How to treat microsporia in children? Microsporia of smooth skin and its treatment
Microsporia is a highly contagious dermatophytosis caused by fungi of the genus Microsporum.
Etiology and epidemiology of microsporia
The most commonly isolated pathogens of microsporia are the fungi Microsporum canis, which are among the most widespread zoophilic fungi in the world, causing dermatophytes in cats (especially kittens), dogs, rabbits, guinea pigs, hamsters, in more in rare cases– in monkeys, tigers, lions, wild and domestic pigs, horses, sheep, silver foxes, rabbits, rats, mice, hamsters, guinea pigs and other small rodents, as well as poultry. Infection occurs mainly through contact with sick animals or through objects contaminated with their fur. Infection between humans and humans is extremely rare, occurring on average in 2% of cases.
Microsporum audouinii is a common anthropophilic pathogen that can cause damage to the scalp and, less commonly, smooth skin in humans. Children get sick more often. The pathogen is transmitted only from a sick person to a healthy person directly through contact or indirectly through contaminated care and household items.
Microsporia is characterized by seasonality. Peaks in the detection of microsporia are observed in May-June and September-November. Various endogenous factors can contribute to the occurrence of the disease: sweat chemistry, the state of endocrine and immune systems. In addition, children have insufficient density and compactness of the keratin of epidermal cells and hair, which also contributes to the introduction and development of fungi of the genus Microsporum.
Microsporia is a disease that is the most highly contagious of the entire group of dermatophytosis. Mostly children, often newborns, are affected. Adults get sick less often, while the disease is often registered in young women. The rarity of microsporia in adults is associated with the presence of fungistatic organic acids (in particular, uncylenic acid) in the skin and its appendages.
IN last years there has been an increase in the number of patients with chronic course mycosis against the background of severe systemic lesions - lupus erythematosus, chronic glomerulonephritis, immunodeficiency states, intoxications.
Classification of microsporia
- microsporia caused by anthropophilic fungi Microsporum audouinii, M. ferrugineum;
- microsporia caused by zoophilic fungi canis, M. distortum;
- microsporia caused by geophilic fungi gypseum, M. nanum.
According to the depth of the lesion there are:
- superficial microsporia of the scalp;
- superficial microsporia of smooth skin (with damage to vellus hair, without damage to vellus hair);
- deep suppurative microsporia.
Symptoms of microsporia
Microsporum canis affects hair, smooth skin, very rarely - nails; foci of the disease can be located on both open and closed parts of the body. Incubation period illness lasts 5–7 days.
On smooth skin, the lesions look like swollen, raised erythematous spots with clear boundaries, round or oval outlines, covered with grayish scales. Gradually, the spots increase in diameter, and a raised ridge, covered with blisters and serous crusts, forms along their periphery. In 80-85% of patients in infectious process vellus hairs are involved. The eyebrows, eyelids and eyelashes may be affected. With microsporia of smooth skin, there are no subjective sensations; sometimes patients may be bothered by moderate itching.
With microsporia of the scalp, the lesions are most often located in the occipital, parietal and temporal regions. In the initial period of the disease at the site of introduction pathogenic fungus a focus of peeling occurs. Subsequently, the formation of one or two large lesions of round or oval shape with clear boundaries, measuring from 3 to 5 cm in diameter, and several small lesions - screenings, ranging in size from 0.3-1.5 cm are characteristic. Hair in the lesions is broken off and protrudes above the level skin by 4-5 mm.
Along with the typical clinical symptoms In recent years, zooanthroponotic microsporia has often seen its atypical variants. These include infiltrative, suppurative (deep), exudative, rosacea-like, psoriasiform and seboroid (proceeding like asbestos-like lichen), trichophytoid, exudative form, as well as a “transformed” version of microsporia (with modification clinical picture as a result of the use of topical corticosteroids).
In the infiltrative form of microsporia, the lesion on the scalp rises somewhat above the surrounding skin, is hyperemic, and the hair is often broken off at a level of 3-4 mm. The sheath of fungal spores is weakly visible at the root of broken hair.
In the infiltrative-suppurative form of microsporia, the lesion usually rises significantly above the surface of the skin due to pronounced infiltration and the formation of pustules. When pressing on the affected area, pus is released through the follicular openings. Discharged hair is glued together with purulent and purulent-hemorrhagic crusts. Crusts and melted hair are easily removed, revealing gaping orifices hair follicles, from which, like a honeycomb, light yellow pus is released. The infiltrative-suppurative form is more common than others atypical forms, sometimes occurs in the form of kerion of Celsus - inflammation of the hair follicles, suppuration and the formation of deep painful nodes.
Due to the absorption of fungal decay products and the associated secondary infection, intoxication of the patient’s body is observed, which is manifested by malaise, headaches, fever, enlargement and soreness of regional lymph nodes.
The formation of infiltrative and suppurative forms of microsporia is facilitated by irrational (usually local) therapy, serious accompanying illnesses, as well as late seeking of medical help.
The exudative form of microsporia is characterized by severe hyperemia and swelling, with small bubbles located against this background. Due to constant impregnation of the scales serous exudate and gluing them together, dense crusts are formed, when removed, the moist, eroded surface of the lesion is exposed.
microsporia exudative form
With the trichophytoid form of microsporia, the lesion process can cover the entire surface of the scalp. The lesions are numerous, small, with weak pityriasis-like peeling. The boundaries of the lesions are unclear, there are no acute inflammatory phenomena. This form of mycosis can acquire a chronic, sluggish course, lasting from 4-6 months to 2 years. The hair is thin or there are areas of patchy baldness.
trichophytoid form
With the seborrheic form of microsporia of the scalp, sparse hair is mainly noted. The areas of discharge are abundantly covered with yellowish scales, upon removal of which a small amount of broken hair can be found. Inflammatory phenomena in the lesions are minimal, the boundaries of the lesion are unclear.
seborrheic form
Diagnosis of microsporia
The diagnosis of microsporia is based on the clinical picture and the results of laboratory and instrumental studies:
- microscopic examination on mushrooms (at least 5 times);
- inspection under a fluorescent filter (Wood's lamp) (at least 5 times);
- cultural study to identify the type of pathogen in order to correct implementation anti-epidemic measures;
When prescribing systemic antimycotic drugs, it is necessary to:
- general clinical analysis blood (once every 10 days);
- general clinical urine analysis (once every 10 days);
- biochemical examination of blood serum (before the start of treatment and after 3-4 weeks) (ALT, AST, total bilirubin).
Differential diagnosis of microsporia
Microsporia is differentiated from trichophytosis, pityriasis rosea, seborrhea, and psoriasis.
The superficial form of trichophytosis of the scalp is characterized by small scaly foci of round or irregular shape with very mild inflammation and some hair thinning. The lesions are characterized by the presence of short hair broken off 1-3 mm above the skin level gray. Sometimes the hair breaks off above the skin level and looks like so-called “black dots”. At differential diagnosis with microsporia, pay attention to highly broken hair, with muff-like covers covering the hair fragments, asbestos-like peeling. Fluorescence is of decisive importance in diagnosis emerald color in the rays of a Wood's lamp of affected hair, detection of elements of a pathogenic fungus and isolation of the pathogen during cultural examination.
For pityriasis rosea Zhiber is characterized by more pronounced inflammation, a pink tint of the lesions, the absence of sharp boundaries, peeling in the form of “crumpled tissue paper”, the absence of the characteristic emerald glow and the identification of elements of a pathogenic fungus during microscopic examination.
Psoriasis is more characterized by clear boundaries, dry lesions, silvery scales, and the absence of muff-like layers of scales on the affected hair.
Treatment of microsporia
Treatment Goals
- clinical cure;
- negative results of microscopic examination for fungi.
General notes on therapy
For microsporia of smooth skin (less than 3 lesions) without damage to vellus hair, external antimycotic agents are used.
Indications for the use of systemic antimycotic drugs are:
- multifocal microsporia of smooth skin (3 or more lesions);
- microsporia with damage to vellus hair.
Treatment of these forms is based on a combination of systemic and local antimycotic drugs.
Hair in the affected areas is shaved once every 5-7 days or epilated.
Indications for hospitalization
- lack of effect from outpatient treatment;
- infiltrative-suppurative form of microsporia;
- multiple lesions with damage to vellus hair;
- severe concomitant pathology;
- according to epidemiological indications: patients from organized groups in the absence of the possibility of isolating them from healthy individuals (for example, in the presence of microsporia in persons living in boarding schools, orphanages, dormitories, children from large and asocial families).
Treatment regimens for microsporia:
- Griseofulvin orally with a teaspoon vegetable oil 12.5 mg per kg body weight per day
Additionally, therapy is carried out with locally active drugs:
- ciclopirox, cream
- ketoconazole cream, ointment
- isoconazole, cream
- bifonazole cream
- 3% salicylic acid and 10% Sulfuric ointment
- sulfur (5%)-tar (10%) ointment
When treating the infiltrative-suppurative form, antiseptics and anti-inflammatory drugs are initially used. medicines(in the form of lotions and ointments):
- Ichthyol, ointment 10%
- potassium permanganate, solution 1:6000
- ethacridine, solution 1: 1000
- furatsilin, solution 1:5000
Then treatment is continued with the above antifungal drugs.
Alternative treatment regimens
- terbinafine 250 mg
- itraconazole 200 mg
Special situations
microsporia - Pregnancy and lactation.
The use of systemic antifungal drugs during pregnancy and lactation is contraindicated.
Treatment of all forms of microsporia during pregnancy is carried out only with locally active drugs.
Treatment of children with microsporia:
Griseofulvin orally with a teaspoon of vegetable oil 21-22 mg per kg body weight per day
Treatment is considered complete after three negative results studies conducted at intervals of 5-7 days.
Additionally, therapy is carried out with locally active drugs:
- ciclopirox, cream
- ketoconazole cream, ointment
- isoconazole, cream
- bifonazole cream
- 3% salicylic acid and 10% sulfur ointment, alcohol tincture iodine
- sulfur (5%)-tar (10%) ointment
Alternative treatment regimens
- terbinafine: for children weighing >40 kg - 250 mg once daily orally after meals, for children weighing from 20 to 40 kg - 125 mg once daily orally after meals, for children with body weight<20 кг — 62,5 мг 1 раз в сутки
- itraconazole: children over 12 years of age - 5 mg per 1 kg of body weight
Requirements for treatment results
- resolution of clinical manifestations;
- lack of hair glow under a fluorescent filter (Wood's lamp);
- three negative control results of a microscopic examination for fungi (microsporia of the scalp - 1 time in 5-7 days; microsporia of smooth skin with damage to vellus hair - 1 time in 5-7 days, microsporia of smooth skin - 1 time in 3-5 days).
Due to the possibility of relapses, after completion of treatment, the patient should be under clinical observation: for microsporia of the scalp and microsporia of smooth skin with damage to vellus hair - 3 months, for microsporia of smooth skin without damage to vellus hair - 1 month.
Control microscopic examinations during dispensary observation must be carried out: for microsporia of the scalp and microsporia of smooth skin involving vellus hair - once a month, for microsporia of smooth skin - once every 10 days.
A conclusion on recovery and admission to an organized team is given by a dermatovenerologist.
Prevention of microsporia
Preventive measures for microsporia include sanitary and hygienic measures, incl. compliance with personal hygiene measures and disinfection measures (preventive and focal disinfection).
Focal (current and final) disinfection is carried out in places where the patient is identified and treated: at home, in children's and medical organizations.
Preventive sanitary-hygienic and disinfection measures are carried out in hairdressing salons, baths, saunas, sanitary checkpoints, swimming pools, sports complexes, hotels, hostels, laundries, etc.
Anti-epidemic measures when microsporia is detected:
- For a patient diagnosed with microsporia for the first time, a notification is submitted within 3 days to the department of accounting and registration of infectious diseases of the Federal Budgetary Institution of Health "Center for Hygiene and Epidemiology" and its branches, to territorial dermatovenerological dispensaries.
- Each new disease should be considered as newly diagnosed.
- When registering a disease in medical organizations, organized groups and other institutions, information about the sick person is entered into the infectious diseases register.
- The journal is kept in all medical organizations, medical offices of schools, preschool institutions and other organized groups. Serves for personal registration of patients with infectious diseases and registration of information exchange between medical organizations and state sanitary and epidemiological surveillance organizations.
- The patient is isolated.
- When a disease is detected in children's institutions, a patient with microsporia is immediately isolated and routine disinfection is carried out before transfer to the hospital or home.
- Until a child with microsporia recovers, he is not allowed to enter a preschool educational institution or school; an adult patient is not allowed to work in children's and communal institutions. The patient is prohibited from visiting the bathhouse or swimming pool.
- For maximum isolation, the patient is allocated a separate room or part of it, personal items (linen, towel, washcloth, comb, etc.).
- In the first 3 days after identifying a patient in preschool educational institutions, schools, higher and secondary specialized educational institutions and other organized groups, medical personnel of these institutions conduct an examination of contact persons. An examination of contact persons in the family is carried out by a dermatovenerologist.
- The inspection is carried out before final disinfection.
- Further medical observation with mandatory examination of the skin and scalp using a fluorescent lamp is carried out 1-2 times a week for 21 days with a note in the documentation (an observation sheet is kept).
- Current disinfection of outbreaks is organized by the medical organization that identified the disease. Routine disinfection before hospitalization and recovery is carried out either by the patient himself or by the person caring for him.
- Responsibility for performing routine disinfection in organized teams and medical organizations rests with its medical personnel. Current disinfection is considered timely organized if the population begins to perform it no later than 3 hours from the moment the patient is identified.
- Final disinfection is carried out in microsporia foci after the patient leaves the foci for hospitalization or after the recovery of a patient who was treated at home, regardless of the length of hospitalization or recovery.
- In some cases, final disinfection is carried out twice (for example, in the case of isolation and treatment of a sick child in the isolation ward of a boarding school: after isolation - in the premises where the patient was and after recovery - in the isolation ward). If a child attending a preschool or school falls ill, final disinfection is carried out at the preschool (or school) and at home. In secondary schools, final disinfection is carried out according to epidemiological indications. The final disinfection in the outbreaks is carried out by a disinfection station. Bedding, outerwear, shoes, hats, carpets, soft toys, books, etc. are subject to chamber disinfection.
- An application for final disinfection in households and isolated cases in organized groups is submitted by a medical worker of a medical organization with a dermatovenerological profile.
- When 3 or more cases of microsporia are registered in organized groups, as well as for epidemiological indications, the exit of a medical worker from a medical organization with a dermatovenerological profile and an epidemiologist from state sanitary and epidemiological surveillance institutions is organized. As directed by the epidemiologist, final disinfection is prescribed and the scope of disinfection is determined.
- The medical worker who has identified the disease is working to identify the source of infection (contact with sick animals). Animals (cats, dogs) are sent to a veterinary hospital for examination and treatment, followed by the submission of a certificate from the place of treatment and observation of the patient with microsporia. If a stray animal is suspected, information is transmitted to the appropriate animal control services.
IF YOU HAVE ANY QUESTIONS ABOUT THIS DISEASE, CONTACT DOCTOR DERMATOVENEROLOGIST KH.M. ADAEV:
EMAIL: [email protected]
INSTAGRAM @DERMATOLOG_95
Microsporia is a common fungal disease that infects the skin, scalp and sometimes the nail plate. The causative agent of the disease is the fungus Microsporum. Microsporia in humans is a fairly common disease. Children are especially often affected by pathological fungus, but adults also suffer from this disease. The fungus penetrates deeply into the skin, where it begins to actively multiply, affects the scalp and destroys hair follicles. The fungus forms a kind of cover around the hair.
Most often, microsporia affects children under 12 years of age. The infection is also especially severe in women. Infection of smooth skin or infection of the scalp may develop. Timely diagnosis and the use of correctly prescribed drugs in treatment contribute to the effective fight against microsporia.
Cats and dogs are often the source of the fungus. A person can become infected from domestic or street animals through direct contact if scales from the animal’s fur or skin get on human skin. Infection can also occur from household items that have become infected with the fungus. The incubation period of microsporia in humans lasts five days to six weeks, depending on the type of fungus. The fungus persists in the soil for up to three months, but the soil is not a source of infection.
Microsporia is a common infectious disease. This fungal infection is particularly contagious. The peak incidence occurs in the summer-autumn period.
Immediately after infection, the microsporia fungus infects the skin, after which it begins its active reproduction. Fungal spores literally grow deep into the hair follicles. The infection then spreads to the entire hair, and fungal spores form under the fungal scales.
There are two types of microsporia - infection of the smooth skin and microsporia of the head and its scalp.
Smooth skin disease
This type of microsporia deeply affects the skin of various parts of the body. In the zone of contact with the fungus, a swollen red-pink spot appears, which rises slightly above the skin and has clearly defined boundaries. As the disease progresses, the spot increases significantly in size.
A kind of roller of small crusts, bubbles or peculiar nodules begins to form along the edge of the spot. In the center of the source of inflammation, the spot has a pronounced pink color, and the surface of the site of infection has pityriasis-like peeling. Externally, the spot resembles a ring and is accompanied by itching. There can be several foci of inflammation - from one to three or four.
The fungus most often affects the neck, face, forearms, shoulders, and arms, but foci of inflammation can also occur in other parts of the human body. Rarely, the disease may occur on the soles of the feet, palms, or nails. If the disease affects a person's nails, the disease is characterized by a dull spot at the outer edge of the nail plate. Then the nail itself of the sick person becomes white and begins to deteriorate greatly.
Or allergies, a fungal infection disguises itself as manifestations of allergies and other pathologies and complicates the medical diagnosis of microsporia. Only regular laboratory tests can reveal the correct nature of the disease and determine the causative agent of the fungal disease.
Disease of the scalp
Microsporia of the scalp is very common among children under 12 years of age, but the disease also occurs in adults. Sometimes, as the child grows up, during puberty, the composition of sebum changes and independent recovery from the disease may occur. However, it is still important to treat the disease as prescribed by the doctor and undergo all necessary examinations.
The lesions are located on the parietal zone, on the temples, on the crown of the head. Typically, the disease of the scalp is characterized by the formation of one or two foci of inflammation. Foci of microsporia have clear boundaries and range in diameter from two to five centimeters. Small screenings up to one centimeter may be located along the edge of the main focus.
When the disease begins, scales form at the hair root. It surrounds the hair. On the seventh day of the disease, the hair is affected - it becomes brittle and dull. The hair breaks off easily, and the remaining ends of the hair acquire a grayish-white coating. When smoothed, the remaining hair does not return to its original position, which is noticeably different from healthy hair. With a disease of the hairy area, the skin becomes covered with small scales and acquires a white-gray tint.
Characteristic symptoms
- pink spots of various diameters;
- clear boundaries of the lesion;
- small scales in the lesion;
- fusion of small lesions;
- crusts and scales in the center of the spot;
- continuous roll along the edges of the spot;
- the presence of bubbles, crusts and nodules;
- the appearance of another ring inside the lesion ring;
- slight itching;
- hair breakage;
- formation of a gray-white sheath around the hair;
- skin hyperemia and swelling;
- Suppuration may occur at the site of the lesion.
Factors predisposing to the disease
Many patients often wonder: is microsporia transmitted from person to person? This disease is infectious, so you can become infected with microsporia through any direct contact with a sick person or through household items. This infection is characterized by an anthroponotic route of spread - from a sick patient to healthy people. The causative agents of the disease are both anthropophilic and zoophilic fungi. However, infection from sick animals is more common. The most common pathogen is the fungus Microsporum canis.
Predisposing factors to microsporia are:
- significant decrease in immunity;
- childhood before puberty;
- deficiency of properdin and lysozyme in the body;
- improper activity of the sebaceous glands;
- nervous and vascular disorders;
- skin microtraumas;
- violation of the proliferative process of the skin;
- avitaminosis.
Diagnosis of the disease
Diagnosis of microsporia includes three types of research:
These studies make it possible to accurately determine the specific source of infection and the type of fungus that causes the disease. Diagnostics are necessary to prescribe the correct treatment and select the correct medications for therapeutic therapy.
Treatment of microsporia in humans
The basis of treatment for microsporia is antifungal therapy with various drugs. The following drugs are very effective in treating the disease:
To combat the disease, the drugs Terbinafine and Griseofulvin are prescribed. The drug Griseofulvin is a special antibiotic. Available in 125 mg tablets. It is necessary to take the medicine together with a teaspoon of vegetable oil, which improves the solubility of the medicine in the body. The oil also promotes longer-lasting effects of the drug. An analogue of Griseofulvin is the drug Lamisil, which is available in tablets.
In order for recovery to proceed much faster, it is necessary to regularly remove crusts and scales from the source of inflammation. For this purpose, dressings with salicylic petroleum jelly are used. You can use olive or vegetable oil. Oils soften scales and crusts, after which the scales are easily removed from the skin.
To eliminate and effectively eliminate the inflammation itself, special ointments, creams, and gels prescribed by the doctor are used, which contain glucocorticosteroids. An excellent combination medicine is Travocort. If a secondary infection has joined the disease, the doctor prescribes the use of antibiotics and various antiseptics. The drug Quinozol may be prescribed.
To combat microsporia on smooth skin, it is recommended to shave the hair once a week in order to prevent further development of the infection along the skin.
External means are used for treatment - applying iodine tincture in the morning, as well as using sulfur ointment. In treatment, you can use sulfur-salicylic ointment or sulfur-tar ointment. Creams or sprays of Isoconazole, Lamisil, Clotrimazole are used twice a day. For severe inflammation, the doctor prescribes combination medications that include certain hormones.
The use of salicylic and sulfur ointments helps to completely eliminate the source of infection. These ointments have excellent anti-inflammatory, antiseptic and restorative properties. The use of these medications quickly and effectively eliminates the fungus, prevents its further reproduction and stops its vital activity.
At the same time, antiseptic ointments perfectly dry and restore the affected skin at the source of infection. The affected areas are also treated with iodine, which eliminates the fungus and dries out the scales and crusts. For microsporia of the scalp, it is extremely important to regularly wash your hair at least twice a week.
The recovery process is also greatly facilitated by the use of immunomodulatory drugs, which restore immunity weakened by the disease. It is important to take vitamin complexes during the treatment of the disease, and you can also use various necessary biological supplements and herbal medicinal infusions that will help to cope with the disease effectively and in a short time. Shaving the hair at the site of infection will have a very positive effect on all therapeutic procedures.
Complete clinical recovery is assessed by a doctor as a result of regularly conducted studies. Thus, when irradiated with a Wood's lamp, there is no green glow. Microscopic examinations are also carried out to confirm complete recovery and the absence of the pathogenic fungus on the skin. Microscopic examinations during treatment must be carried out regularly at intervals of five days.
Features of the disease
The incubation period of microsporia lasts from seven days or more. The pathogenic fungus penetrates the skin. It is at this point that a red spot appears - the source of infection. As a result of further development of the disease, the spot begins to increase in size. In this case, the spot acquires clear boundaries.
The spots are outlined by a protruding ridge, which gradually forms during the development of the disease. Then the focus of inflammation takes the shape of a ring. Sometimes another ring may appear inside one ring. This symptom is very often characteristic of microsporia.
As the disease develops, the site of infection begins to peel off and become covered with scales and crusts. During the treatment process, they must be regularly removed before applying medicinal ointments. Using regular vegetable oil helps soften scales, regenerates and restores damaged skin.
Softened scales and crusts are very easy to scrape off with a comb or cotton swab. After this, you can apply a medicinal ointment prescribed by your doctor to the site of infection.
Often the disease can be characterized by slight itching. Itching is especially pronounced in areas of infection. A person with microsporia usually develops from one to three lesions.
The spots may enlarge and spread further into the skin. Therefore, treatment of microsporia must be started in a timely manner. In children and women, inflammation appears especially severe and can cause severe discomfort. Severe inflammation can affect the scalp, shoulders, neck, palms, arms, and chest.
Prevention
The main preventive measure is timely detection of the disease, isolation of the sick person and correctly prescribed treatment for microsporia. The belongings of a person suffering from microsporia must be thoroughly disinfected.
It is important to conduct an examination of people who have come into contact with a person sick with microsporia or with sick animals. Animals with microsporia must be treated by a veterinarian. The sick animal has clearly visible foci of microsporia on the muzzle and paws, and partial baldness on the ears is visible. Many animals may not show characteristic signs of the disease.
It is animals that serve as the main distributors of fungal infections. They are also carriers of the disease. Therefore, after interacting with animals, it is important to thoroughly wash your hands after each contact.
Microsporia can also be transmitted through household contact. Fungal spores accumulate over time under the scales. When released into the external environment, the fungus retains its vital activity for up to three months or more. Therefore, you can become infected with fungus through bedding, towels, toys, combs and other household items.
It is necessary to fight microsporia daily. It is important to wet clean the room using disinfectants, disinfect the linen of a sick person, and regularly ventilate the room. Prevention of the disease is to avoid contact with sick people and sick animals.
Microsporia is a highly contagious infectious disease caused by a fungus of the genus Microsporum, which mainly affects the skin, scalp, hairy areas of the skin (beard, mustache), less often nails, skin of the palms and feet.
The disease is common on all continents, but mainly in the western part of Europe, Southeast Asia, Central Asia, Transcaucasia, Japan and the USA.
Microsporia affects children aged 1 to 13 years and women, although the percentage of the disease in the adult population is small and ranges from 10 to 12%. This is due to the fact that during puberty the composition of the secretion of the sweat and sebaceous glands located in the human skin changes; a large amount of fatty acids appear on the surface of the skin, which are destructive for this type of fungus.
There is a risk group that is most susceptible to infection with microsporia:
- children and young women;
- persons with a compromised immune system;
- children with endocrinological diseases (diabetes mellitus, hypothyroidism);
- hypovitaminosis;
- children from disadvantaged families with poor housing, communal and living conditions.
Microsporia can be completely cured, the outcome of the disease is favorable. If the disease is not treated, self-healing occurs by the time of puberty.
Microsporia, which is transmitted from sick animals, is characterized by seasonality; the highest number of disease outbreaks occurs at the end of summer and beginning of autumn.
Causes of microsporia
Microsporia is caused by a fungus of the genus Microsporum, which is divided into several species based on environmental criteria:
There are two common species in Russia: Microsporum ferrugineum and Microsporum canis.
The most contagious is the anthropophilic fungus Microsporum ferrugineum. The source of infection in anthropophilic microsporia is a sick person and things with which he came into contact (personal hygiene items, bed linen, stationery, toys).
The source of infection for zoophilic microsporia is domestic animals (dogs, cats, hamsters, guinea pigs, rats), a person becomes infected both through direct contact and through objects that have received hair or skin scales from infected animals.
Classification of microsporia
By pathogen:
- anthropophilic microsporia;
- zoophilic microsporia;
- geophilic microsporia.
By localization:
- superficial microsporia of the scalp;
- superficial microsporia of smooth skin;
- deep suppurative microsporia.
Symptoms of microsporia
The incubation period lasts 3 – 5 days. The causative agent of the disease first gets on the skin and penetrates it; a reddish spot forms at the site of its penetration into the skin. From the surface of the skin, the fungus penetrates the hair follicle (bulb), from where it enters the hair. Swelling forms around the affected hair, which grows and acquires a red tint. Inflammatory processes in the foci of infection are weakly expressed.
Further symptoms of the disease depend on the location of the pathogen:
At superficial microsporia of the scalp single lesions of a regular, round shape with a diameter of 2–5 cm are formed. The lesions are clearly delimited from each other, there is no tendency to merge. The skin above the lesions is covered with many whitish scales. The hair in the lesion breaks off and rises above the skin at a height of 4–6 mm. The skin in the area of the lesion is red, slightly swollen, bubbles filled with liquid form on the surface, after their resolution crusts form. The base of the infected hair is wrapped in a round, whitish, cuff-shaped scale; the hair becomes thin, dull, grayish-white in color, and very brittle. On the periphery of the lesion, where the hair does not break off, but still falls into the zone of inflammation, it falls out at the slightest touch.
Superficial microsporia of smooth skin. The favorite localization of infection is the face, neck, upper limbs, and back. The disease is characterized by the appearance of pink oval or round spots with a diameter of 0.5 to 2 - 4 cm. The lesions do not merge with each other; a large number of lesions of 30 or more is characteristic. In the center, the lesion is covered with white scales; on the periphery, bubbles with clear liquid appear, which form into crusts. There are no atrophic scars left on the skin.
Diagnosis of microsporia
For deep suppurative microsporia, general clinical laboratory tests are indicated:
- General blood analysis.
- General urine analysis.
- Blood glucose.
- Biochemical studies (total and direct bilirubin, total protein and its fractions, transaminase levels - ALT, AST, alkaline phosphatase, thymol test).
For other types, only specific diagnostics are sufficient, which is carried out using:
Microscopy of hair, crusts from lesions, skin and nail scales. Hair affected by microsporia looks quite specific; fungal spores surround its base like a muff, tightly fitting to each other. In skin scales and crusts, the mushroom is represented by thin branching threads of mycelium with sparse partitions.
Growing the pathogen on nutrient media. The method is quite labor-intensive and time-consuming, so it plays a minor role in diagnosing the disease. But it plays a high role in tracking the spread of the pathogen and its frequency of occurrence in different countries.
Smear from an infected lesion applied to the nutrient medium and then germinates within 7–10 days; representatives of different species have different structures and shapes:
- Microsporura canis - appears as gray or yellowish-pink, round, wide, fluffy colonies.
- Microsporum ferrugineum – rusty in color, branched colonies.
- Microsporum gypseum - colonies are pinkish in color, changing towards the edges to white, flat, smooth, velvety.
Luminescent study– under an ultraviolet lamp (Wood’s lamp), the affected skin and hair glow green. When infected by an anthropophilic pathogen, the glow is more emerald; when infected by a zoophilic pathogen, it is pale greenish.
Treatment of microsporia
Antifungal drugs
Griseofulvin is prescribed in tablets of 0.125 g with meals. For better absorption, the drug is washed down with a tablespoon of sunflower oil or fish oil. The daily dose is calculated from 20-22 mg per 1 kg of body weight. The drug is toxic. Treatment is carried out under the control of a general blood test and a general urinalysis every 7 to 10 days. Treatment is continued until tests for fungi are 3 times negative. Analyzes are carried out every 7 days. After the first negative test, griseofulvin is taken every other day for 2 weeks, and after the third negative test, once every 3 days for another 2 weeks.
In case of intolerance, griseofulvin can be replaced with drugs such as:
- Imidazole (ketoconazole, nizoral) 1 tablet 0.2 g 1 time per day for 1 – 2 months.
- Terbezil 125 and 250 mg per tablet. Prescribed 125 mg 2 times a day or 250 mg 1 time a day. For skin lesions, the course of treatment is 2–4 weeks, for scalp lesions – 4–6 weeks.
Local treatment
- shaving hair once a week;
- washing your hair 2 times a week with soap;
- lubricate the lesions with an alcohol solution of iodine;
- rub antifungal ointments into the skin (Wilkinson ointment, sulfur-salicylic ointment, ketoconazole, lamzil, clotrimazole).
Complication of microsporia
- pustular lesions of the skin and subcutaneous fat layer (phlegmon);
- baldness.
Prevention of microsporia
- compliance with personal hygiene rules;
- Always wash your hands after contact with pets;
- if you suspect a pet is infected with microsporia, you should immediately contact a veterinarian;
- a person with microsporia is not allowed into kindergarten, school, swimming pool or sports clubs;
- Children who have recovered from the disease should be under medical supervision for up to 1 year and undergo timely control tests for fungi in order to avoid a relapse.
Microsporia is a fungal disease that affects the skin and hair, and in extremely rare cases, the nail plates. The name of this fungal disease comes from the name of its causative agent - a fungus of the genus Microsporum. The disease is also known as “ringworm,” due to the characteristics of its manifestation.
Once on the skin, the fungus penetrates it and begins to multiply. When located near the hair follicles, fungal spores germinate, leading to hair damage. Spreading quite quickly over the surface of the hair, the fungus destroys the cuticle, between the scales of which spores accumulate. Thus, the fungus surrounds the hair, forming a sheath, and tightly fills the bulb.
Microsporia is the most common fungal infection, not counting foot fungus. The disease occurs everywhere. Microsporia is highly contagious and children are more often affected. Adults rarely get sick - mostly young women. The rarity of the disease with microsporia in adults, especially with damage to the scalp, and usually the onset of independent recovery at the beginning of adolescence is explained by the presence of organic acids in the hair of adults that slow down the growth of the fungus.
The main source of the disease is cats (usually kittens), less often dogs. Infection with microsporia occurs through direct contact with a sick animal or objects infected with hair or scales. Once in the soil, the fungus remains viable only for 1-3 months. Thus, soil is only a factor in the transmission of infection and does not serve as its natural source.
Symptoms of microsporia
Manifestations of microsporia in animals are characterized by areas of baldness on the face, the outer surfaces of the ears, as well as on the front, less often the hind, paws. Often, apparently healthy cats can be carriers of the fungus.
Seasonal fluctuations in incidence are associated with litters in cats, as well as more frequent contact of children with animals in the summer. The rise in the incidence of microsporia begins in late summer, the peak occurs in October-November, and the decrease to a minimum occurs in March-April.
The incubation period for zoonotic microsporia is 5-7 days. The nature of the manifestations of microsporia is determined by the location of the lesions and the depth of penetration of the pathogen.
There are microsporia of smooth skin and microsporia of the scalp.
Microsporia of smooth skin
At the site where the fungus has invaded, a swollen, raised red spot with clear boundaries appears. Gradually the spot increases in diameter. A continuous raised ridge is formed along the edge, represented by small nodules, bubbles and crusts. In the central part of the spot, inflammation resolves, as a result of which it acquires a pale pink color, with pityriasis-like peeling on the surface. Thus, the focus has the appearance of a ring.
The number of foci with microsporia of smooth skin is usually small (1-3). Their diameter ranges from 0.5 to 3 cm. Most often, lesions are located on the skin of the face, neck, forearms and shoulders. There are no subjective sensations or moderate itching.
In newborns and young children, as well as in young women, severe inflammation and minimal peeling are often observed.
In people prone to allergic reactions (in particular, in patients with atopic dermatitis), the fungus is often masked by manifestations of the underlying process and is not always diagnosed in a timely manner. The use of local hormonal drugs only increases the spread of fungal infection.
A rare type of microsporia includes damage to the skin of the palms, soles and nail plates. Nail lesions are characterized by isolated lesions of the nail plate, usually its outer edge. Initially, a dull spot is formed, which becomes white over time. The nail in the area of whitening becomes softer and more fragile, and may subsequently collapse.
Microsporia of the scalp
Damage to the scalp by microsporia occurs mainly in children 5-12 years old. It is generally accepted that the rarity of this form in adults is explained by the presence of organic acids in their hair, which slow down the growth of the fungus. This fact indirectly confirms the independent recovery of children during puberty, when the composition of sebum changes. Interestingly, microsporia of the scalp is practically never found in children with red hair.
Foci of microsporia of the scalp are located mainly on the crown, in the parietal and temporal regions. Usually there are 1-2 large lesions ranging from 2 to 5 cm in size, with round or oval outlines and clear boundaries. Along the edges of large lesions there may be screenings - small lesions with a diameter of 0.5-1.5 cm. At the beginning of the disease, a peeling area forms at the site of infection. In the first days, the fungus is located only at the mouth of the hair follicle. Upon closer inspection, you will notice a whitish ring-shaped scale surrounding the hair like a cuff. On the 6-7th day, microsporia spreads to the hair itself, which becomes brittle, breaks off above the level of the surrounding skin by 4-6 mm and looks as if it has been trimmed (hence the name “ringworm”). The remaining stumps look dull and are covered with a grayish-white sheath, which is the spores of a fungus. If you “stroke” the stumps, they deviate in one direction and, unlike healthy hair, do not restore their original position. The skin in the affected area is usually slightly reddened, swollen, and its surface is covered with grayish-white small scales.
Photo: website of the Department of Dermatovenereology of the Tomsk Military Medical Institute
Suppurative form
In the suppurative form of microsporia, against the background of significant inflammation, soft bluish-red nodes form, the surface of which is covered with pustules. When pressed, pus is released through the holes. The formation of a suppurative form of microsporia is facilitated by irrational (usually local) therapy, the presence of serious concomitant diseases, and late consultation with a doctor.
Diagnostics
Diagnosis of microsporia is carried out by a dermatologist.
To confirm the diagnosis of microsporia, fluorescent, microscopic and cultural studies are used.
Luminescent research: the method is based on identifying the bright green glow of hair affected by fungi of the genus Microsporum when examined under a Wood's lamp. The reason for this phenomenon has not yet been established. Luminescence testing must be carried out in a darkened room. The lesions are first cleaned of crusts, ointments, etc. When examining fresh lesions, there may be no glow, which is due to insufficient hair damage. In such situations, the hair should be removed from the suspected site of the fungus, and the glow can be detected in its root part. When the fungus dies, the glow in the hair remains.
The luminescent method is used for:
- pathogen identification;
- identifying affected hair;
- evaluation of therapy results;
- control over persons in contact with the patient;
- determining infection or carriage in animals
Microscopic examination: to confirm the fungal origin of the disease, scales from lesions when smooth skin is affected are subjected to microscopic examination, and when the scalp is involved in the process, hair fragments are subjected to microscopic examination. In scales from lesions on smooth skin, twisted threads of mycelium are found. A microscopic examination of the affected hair reveals many small spores on its surface.
Cultural examination: carrying out cultural diagnostics with positive results of luminescent and microscopic examinations is required to identify the causative fungus. The method allows you to determine the genus and type of pathogen and, therefore, carry out adequate therapy and prevention of the disease. The material (scales, hair) is placed on a nutrient medium. The growth of Microsporum colonies (the main pathogen of microsporia) is observed on the 3rd day after sowing.
Treatment of microsporia
Treatment of smooth skin microsporia
When treating microsporia of smooth skin without hair damage, external antifungal drugs are used. Apply 2-5% iodine tincture to the affected areas in the morning and apply antifungal ointment in the evening. Use traditional 10-20% sulfur, 10% sulfur-3% salicylic or 10% sulfur-tar ointments. Modern ointments are used twice a day:
- clotrimazole,
- ciclopirox,
- isoconazole,
- bifonazole, etc.
In case of severe inflammation, it is advisable to prescribe combination drugs containing additional hormones. Similar products include mycozolon ointments and travocort.
When a bacterial infection occurs, Triderm cream is useful. For deep forms of microsporia, preparations containing dimexide are indicated. In particular, in such situations, a 10% solution of quinosol is widely used (quinosole and salicylic acid 10.0 each, dimexide 72.0, distilled water 8.0). The solution should be applied 2 times a day until the mushrooms disappear.
When vellus hair, and especially long hair, is affected, systemic antifungal therapy for microsporia is necessary.
Treatment of microsporia of the scalp
When treating this form of the disease, griseofulvin, an antibiotic produced by a mold, is still the drug of choice. Griseofulvin, available in the form of 125 mg tablets. The drug is taken daily in 3-4 doses during meals with a teaspoon of vegetable oil, which is necessary to increase the solubility of griseofulvin and increase the duration of its action. For children under 3 years of age, it is preferable to prescribe griseofulvin in the form of a suspension, 8.3 ml of which corresponds to 1 tablet (125 mg) of the drug. Continuous therapy is carried out until the first negative test result for fungi, after which griseofulvin is taken at the same dose every other day for 2 weeks, and then for another 2 weeks, 2 times a week. The general course of treatment is 1.5-2 months.
During treatment, you need to shave your hair weekly and wash your hair 2 times a week. It is recommended to simultaneously rub any antifungal ointment into the affected area. In parallel with taking the antifungal drug, manual hair removal can be performed with preliminary application of a 5% griseofulvin patch to the lesion.
Side effects of griseofulvin include headache, allergic rashes, and discomfort in the pancreas. Due to its toxic effect on the liver, griseofulvin is contraindicated in children who have had hepatitis or suffer from liver disease. The drug is also not prescribed for kidney diseases, gastric and duodenal ulcers, neuritis, blood diseases, photodermatoses.
In recent years, terbinafine (Lamisil) has been used as an alternative to griseofulvin. In the treatment of microsporia of the scalp, terbinafine is used in the form of tablets, available in doses of 125 and 250 mg. When treating children, the dose of terbinafine is determined depending on body weight. Terbinafine is taken once a day. The drug is well tolerated. Patients may be bothered by a feeling of fullness in the stomach, minor abdominal pain. Following a diet aimed at relieving flatulence relieves patients from unpleasant sensations.
Prevention
Prevention of microsporia consists of timely identification, isolation and treatment of patients with microsporia. In children's institutions, periodic medical examinations should be carried out. A child diagnosed with microsporia must be isolated from other children and sent for treatment to a specialized hospital. Things belonging to the patient must be disinfected.
Relatives and people in contact with the patient must be examined. Particular attention should be paid to pets, since they are often the source of infection. Animals with microsporia are either destroyed or given full antifungal treatment.
Microsporia is an infectious disease of a fungal nature. Counts quite common, appears in approximately 0.5% of cases.
Most susceptible the emergence and development of the disease in young children, since it is during this period that the child is most active, because he learns about the world around him, often comes into contact with animals, without fully realizing the need to observe the rules of personal hygiene.
According to statistics, boys are most often affected, although there is no proven evidence of gender dependence. ABOUT symptoms and treatment We will discuss microsporia in children in the article.
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Characteristics of the disease
Microsporia in children - photo:
Microsporia is a disease caused by fungus of the Microsporium species. This pathology is highly contagious, and you can get infected not only from a sick animal, but also from a person. Although cases of person-to-person transmission are the least common.
Once on the child’s skin, the pathogen penetrates into it and begins actively reproduce. The incubation period ranges from 2 weeks to 2 months. After its expiration, the child exhibits characteristic symptoms of the disease.
The pathogen can affect the skin on any part of the body, as well as the scalp area. In rare cases, a fungal infection affects the nails.
If the pathogen affects an area of the body where there is hair, the hair shaft and follicle are destroyed, which leads to its loss.
This is why the child develops specific bald patches on the affected areas of the skin (especially when it comes to the scalp).
The disease is most common in children. There are special ones for this causes:
Causes and risk factors
The root cause of the occurrence and development of the disease is infection of a child with a fungal infection, which becomes possible upon contact with:
- infected animals;
- sick person;
- contaminated household items;
- contaminated soil.
Exists a number of risk factors, the presence of which increases the likelihood of developing infection. These include:
- climatic conditions, such as hot weather, high humidity;
- weakness of the child's immune system;
- hyperhidrosis;
- failure to comply with hygiene rules;
- skin damage, violation of its integrity;
Routes of infection
You can get infected through contact and everyday life, that is, through direct contact with a sick person or animal.
Moreover, the second option is much more common.
Infection can also occur when using the patient’s personal belongings or items that contain hair or microparticles of skin from an infected animal.
Incubation period
Depending on the form of the disease, the incubation period may vary in length. Thus, with the bestial form of the disease, from the moment of infection until the appearance of the first symptoms, approximately 7-14 days.
If anthropophilic microsporia occurs, the duration of the incubation period is increased and can be up to 2 months.
Types and forms of the disease
Depending on the method of infection and the location of the skin manifestations, several types of the disease are distinguished.
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Classification criterion |
Form of the disease and its characteristics |
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Transfer method |
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Localization location |
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Symptoms and signs
Depending on the location of the lesions, the symptoms pathology.
However, there is a number of signs, which are considered common to all forms. These include:
- The appearance of red spots is the main symptom of microsporia. The spots can appear on any part of the body.
- After some time, the spots become covered with small white scales.
- Severe itching and peeling on the affected areas of the skin.
- Increased body temperature. This sign is optional; many children suffering from microsporia do not have hyperthermia.
- Enlarged lymph nodes, most often in the neck.
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Symptoms of skin microsporia |
Symptoms of microsporia of the scalp |
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Complications and consequences
With timely treatment, microsporia does not leave behind any complications.
If therapy is delayed or absent altogether, unpleasant consequences such as the appearance of suppuration may occur.
Diagnostics
For making a diagnosis the doctor needs:
The symptoms of microsporia are similar to those of other diseases. Diagnostic methods allow differentiate this pathology with such ailments as alopecia areata, psoriasis, lichen planus.
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Treatment methods and drugs
To eliminate the causes and symptoms of the disease, various medications. The choice of one or another drug is made by the doctor depending on the form of the disease and its severity.
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For oral administration |
Local remedies |
Shampoos |
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It is necessary to take antifungal drugs. Oral medications are prescribed for severe disease and extensive infection. The following drugs are used:
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In case of damage to the skin, when the vellus hair on the body remains intact, it is sufficient to use external agents, such as:
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Before washing your hair, the hair is shaved (this must be done once a week). The composition of the medicinal shampoo should include substances such as selenium sulfide and Ketoconazole. |
Traditional medicine
In addition to the main methods of therapy, you can also use traditional recipes, such as:
Rules of care
To prevent the spread of infection, The following rules must be observed:
- The child must have separate hygiene items (comb, towel, washcloth, etc.).
- The baby's clothes must be washed in hot water with powder.
- The child’s toys and personal belongings need to be boiled.
- It is recommended to disinfect furniture and other items in the children's room with a fungus-killing agent.
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Prevention measures
You can reduce the risk of infection, following simple rules of prevention:
Microsporia is an unpleasant disease, caused by fungal infection. Most often, the carriers of the pathogen are animals, including domestic ones. Infection from a sick person is much less common.
The pathology is accompanied by characteristic symptoms that can be seen even with the naked eye, however, for an accurate diagnosis it is necessary to visit a doctor.
Treatment consists of taking antifungal drugs, using topical products and medicated shampoos. The choice of therapy method is made by the doctor.
You can learn about the symptoms and treatment of microsporia in children from the video:
We kindly ask you not to self-medicate. Make an appointment with a doctor!
