RESUMO
Resumen Querión Celso es una micosis ocasionada por hongos dermatofitos que daña el cuero cabelludo principalmente a niños y en raras ocasiones a adultos. La forma de infección para los humanos proviene de los animales y del suelo y se relaciona con mala higiene personal, hacinamiento en las viviendas, condiciones de subdesarrollo y pobreza. Se presenta un caso de un niño de 9 años con una úlcera de 7 cm de diámetro en el cuero cabelludo y en forma de placa circular que presentaba material purulento, pelo quebradizo y un área alopécica. Al inicio, se abordó de manera terapéutica como una infección bacteriana; posteriormente, se solicitó estudio micológico que evidenció una coinfección por el microorganismo Microsporum gypseum. Se le confirmó el diagnóstico de tiña capitis con afección inflamatoria y se le prescribió griseofulvina, lo que resultó en una curación completa.
Abstract Kerion Celsi is a mycosis caused by dermatophyte fungi that mostly affects children and rarely adults, causing damage to the scalp. The form of infection for humans comes from animals and the soil. The infection is related to poor personal hygiene, overcrowded homes, underdeveloped conditions, and poverty. A case of a 9-year-old boy with a 7cm diameter ulcer on the scalp and in the form of a circular plaque that presented purulent material, brittle hair and an alopecic area is presented. Initially it was therapeutically addressed as a bacterial infection, a mycological study was requested, which showed coinfection by the microorganism Microsporum gypseum, the diagnosis of tinea capitis with inflammatory condition was confirmed, and Griseofulvin was prescribed, resulting in complete cure.
Assuntos
Humanos , Masculino , Criança , Tinha , Tinha do Couro Cabeludo/diagnóstico , Infecções Bacterianas e Micoses , Microsporum , Costa RicaRESUMO
Introducción. Las dermatofitosis son infecciones fúngicas superficiales de epitelios queratinizados. La tinea capitis es una de ellas y afecta a poblaciones escolares vulnerables. Carpinelo es un barrio del área periférica de Medellín con precarias condiciones socioeconómicas. Ante la sospecha de un brote de dermatofitosis, los afectados fueron evaluados. Objetivo. Evaluar clínica y microbiológicamente pacientes del barrio Carpinelo con sospecha de micosis cutáneas para determinar la presencia de un brote por dermatofitos. Materiales y métodos. Se llevó a cabo un estudio descriptivo, de corte longitudinal, con muestreo a conveniencia. Se hizo una búsqueda activa de casos en el Jardín Educativo Buen Comienzo de Carpinelo en niños de la institución y sus familiares. Se evaluaron clínicamente y se tomaron muestras de escamas y cabellos para exámenes directos y cultivos microbiológicos. Se analizó el perfil demográfico, clínico y micológico, con el programa estadístico SPSS™, versión 25. Resultados. Se estudiaron 57 pacientes, 47 eran menores de edad con una media de edad de seis años; se observó una proporción de hombres y mujeres de 2:1. Los pacientes con resultados positivos se diagnosticaron con tinea capitis (78,95 %), tinea faciei (15,79 %) y tinea corporis (10,52 %). El 75,43 % de los pacientes recibió tratamiento previo y de estos el 69,73 % fue con esteroides. El examen directo fue positivo en el 53,84 % y los cultivos en el 46,5 % de los casos. Los agentes aislados fueron: Microsporum canis (77,77 %), Trichophyton spp. (11,11 %), Trichophyton rubrum (5,55 %) y Malassezia spp. (5,55 %). Conclusión. Tinea capitis fue la presentación clínica más común y M. canis el dermatofito más frecuentemente aislado. Llamó la atención el uso de esteroides como primera y única opción del tratamiento empírico' lo cual resalta la importancia del diagnóstico microbiológico para proporcionar la terapia apropiada.
Introduction. Dermatophytoses are superficial fungal infections of the keratinized epithelium like tinea capitis. The latte mainly affects school-vulnerable populations. Carpinelo is a peripheral neighborhood in Medellín with poor socioeconomic conditions and where a suspected tinea capitis outbreak took place. Objective. To study and characterize, clinically and microbiologically, patients with suspected dermatophytosis in Carpinelo. Materials and methods. We carried out a descriptive and longitudinal study with an active case search of tinea capitis in children and their relatives from the Jardín Educativo Buen Comienzo community in Carpinelo. Patients were clinically evaluated, and samples of scales and hair were taken to perform mycological studies with a 10 % potassium hydroxide and culture in Sabouraud and Mycosel agar. We analyzed the data with the statistical program SPSS™. 25 version. Results. Fifty-seven individuals were studied: 47 were children with a mean age of six years and a ratio of 2:1 male to female. Patients with confirmed diagnosis presented the following clinical forms: tinea capitis (78.95%), tinea faciei (15.79%) or tinea corporis (10.52%). Out of the total, 69.76% of the patients had previous treatment with steroids. The direct test was positive in 53.84% of the samples, and 46.15% had positive cultures. The isolated species were: Microsporum canis (77.77%), Trichophyton spp. (11.11%), Trichophyton rubrum (5.55%), and Malassezia spp. (5.55 %). Conclusion.Tinea capitis was the most common clinical form, and M. canis was the most frequently isolated species. The use of steroids as the first and only option for empiric treatment was worth of notice. The findings of this study point out the importance of microbiological diagnosis in choosing the best treatment for the patients.
Assuntos
Tinha , Dermatomicoses , Tinha do Couro Cabeludo , Surtos de DoençasRESUMO
Introducción. La tiña de la cabeza es una micosis que se presenta en el tejido queratinizado, afecta al cuero cabelludo y puede causar alopecia, prurito y descamación. Este tipo de micosis es más frecuente en niños de edad escolar, por lo que puede desencadenar un problema de salud pública. En Colombia, los principales agentes etiológicos reportados son los dermatofitos zoofílicos. Objetivo. En el presente estudio se buscó caracterizar un brote de tinea capitis en 32 niños de un colegio de la zona rural del departamento del Cauca. Materiales y métodos. Se llevó a cabo una investigación epidemiológica de campo en la que se aplicó una encuesta estructurada para caracterizar aspectos sociodemográficos y factores predisponentes para su ocurrencia. Se recolectaron muestras de escamas de cuero cabelludo y cabellos afectados para estudios micológicos. Finalmente, por medio de la Secretaría Departamental del Cauca y del hospital local, se manejó el brote de tinea capitis y se hicieron recomendaciones a los niños, los padres de familia y la población en general para prevenir estas micosis. Este estudio contó con el consentimiento informado verbal por parte de los padres de familia y los niños. Resultados. El agente etiológico aislado en el 63 % de las muestras recolectadas fue Trichophyton tonsurans y el principal factor predisponente para esta micosis fue compartir máquinas rasuradoras (87,5 %). El agente etiológico de este brote de tinea capitis no inflamatoria fue un dermatofito antropofílico. Conclusión. Idealmente, se deben practicar los estudios micológicos con el fin de establecer el agente etiológico y, así, plantear las terapéuticas y recomendaciones según las guías de manejo. Además, se debe realizar un trabajo multidisciplinario para el control del brote y la educación de la población respecto a esta micosis.
Introduction. Tinea capitis is a mycosis of keratinized tissue, which affects the scalp and may cause alopecia, pruritus, and desquamation. This type of mycosis is more frequent in school-age children, and it may represent a public health problem; the main etiological agents reported for Colombia are zoophilic dermatophytes. Objective. To characterize an outbreak of Tinea capitis in 32 children from a rural school in the department of Cauca. Materials and methods. We conducted an epidemiological field study using a structured survey to characterize sociodemographic aspects and predisposing factors for this mycosis. We collected samples of affected scalp scales and hair for mycological studies. The children and the general population received recommendations, about these mycoses' prevention, from Cauca's health authorities and the local hospital. The parents verbally approved the informed consent. Results. The etiological agent isolated in 63% of the collected samples was Trichophyton tonsurans, an anthropophilic dermatophyte, and the main predisposing factor was sharing razors (87.5%). Conclusions. Ideally, mycological studies define the etiological agent to propose therapeutics and recommendations in agreement with management guidelines. Implementation of multidisciplinary measures to control the outbreak and educate the population is required.
Assuntos
Tinha do Couro Cabeludo , Micologia , Saúde PúblicaRESUMO
La tiña capitis (TC) es una micosis superficial del cuero cabelludo, considerada una de las infecciones más frecuentes por dermatofitos en niños. Hasta la actualidad, las especies descritas con mayor frecuencia en nuestro medio son el Microsporum y, en segundo término, Trichophyton, los cuales se contraen principalmente por contacto directo con animales o seres humanos infectados, respectivamente. Se presenta el caso de una paciente de 8 años con alopecia y lesiones inflamatorias de 2 años de evolución, en la que finalmente se llegó al diagnóstico de TC inflamatoria causada por T. tonsurans, un hongo antropofílico considerado poco frecuente en Argentina y emergente en la provincia de Buenos Aires. Este patógeno presenta alta transmisibilidad; son varios los países que han reportado brotes escolares y comunitarios. Se debe resaltar la importancia de su sospecha clínica temprana para un tratamiento adecuado.
Tinea capitis (TC) is a superficial mycosis of the scalp, considered one of the most common dermatophyte infections in children. Until now, the species mainly described in our environment are Microsporum and secondly Trichophyton, which are contracted mainly by direct contact with infected animals or humans, respectively. We present the case of an 8-year-old patient with alopecia and inflammatory lesions of 2 years of evolution, finally reaching the diagnosis of inflammatory tinea capitis caused by T. tonsurans, an anthropophilic fungus considered rare in Argentina and emerging in the province of Buenos Aires. This pathogen has high transmissibility; several countries have reported school and community outbreaks. The importance of its early clinical suspicion for adequate treatment should be emphasized.
Assuntos
Humanos , Animais , Feminino , Criança , Tinha do Couro Cabeludo/diagnóstico , Arthrodermataceae , Trichophyton , MicrosporumRESUMO
La tiña capitis (TC) es una infección por dermatofitos con una alta prevalencia en la población pediátrica. Su epidemiología ha cambiado en las últimas décadas debido a la creciente migración poblacional alrededor del mundo. Se han identificado factores de riesgo ambientales y propios del huésped, relacionados al desarrollo de esta infección. Las manifestaciones clínicas son variables y dependen del agente causal. La dermatoscopia y la luz de Wood son herramientas útiles para la aproximación diagnóstica, sin embargo, la confirmación de la infección se basa en las pruebas micológicas. El aislamiento del agente causal permite orientar el tratamiento antifúngico adecuado, siendo estos eficaces y seguros en población pediátrica. El tratamiento se centra en la terapia antimicótica sistémica en combinación con medidas locales. El objetivo del manuscrito es hacer una revisión actualizada sobre el enfoque clínico y terapéutico de la TC en población pediátrica.
Tinea capitis (TC) is a dermatophyte infection with a high prevalence in the pediatric population. Its epidemiology has changed in recent decades due to increasing population migration worldwide. Environmental and host-specific risk factors have been identified which are with the development of this infection. The clinical manifestations are variable and depend on the causal agent. Dermatosco- py and Wood's lamp are useful tools for the diagnostic approach; however, the confirmation of in fection is based on mycological tests. The identification of the causal agent allows guiding the appro priate antifungal treatment, which is specific and safe in the pediatric population. Treatment focuses on systemic antifungal therapy combined with local measures. The objective of this paper is to carry out an updated review of the clinical and therapeutic approach to TC in the pediatric population.
Assuntos
Humanos , Pré-Escolar , Criança , Tinha do Couro Cabeludo/diagnóstico , Tinha do Couro Cabeludo/microbiologia , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/epidemiologia , Saúde Global , Prevalência , Dermoscopia , Diagnóstico Diferencial , Antifúngicos/uso terapêuticoRESUMO
Abstract Tinea capitis comprising of tinea favosa and kerion is mostly seen in school-aged children. Some tinea capitis often presented with insignificant findings under the naked eyes are easily overlooked. The authors describe an unusual case of tinea capitis caused by Trichophyton violaceum. The patient was an 8-year-old girl, with a history of pruritus on the scalp for more than one year. A diagnosis of tinea capitis was confirmed by clinical examination aided by dermoscopy, calcium fluorescent microscopy and culture. Comma and corkscrew hairs are two specific dermoscopic patterns of tinea capitis. The patient was treated with systemic itraconazole, topical application with 1% naftifine 0.25% ketoconazole cream followed after daily hair wash with 2% ketoconazole shampoo for 8 weeks.
Assuntos
Humanos , Feminino , Criança , Tinha do Couro Cabeludo/diagnóstico por imagem , Cálcio , Microscopia de Fluorescência/métodos , Tinha do Couro Cabeludo/patologia , Trichophyton/isolamento & purificação , Reprodutibilidade dos Testes , Dermoscopia/métodosRESUMO
Dermatofitose é uma micose superficial, causada por fungos filamentosos denominados dermatófitos, que são capazes de degradar estruturas queratinizadas. Os agentes dessas infecções em humanos pertencem a três gêneros: Microsporum, Trichophyton e Epidermophyton. O objetivo deste trabalho é revisar os estudos epidemiológicos e relatos de casos de tinea capitis, a partir de artigos publicados entre 2000 e 2018. Com base nos dados analisados, o gênero masculino foi o mais afetado pela tinea capitis e a faixa etária mais relatada foi a de indivíduos menores de 10 anos. As principais espécies isoladas foram: T. tonsurans e M. canis, sendo o primeiro mais encontrado nas regiões norte, nordeste e centro-oeste, e o segundo, nas regiões sudeste e sul do Brasil. Nos relatos de casos foram reportadas lesões com diferentes características, sendo algumas mais inflamatórias, eritematosas, com pústulas, placas de alopécia ou descamativas do que outras. Dor e prurido foram sintomas observados em alguns casos. A griseofulvina e os derivados azólicos foram os principais fármacos empregados na terapia, ainda que em associação em alguns casos. As avaliações dos tratamentos empregados nos casos de tinea capitis devem ser minuciosamente realizadas, visto que há relatos de casos em que a reposta terapêutica não é eficiente, agravando as lesões e prolongando o tempo de tratamento.
Dermatophytosis is a superficial mycosis, caused by filamentous fungi called dermatophytes, which are capable of degrading keratinized structures. The agents of these infections in humans belong to three genera: Microsporum, Trichophyton and Epidermophyton. The objective of this study is to review the epidemiological studies and reports of tinea capitis cases in Brazil, based on articles published between 2000 and 2018. Based on the data analyzed, the male gender was the most affected by Tinea capitis and the most reported age group was of individuals with less than 10 years. The main species isolated from the samples were: T. tonsurans and M. canis, being the first one most found in the north, northeast and center-west regions and the second one found in the southeastern and southern regions of Brazil. In the case reports, lesions with different characteristics were reported, being some more inflammatory, erythematous, with pustules, others with plaques of alopecia or desquamative than others. Pain and itching were symptoms observed in some cases. Griseofulvin and azole derivatives were the main drugs used in therapy, although in association in some cases. The evaluations of the treatment employed in the cases of Tinea capitis should be thoroughly done since there are reports of cases in which the therapeutic response is not efficient, aggravating the lesions and prolonging the treatment time
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Tinha do Couro Cabeludo/etiologia , Tinha do Couro Cabeludo/epidemiologia , TinhaRESUMO
BACKGROUND: Tinea capitis manifests either as a non-inflammatory or inflammatory type including kerion, which may cause permanent alopecia. In addition to antifungals, systemic corticosteroids (prednisolone at 1~2 mg/kg/day) have been used to reduce inflammation in patients with kerion. OBJECTIVE: We studied the clinical and laboratory features, treatments, and prognosis of tinea capitis. METHODS: We performed a retrospective review of 12 cases of kerion and 12 cases of non-inflammatory tinea capitis (median age, 8 years; range, 3 months~80 years) diagnosed using a potassium hydroxide mount at the National Health Insurance Service Ilsan Hospital between November 2011 and April 2018. RESULTS: Fungal cultures showed Microsporum species in 6 cases and Trichophyton species in 1 case. The duration of diseases and extent of lesions were greater in the kerion group than in the non-inflammatory tinea capitis group (p<0.05). Sixteen patients were treated with systemic antifungals. In the kerion group, 10 patients were treated with systemic antifungals (6 with itraconazole [median, 26 days; range, 21~58 days] and 4 with terbinafine [median, 24.5 days; range, 13~31 days]). The median intervals between the onset of treatment and scalp clearing (in 10 cases), the onset of new hair growth (in 9 cases), and complete regrowth of hair (in 7 cases) were 27 (range, 13~77), 33 (range, 19~63), and 89 (range, 42~180) days, respectively, in the kerion group. The median dosage of prednisolone used in patients with kerion was 0.26 mg/kg/day (range, 0.15~0.42) with good clinical response. CONCLUSION: The patients with kerion responded well to antifungal treatments. A lower dose of prednisolone was adequate when systemic corticosteroids were required for the treatment of kerion.
Assuntos
Humanos , Corticosteroides , Alopecia , Cabelo , Inflamação , Itraconazol , Microsporum , Programas Nacionais de Saúde , Potássio , Prednisolona , Prognóstico , Estudos Retrospectivos , Couro Cabeludo , Tinha do Couro Cabeludo , Tinha , TrichophytonRESUMO
La tiña capitis es considerada la infección por dermatofitos más frecuente en los niños. Los agentes etiológicos varían con el tiempo y según la zona geográfica, aunque, normalmente, son dermatofitos de origen zoofílico y, en los últimos años, también dermatofitos antropofílicos. Se presenta un caso de tiña capitis inflamatoria en un niño de 6 años de edad causada por Microsporum gypseum, un hongo geofílico patógeno para humanos y animales. Las fuentes de infección humana son el suelo, los gatos, los perros y pequeños mamíferos. Esta especie es poco frecuente como causa de dermatofitosis en el hombre, descrita, sobre todo, en tiña corporis y, raramente, en tiña capitis. En el diagnóstico de tiña capitis, identificar la especie causal es un factor determinante para el tratamiento.
Tinea capitis is considered the most frequent dermatophyte infection in children. The etiological agents vary from time to time and by geographical area, although they normally are zoophilic dermatophytes and in the last years also anthropophilic species. We report a clinical case of inflammatory tinea capitis in a 6-year-old child caused by Microsporum gypseum, a geophilic fungus pathogenic to humans and animals. The sources of human infection are soil, cats, dogs and small mammals. This species is less frequent as a cause of dermatophytosis in humans, described mainly in tinea corporis and rarely in tinea capitis. In the diagnosis of tinea capitis identifying the causative species is a determinant of the treatment.
Assuntos
Humanos , Masculino , Criança , Tinha do Couro Cabeludo/microbiologia , Microsporum/isolamento & purificaçãoRESUMO
Destacado dermatólogo, el doctor Julio V. Uriburu propició el estudio de las afecciones micóticas en nuestro medio. Realizamos una breve actualización del diagnóstico y tratamiento de tiñas de cuero cabelludo.
Dr. Julio V. Uriburu was a very important specialist in skin disorders. He worked in the investigation of micotics infections of hair and scalp disorders. We did a review of diagnostic and treatment of tinea capitis.
Assuntos
Micologia/história , Tinha do Couro Cabeludo/diagnóstico , Tinha do Couro Cabeludo/tratamento farmacológico , Antifúngicos/uso terapêutico , Dermatologia/história , Dermatologistas/história , Tinha do Couro Cabeludo/terapia , Estudos Retrospectivos , Estudo ObservacionalRESUMO
Abstract: Tinea capitis is the most common fungal infection in children. The identification of the etiologic agent helps clinicians make their therapeutic choice. Studies conducted in different countries show a changing pattern of the main etiological agents according to their regions. We performed a retrospective study in the tertiary public service in São Paulo, analyzing the isolated etiological agents in patients with tinea capitis from March 2013 to May 2015. Microsporum canis was the main agent (56.6%), followed by Trichophyton tonsurans (36.6%). Despite recent migratory movements in the city, we observed no change in the causative agent of tinea capitis.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Tinha do Couro Cabeludo/epidemiologia , Tinha do Couro Cabeludo/microbiologia , Trichophyton/isolamento & purificação , População Urbana , Brasil/epidemiologia , Incidência , Estudos Retrospectivos , Microsporum/isolamento & purificaçãoRESUMO
BACKGROUND: Tinea capitis remains a prevalent health problem among school-aged children. OBJECTIVE: To estimate the prevalence of tinea capitis among primary school students, in Fayoum, Egypt with identification of etiological agents in both public and private primary schools. METHODS: A cross-sectional study was conducted in twelve primary schools. The students were selected from different grades with a total number of 12,128 students. Hair and scalp were clinically examined for any lesions that may suspect tinea capitis and mycological samples were collected for direct microscopy and culture. RESULTS: The prevalence of tinea capitis in the study group was 0.4% and higher in public than private schools (73.5% versus 26.5% respectively). Boys were more affected than girls with boy to girls' ratio 5:1. Intrafamily history of infection was present in 40.8% of tested group while 51% showed low social standard profile. Mycological culture revealed that Microsporum canis was the predominant isolated organism followed by M. audouinii (52% and 36% respectively). CONCLUSION: M. canis is replacing Trichophyton violaceum as an etiology for tinea capitis in Egypt with lower prevalence rate than reported previously.
Assuntos
Criança , Feminino , Humanos , Masculino , Estudos Transversais , Egito , Epidemiologia , Cabelo , Microscopia , Microsporum , Prevalência , Couro Cabeludo , Tinha do Couro Cabeludo , Tinha , TrichophytonRESUMO
Introducción: los dermatofitos son las principales causas de micosis superficial. Su epidemiología es poco conocida en Paraguay. Objetivos: describir las especies prevalentes, tipos de tiñas y características según sexo y edad de pacientes que acudieron al Laboratorio Central de Salud Pública, Asunción- Paraguay,en el período 2000-2016. Materiales y Métodos: se estudiaron pacientes de todas las edades con diagnóstico de micosis superficiales. Las muestras procesadas fueron uñas, pelos y escamas epidérmicas Se realizaron exámenes directos con KOH y cultivos. La identificación fue por macro y microscopía de las colonias. Resultados: de 6.652 pacientes con sospecha de micosis superficiales, 803 (12%) fueron positivas para dermatofitos. Los aislamientos fueron Microsporumcanis (33,9%), Trichophytonrubrum (23,8%), Trichophytonmentagrophytes (22%), Trichophytontonsurans (12,6%), Microsporumgypseum (6,2%), Trichophytonverrucosum (1,4%), un aislamiento para Microsporummanuumy Epidermophytonfloccosum respectivamente. Los tipos de tiñas fueron: capitis (54,3%), corporis (27,1%) yunguium (9,8%), pedís (3,8%), cruris (3%) y manuum (2%). Conclusión: el hongo prevalente fue Microsporumcanis (33,9%) y la tiña más frecuente fue capitis.
Introduction: dermatophytes are the main causes of superficial mycosis. Its epidemiology is less known in Paraguay. Objectives: to describe the prevalent species, types of tinea and features according to sex and age of patients who attended the Central Laboratory of Public Health, Asunción-Paraguay, in the period 2000-2016. Materials and Methods: patients of all ages with a diagnosis of superficial mycosis were studied. The samples processed were nails, hairs and epidermal scales. Direct tests were carried out with KOH and cultures. The identification was by macro scopy and microscopy of the colonies. Results: of 6,652 patients with suspected superficial mycoses, 803 (12%) were positive for dermatophytes. The isolates were Microsporum canis (33.9%), Trichophyton rubrum (23.8%), Trichophyton mentagrophytes (22%), Trichophyton tonsurans (12.6%), Microsporum gypseum (6.2%), Trichophyton verrucosum (1,4%), isolation for Microsporum manuum and Epidermophyton floccosum respectively. The types of tinea were: capitis (54.3%), corporis (27.1%) and unguium (9.8%), pedis (3.8%), cruris (3%) and manuum (2%). Conclusion: The prevalent fungus was Microsporum canis (33.9%) and the most frequent tinea was capitis.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Dermatomicoses/epidemiologia , Paraguai/epidemiologia , Tinha/epidemiologia , Tinha do Couro Cabeludo/epidemiologia , Estudos Transversais , Estudos Retrospectivos , Microsporum/isolamento & purificaçãoRESUMO
BACKGROUND: Tinea capitis has been recognized as the most commonly misdiagnosed scalp disease. Inappropriate medication and delayed intervention leads to a broad array of complications from prolongation of treatment to scarring of the scalp. The financial deficits and problems imparted on patients continue to be a clinical and social burden. OBJECTIVE: The clinical and financial aspects between the initially misdiagnosed group and the properly diagnosed group were analyzed, to provide the epidemiologic basis and to address improvements for misdiagnoses of tinea capitis. METHODS: A retrospective review of electronic and written chart was performed on all patients diagnosed of tinea capitis at Daegu Catholic University Medical Center (DCUMC) from January 2006 to June 2016. A total of 100 patients were included in the study and an initially misdiagnosed group and initially diagnosed group were evaluated. RESULTS: Significant differences between the groups were not observed in variables including age, sex and occupation. The highest diagnostic precision was observed in dermatologists (78.4%) by using standard microscopic (31.0%) and culture studies (13.0%). Misdiagnosis rate was highest in pediatrics (34.9%) and erroneous examination such as laboratory test (48.4%) and Gram stain (19.4%) were countered in the misdiagnosed group. Additional clinic visits, prescriptions and extra trips to clinics resulted financial disadvantage in the misdiagnosed group. CONCLUSION: The misdiagnosed tinea capitis was found to arise from unawareness of the disease that leads to inappropriate approach and medication prescription. The duration, complications and financial loss were reported to be higher in misdiagnosed group based on the study.
Assuntos
Humanos , Centros Médicos Acadêmicos , Assistência Ambulatorial , Cicatriz , Erros de Diagnóstico , Ocupações , Pediatria , Prescrições , Estudos Retrospectivos , Couro Cabeludo , Tinha do Couro Cabeludo , TinhaRESUMO
While mycological examinations, potassium hydroxide preparation, and fungus culture remain the gold standard for the diagnosis of superficial dermatomycoses, mycological procedures have limitations because they are rather complex, time-consuming, and require skilled personnel and additional mycological tools. Dermoscopy is a simple, non-invasive diagnostic technique that allows better visualization of morphologic structures of the skin than the naked eye. It is easily performed with a hand-held dermoscope and allows immediate diagnosis. It has been primarily used to evaluate pigmented skin lesions, but recent advances indicate that it can also be a useful and convenient tool for diagnosing superficial dermatomycoses. The determination of specific dermoscopic patterns of fungal infection, especially in selected cases involving terminal hairs or nails, could lead to a straightforward diagnosis and facilitate their differentiation from non-fungal skin diseases. In addition, dermoscopy permits better inspection of subtle clinical features caused by fungi that are less evident to the naked eye; thus, in most cases, it can enhance clinician's diagnostic accuracy and confidence level, and allow determination of the best site for adequate mycological sampling as well as therapeutic monitoring. However, it should be a part of the evaluation in combination with other mycological tests because it does not substitute confirmatory examination for superficial dermatomycoses.
Assuntos
Dermatomicoses , Dermoscopia , Diagnóstico , Fungos , Cabelo , Onicomicose , Potássio , Pele , Dermatopatias , Tinha do Couro CabeludoRESUMO
No abstract available.
Assuntos
Humanos , Microsporum , Irmãos , Tinha do Couro Cabeludo , TinhaRESUMO
Dermatofitoses são infecções cutâneas superficiais causadas por fungos denominados genericamente de dermatófitos (gêneros: Microsporum, Trichophyton e Epidermatophyton) que afetam tecidos queratinizados como pele, cabelos e unhas. Uma vez que estes fungos são encontrados em humanos, animais e no ambiente, o principal fator de risco para o desenvolvimento da doença é o contato direto com animais ou humanos doentes ou portadores. A transmissão também pode ocorrer através do contato com objetos ou ambientes contaminados tais como: escovas de cabelo, roupa de cama, vestiários, carpetes ou outras superfícies contaminadas. O diagnóstico das dermatofitoses costuma ser com base no quadro clínico. Porém, na dúvida diagnóstica ou falha ao tratamento, pode-se solicitar o exame micológico direto para confirmar a infecção. A seguir, são apresentadas as formas mais comuns das dermatofitoses e seus respectivos tratamentos. Esta guia apresenta informação que orienta a conduta para casos de dermatofitoses no contexto da Atenção Primária à Saúde, incluindo: tinea corporis, tinea capitis, tinea cruris, tinea pedis e mannum, encaminhamento para serviço especializado.
Assuntos
Humanos , Tinha/diagnóstico , Tinha/terapia , Tinha do Couro Cabeludo/diagnóstico , Atenção Primária à Saúde , /uso terapêutico , Griseofulvina/uso terapêutico , Antifúngicos/administração & dosagemRESUMO
Introducción: En la literatura colombiana son escasos los reportes acerca de la epidemiología de la tinea capitis. Objetivo : Realizar un estudio retrospectivo para describir el comportamiento de esta micosis y de sus agentes etiológicos, en una serie de pacientes remitidos a un centro de diagnóstico especializado en Medellín, Colombia. Métodos : Estudio retrospectivo donde se analizaron los registros de pacientes remitidos entre los años 1994 y 2013 para estudio micológico a la Unidad de Micología Médica y Experimental de la Corporación para Investigaciones Biológicas (CIB), en Medellín, Colombia. Resultados : Fueron analizados 415 pacientes con sospecha clínica de tinea capitis, 133 (32%) de los cuales fueron confirmados por el laboratorio. La mayoría de los pacientes positivos, 124/133 (93%), fueron menores de edad y 89/133 (67%) correspondieron al sexo masculino. En 52 de los 133 casos comprobados se pudo determinar algún factor de riesgo asociado: el contacto con animales fue el principal factor de riesgo en 39/52 pacientes (75%). El examen directo fue positivo en el 87% y el cultivo para hongos en el 92% de los casos comprobados. El agente etiológico más frecuentemente aislado fue Microsporum canis (86%), seguido con una amplia diferencia por Microsporum gypseum(4%), Trichophyton tonsurans (3%), Trichophyton mentagrophytes (3%), Microsporum audouinii (3%) y Microsporum spp. (1%). Conclusión : Nuestros resultados representan una casuística importante para la epidemiología de la tinea capitis en Colombia. En ausencia de estudios más extensos en cobertura geográfica y en población estudiada que permitan conocer la incidencia real de esta micosis en nuestro medio, estos datos deben ser considerados como aporte valioso en el conocimiento de los agentes etiológicos de tinea capitis más frecuentes en el país.
Introduction: There are few written reports on the epidemiology of tinea capitis in Colombia. Objective: To undertake a retrospective study (1994-2013) aimed at describing the behavior of this mycosis and its etiological agents, using a series of patients referred to a specialized diagnostic center in Medellin, Colombia. Methods: This is a retrospective study in which the records were analysed of patients from 1994-2013, who were referred for mycological studies (direct examination and culture) to the Medical and Experimental Mycology Unit of the Corporación para Investigaciones Biológicas (CIB) with the clinical suspicion of tinea capitis. Results: In this period, 415 patients with clinical suspicion of tinea capitis were reported, of which 133 cases were confirmed by the laboratory (32%); most patients 124 (93%) were children, mostly boys 89 (67%). In terms of associated risk factors there was information from 52 confirmed cases, of which 39 (75%) had contact with animals. Direct examination was positive in 87% and fungal culture in 92% of confirmed cases; the etiologic agent most isolated was Microsporum canis (86%), followed by Microsporum gypseum (4%), Trichophyton tonsurans (3%), Trichophyton mentagrophytes (3%), Microsporum audouinii (3%) and Microsporum spp. (1%). Conclusion: Our results represent an important casuistry for the epidemiology of tinea capitis in Colombia. In the absence of more extensive studies on geographic coverage and population characteristics that reveal the true incidence of this mycosis in our country, these data should be considered a valuable contribution to the understanding of the most frequent etiologic agents of tinea capitis in Colombia.