
The disease occurs at a place 2~4mm higher than the scalp, and the residual root is surrounded by gray-white sleeve-like scales, called mycotheca, formed by fungi parasitizing on the hair shaft
.
Generally, there are no obvious symptoms, and occasionally itching of varying degrees
.
White ringworm generally has no inflammatory reaction and can heal itself in puberty.
This is related to the active secretion of sebaceous glands in puberty and the inhibitory effect of unsaturated fatty acids in sebum on the growth of fungi
.
This type does not damage the hair follicles, so it does not cause permanent baldness and does not leave scars after healing
.
(2) Black spot ringworm: both children and adults can develop the disease
.
The skin lesions were scattered scaly gray-white spots at first, and then gradually expanded into pieces
.
The characteristic is that the scalp is broken immediately after the disease occurs, and the residual roots appear as black spots at the mouth of the hair follicle, so it is called "black spot ringworm"
.
The skin lesions have mild or no inflammation, and are slightly itchy.
This type is an intra-type infection
.
Focal alopecia and punctate atrophic scars often remain after healing
.
(3) Xanthelasma: The skin lesions are initially yellowish-red spots the size of a needle tip, covered with flake-like scales, and later form a soy-sized light yellow scab, with the periphery tilted up, and the center is tightly attached to the scalp and shaped like a dish (yellow ringworm scab).
In severe cases, the entire scalp can be covered.
After the scab is removed, the flushing and erosion surface will appear underneath
.
The fungus grows in the hair, causing the diseased hair to become dry, dull, thin, brittle, and easily broken.
It can damage the hair follicles and cause permanent hair loss, leaving atrophic scars after healing
.
It can be accompanied by varying degrees of itching and pain, and has a special rat smell
.
(4) Tinea pus: a serious infection of the scalp mainly caused by pro-animal dermatophytes
.
The skin lesions started out as clusters of inflammatory follicular papules, which gradually merged into a raised inflammatory mass with a soft texture.
The surface of the skin formed a honeycomb-like pus hole at the mouth of the hair follicle, which can squeeze out the pus
.
The hair on the skin lesion is loose and easy to pull out
.
It is often accompanied by swollen, painful and tender lymph nodes in the neck and occipital area behind the ears, and may form abscesses after secondary bacterial infections, or may be accompanied by tinea rash
.
This type can destroy hair follicles, leaving permanent baldness and scars after healing
.
There is nowhere to escape suspect tracking-the diagnosis of tinea capitis combined with clinical manifestations, fungal examination, and skin microscopy can confirm the diagnosis
.
Diagnosis of inflammatory tinea capitis can sometimes be difficult, because mycological examination and even pathology may give negative results
.
1.
Evidence collection 2.
Evidence comparison.
Direct microscopic examination of fungi: chain hyphae and articular spores can be seen in the yellow ringworm hair, thick-walled spores and staghorn hyphae can be seen in the yellow ringworm scab; white ringworm hair can be seen in piles surrounding the hair Arranged round microspores; chain-like round spores can be seen in the hair of tinea melanogaster
.
Filtered ultraviolet light (Wood lamp) inspection: yellow ringworm is dark green fluorescence; white ringworm is bright green fluorescence; black spot ringworm has no fluorescence
.
Dermoscopy (trimoscope) examination: the affected hair shows black spots, spirals, barcode-like, broken hair and other changes
.
The culprit's uniform-seemingly simple, hidden mystery The purpose of treatment for ringworm of the head: remove the fungus, cure the patient, reduce scars, and block transmission
.
Treatment is based on systemic drugs, supplemented with topical drugs, and at the same time, it is necessary to disinfect and sterilize pollutants and polluted environments to prevent re-infection and spread
.
Two or three questions about the treatment of tinea capitis in children? 1.
How to use systemic drugs in children? Children's antifungal drugs are griseofulvin, terbinafine, itraconazole and fluconazole.
The effect of the latter three drugs on tinea capitis is similar to that of griseofulv.
The factors are equivalent, but the safety is higher and the adverse reactions are fewer
.
For tinea capitis caused by Microsporum, griseofulvin or itraconazole are recommended
.
For tinea capitis caused by Trichophyton, terbinafine is recommended
.
The adverse reactions of griseofulvin are relatively more obvious, including headache, gastrointestinal symptoms, light sensitivity, and neutropenia
.
Routine blood and liver function tests are required before treatment and 2 weeks after treatment .
Special attention should be paid to the treatment of tinea pus.
Because of the severe clinical symptoms, the course of systemic antifungal drugs should be appropriately extended.
In addition, due to the obvious host response, glucocorticoids can be combined with the system when necessary.
When combined with bacterial infections, combined with sensitive antibiotics should not be used.
Incision and drainage
.
Fig.
Improper treatment of pus ringworm can cause permanent hair loss 2.
How safe is the drug? Body weight is used to determine the dose of the drug to ensure a safe dose
.
3.
How to evaluate the treatment effect? Comprehensive judgment based on clinical manifestations combined with mycological examination results
.
If the mycological test is negative, the oral antifungal drug can be stopped, and the patient should be reviewed regularly after the drug is stopped, and the follow-up visit will be performed every 2 weeks
.
If the mycological examination is negative for 2 to 3 consecutive times, it can be considered as cured
.
Summary In summary, tinea capitis is a dermatophyte infection that affects the hair and scalp.
It mainly affects preschool children.
It is divided into four types: yellow ringworm, white ringworm, black spot ringworm, and pus ringworm, each with its own unique clinical manifestations
.
Doctors can accurately diagnose tinea capitis through key medical history, physical examination, mycological examination, and skin microscopy, so as to accurately give antifungal treatment
.
The early diagnosis and accurate treatment of children with suspected tinea capitis cannot be overemphasized, because permanent hair loss has a serious impact on children’s lives and psychology
.
How can I get the full course? Scan the QR code of the poster below to unlock for free
How to use the reference drug? How safe is it? There are many difficulties in the adult world.
Staying up late to work overtime, scratching your head and sighing, standing in front of the mirror, looking tired and moving the hairline backward
.
Everyone knows that pre-adolescent carefree children also have a hair loss crisis.
The fledgling immunity is often difficult to resist the invasion of certain microorganisms, and various fungi cliques occupy the scalp territory
.
Today we will discuss the infections caused by dermatophytes colonizing the hair and scalp, causing rashes, itching, even hair loss, and permanent scars, which have an indelible impact on children's psychology and life
.
In order to diagnose and treat tinea capitis caused by dermatophyte infection, Dr.
Huang Xiaowen from the Department of Dermatology of Nanfang Hospital explained the clinical manifestations and treatment plans of tinea capitis in detail.
Let us follow Holmes Huang to "uniform" tinea capitis in children
.
The scene of the crime-the clinical manifestations of tinea capitis Tinea capitis is a dermatophyte infection that affects the hair and scalp
.
White ringworm in tinea capitis is the most common in China, and is mainly caused by Microsporum canis and Microsporum rust; Tinea melanogaster is mainly caused by Trichophyton purple and Trichophyton rubrum, which are more common in North America
.
The way of transmission is mainly through direct contact with ringworm patients or affected animals, asymptomatic carriers, and indirectly through sharing contaminated hairdressing tools, hats, pillow covers and other items
.
According to different pathogens and clinical manifestations, tinea capitis is mainly divided into four types: white ringworm, black spot ringworm, yellow ringworm, and pus ringworm
.
(1) White ringworm: more common in school-age children, more men than women
.
At first, the skin lesions are clusters of small red papules, which can expand into a round or oval shape and cover with gray-white scales
.
The disease occurs at a place 2~4mm higher than the scalp, and the residual root is surrounded by gray-white sleeve-like scales, called mycotheca, formed by fungi parasitizing on the hair shaft
.
Generally, there are no obvious symptoms, and occasionally itching of varying degrees
.
White ringworm generally has no inflammatory reaction and can heal itself in puberty.
This is related to the active secretion of sebaceous glands in puberty and the inhibitory effect of unsaturated fatty acids in sebum on the growth of fungi
.
This type does not damage the hair follicles, so it does not cause permanent baldness and does not leave scars after healing
.
(2) Black spot ringworm: both children and adults can develop the disease
.
The skin lesions were scattered scaly gray-white spots at first, and then gradually expanded into pieces
.
The characteristic is that the scalp is broken immediately after the disease occurs, and the residual roots appear as black spots at the mouth of the hair follicle, so it is called "black spot ringworm"
.
The skin lesions have mild or no inflammation, and are slightly itchy.
This type is an intra-type infection
.
Focal alopecia and punctate atrophic scars often remain after healing
.
(3) Xanthelasma: The skin lesions are initially yellowish-red spots the size of a needle tip, covered with flake-like scales, and later form a soy-sized light yellow scab, with the periphery tilted up, and the center is tightly attached to the scalp and shaped like a dish (yellow ringworm scab).
In severe cases, the entire scalp can be covered.
After the scab is removed, the flushing and erosion surface will appear underneath
.
The fungus grows in the hair, causing the diseased hair to become dry, dull, thin, brittle, and easily broken.
It can damage the hair follicles and cause permanent hair loss, leaving atrophic scars after healing
.
It can be accompanied by varying degrees of itching and pain, and has a special rat smell
.
(4) Tinea pus: a serious infection of the scalp mainly caused by pro-animal dermatophytes
.
The skin lesions started out as clusters of inflammatory follicular papules, which gradually merged into a raised inflammatory mass with a soft texture.
The surface of the skin formed a honeycomb-like pus hole at the mouth of the hair follicle, which can squeeze out the pus
.
The hair on the skin lesion is loose and easy to pull out
.
It is often accompanied by swollen, painful and tender lymph nodes in the neck and occipital area behind the ears, and may form abscesses after secondary bacterial infections, or may be accompanied by tinea rash
.
This type can destroy hair follicles, leaving permanent baldness and scars after healing
.
There is nowhere to escape suspect tracking-the diagnosis of tinea capitis combined with clinical manifestations, fungal examination, and skin microscopy can confirm the diagnosis
.
Diagnosis of inflammatory tinea capitis can sometimes be difficult, because mycological examination and even pathology may give negative results
.
1.
Evidence collection 2.
Evidence comparison.
Direct microscopic examination of fungi: chain hyphae and articular spores can be seen in the yellow ringworm hair, thick-walled spores and staghorn hyphae can be seen in the yellow ringworm scab; white ringworm hair can be seen in piles surrounding the hair Arranged round microspores; chain-like round spores can be seen in the hair of tinea melanogaster
.
Filtered ultraviolet light (Wood lamp) inspection: yellow ringworm is dark green fluorescence; white ringworm is bright green fluorescence; black spot ringworm has no fluorescence
.
Dermoscopy (trimoscope) examination: the affected hair shows black spots, spirals, barcode-like, broken hair and other changes
.
The culprit's uniform-seemingly simple, hidden mystery The purpose of treatment for ringworm of the head: remove the fungus, cure the patient, reduce scars, and block transmission
.
Treatment is based on systemic drugs, supplemented with topical drugs, and at the same time, it is necessary to disinfect and sterilize pollutants and polluted environments to prevent re-infection and spread
.
Two or three questions about the treatment of tinea capitis in children? 1.
How to use systemic drugs in children? Children's antifungal drugs are griseofulvin, terbinafine, itraconazole and fluconazole.
The effect of the latter three drugs on tinea capitis is similar to that of griseofulv.
The factors are equivalent, but the safety is higher and the adverse reactions are fewer
.
For tinea capitis caused by Microsporum, griseofulvin or itraconazole are recommended
.
For tinea capitis caused by Trichophyton, terbinafine is recommended
.
The adverse reactions of griseofulvin are relatively more obvious, including headache, gastrointestinal symptoms, light sensitivity, and neutropenia
.
Routine blood and liver function tests are required before treatment and 2 weeks after treatment .
Special attention should be paid to the treatment of tinea pus.
Because of the severe clinical symptoms, the course of systemic antifungal drugs should be appropriately extended.
In addition, due to the obvious host response, glucocorticoids can be combined with the system when necessary.
When combined with bacterial infections, combined with sensitive antibiotics should not be used.
Incision and drainage
.
Fig.
Improper treatment of pus ringworm can cause permanent hair loss 2.
How safe is the drug? Body weight is used to determine the dose of the drug to ensure a safe dose
.
3.
How to evaluate the treatment effect? Comprehensive judgment based on clinical manifestations combined with mycological examination results
.
If the mycological test is negative, the oral antifungal drug can be stopped, and the patient should be reviewed regularly after the drug is stopped, and the follow-up visit will be performed every 2 weeks
.
If the mycological examination is negative for 2 to 3 consecutive times, it can be considered as cured
.
Summary In summary, tinea capitis is a dermatophyte infection that affects the hair and scalp.
It mainly affects preschool children.
It is divided into four types: yellow ringworm, white ringworm, black spot ringworm, and pus ringworm, each with its own unique clinical manifestations
.
Doctors can accurately diagnose tinea capitis through key medical history, physical examination, mycological examination, and skin microscopy, so as to accurately give antifungal treatment
.
The early diagnosis and accurate treatment of children with suspected tinea capitis cannot be overemphasized, because permanent hair loss has a serious impact on children’s lives and psychology
.
How can I get the full course? Scan the QR code of the poster below to unlock for free