Trihofitia - a fungal disease that affects the skin and hair, and sometimes nails.
The causative agent is the fungus Trichophyton. Infection occurs by contact with a patient and his belongings (hats, combs, scissors, bedding, etc.). Can be transferred to the hairdressers, kindergartens, boarding schools. Fungal vectors are also rodents (mice, rats), and cattle (mainly calves).
Human infection usually occurs in contact with hay dust, contaminated affected fungus wool, less direct contact with the animal. The disease is most often recorded in the autumn, which corresponds to the periods of agricultural work.
manifestations trihofitii
Distinguish superficial, chronic and infiltrative-suppurative trichophytosis.
Surface shape trihofitii
The incubation period is 1 week. Depending on the location of the focal surface trihofitii secrete the scalp and smooth skin. nail infections in surface shape is extremely rare.
Surface trihofitia scalp occurs in childhood. As an exception, it happens in infants and adults. The disease is characterized initially isolated, and within multiple foci size of 1-2 cm, with irregular contours and indistinct borders. Lesions are isolated, without tendency to merge with each other; skin lesions in a slightly swollen and reddened, covered pityriasis scales grayish white color, which layers can impart hearth whitish appearance.
Sometimes redness and swelling increase, joining bubbles, pustules, crusts. Within Lesions hair loses its color, shine, elasticity, partially bent and twisted. There their thinning due to breaking of at 2-3 mm from the skin surface. Sometimes the hair break off at the root, then they have the form of "black spots". "Hemp" hair dull, covered with a grayish-white "bloom". Sometimes only scaling is observed on the affected area. In such situations, a careful examination fails to identify the "hemp" Hair.
Surface trichophytosis smooth skin can be isolated or combined with lesions of the scalp. Its primary localization are the exposed areas of the skin - face, neck, forearms and torso. This form occurs at any age, with equal frequency in men and women.
The disease begins with the appearance of one or more swollen and thus slightly above the level of the surrounding skin spots pink-red color. Unlike ochagov patches on the scalp of the head are properly rounded shape and sharp boundaries. Their surface is covered with scales and small bubbles, quickly dry up in the crust. Over time, the inflammation in the core of the center is weakening, and the lesion takes the form of a ring. Itching is absent or weakly expressed.
The chronic form trihofitii
Chronic trihofitia common in adolescents and adults, especially in women, and is characterized by scarce manifestations. Adult patients are usually long-not detected, which is caused, on the one hand, the low severity manifestations disease and therefore negotiability small patients, on the other - rarity of fungal diseases currently time.
As a rule, the disease is detected in the survey, "the epidemiological chain" to establish the source of infection of children in the family. In chronic trihofitii alone or in various combinations with each other affects the scalp, smooth skin and nails, usually the fingers.
The favorite location - preferably in the occipital region and shows only slight whitish scaling pityriasis. In some places, the scales are located at barely noticeable purplish background. Broken off hair in the form of "black spots" are found with difficulty. However, "black dots" can be the only sign of disease. This form of chronic trihofitii scalp called chernotochechnoy. Often, tender scars persist in areas lost hair.
Photo: site of the Department of dermatology Tomsk Military Medical Institute
For chronic trihofitii smooth skin lesion characterized by lower leg, buttocks, upper arms and elbows, sometimes the face and torso. Occasionally process receives widespread. Outbreaks are presented pinkish spots bluish color without clear boundaries, with flaky surface. The edge bead, bubbles, pustules are absent. If it affects the palms and soles are observed weakly expressed redness, peeling, increased skin pattern. Perhaps the continuous thickening of the stratum corneum, resulting in to the palms and soles are formed deep furrows and even cracks in the skin folds. When trihofitii palms and soles never bubbles are formed.
Chronic trichophytosis often accompanied by lesions of the nail plate. In the initial period of the disease in the area of the nail appears slick whitish-gray color, which gradually increases in size. Subsequently nail plate becomes dull, dirty gray color with a yellowish tinge; its surface - uneven. The nails become thickened, deformed, easy to crumble.
Infiltrative-suppurative form trihofitii
The incubation period of infiltrative-suppurative trihofitii ranges from 1-2 weeks to 1-2 months. It begins with the appearance of one or more pale pink scaly patches with rounded outlines and clear boundaries. Marginal ridges made plaques, small bubbles, shrinking in the crust. Later lesions increase in size, increases inflammation, they are raised above the level of healthy skin. At confluence foci formed fancy shapes and their surface is covered with plaques, vesicles, pustules and crusts. The process involves the vellus hair. With the localization of lesions in the area of long hair growth observed "hemp" broken off hair.
In the future, grow in the centers of inflammation localized in the scalp, beard and mustache growth - intensify redness, swelling, formed sharply delimited hemispherical nodes bluish-red, bumpy surface is covered by numerous expressions of. Hair partially fall out, loosened and easily removed.
A very characteristic feature of the mouth are sharply enhanced hair follicles formed pus released during pressing in the form of droplets, and even heavy streams. Dense knots initially consistency becomes soft over time. These lesions on the scalp look like a honeycomb, and in the beard and mustache - figs. On the smooth skin is dominated by flat plaques, sometimes very extensive, transforming gradually into pustules. Developing abscess leads to the death of fungi. They are stored only in the scales of the edge of lesions, and wherein detected by microscopic examination.
When infiltrative-suppurative trihofitii often an increase in lymph nodes, sometimes marked malaise, headache, fever.
diagnosis trihofitii
The diagnosis is made dermatologist using laboratory and instrumental methods.
Microscopic examination. On the surface of foci and chronic trihofitii to smooth the skin is scraped with a blunt scalpel scales and "hemp" broken off vellus hair. Broken off the hair is removed with tweezers. Microscopically in flakes of skin lesions on smooth found coiled strands of mycelium. Microscopic examination of a large increase in the affected hair has clear boundaries and is filled with large mushroom spores are arranged in parallel longitudinal chains.
Cultures. Growth of colonies observed at 5-6 days after sowing in a white lump.
trihofitii treatment
In the treatment of Trichophyton smooth skin without defeat vellus hair is used topically antifungal drugs. On the morning of the lesions cause 2-5% tincture of iodine, and in the evening smeared with antifungal ointment. Apply 10-20% sulfuric, 10% sulfuric 3% salicylic or 10% sulfuric tar ointment. Widely used modern antifungal ointment - Lamisil, mikospor, ekzoderil, clotrimazole and others. At the phenomena of significant inflammation apply combined preparations containing hormones.
When multiple lesions on the skin, especially with involvement in the process of vellus hair, as well as in the defeat of the scalp requires systemic antifungal therapy. The main drug used in the treatment of Trichophyton is griseofulvin. Griseofulvin taken daily to assay the first negative, then for 2 weeks in a day, and then for 2 weeks every 3 days. The shaved hair during treatment.
Simultaneously with the reception of systemic drug held spot antifungal therapy. With the defeat vellus hair epilation is carried out with preliminary detachment of the stratum corneum. For detachment applies milky salitsilovo- resorcinol collodion.
In chronic trihofitii scalp to remove "black spots" detachment of the stratum corneum is carried out by the method Arievich: on 2 days under compress superimposed lactic salicylic ointment, a cast is removed and then also superimposed compress under 2-5% salicylic ointment. Blunt scalpel to remove the horny layer of the skin, and with tweezers - "black spots". Detachment is carried out 2-3 times.
When infiltrative-suppurative trihofitii carried crusts removal using 2-3% salicylic ointment. Used disinfecting solutions (furatsilin, rivanol, potassium permanganate, ihtiola solution), as well as absorbable ointments, in particular sulfur-Tar.
Prevention trihofitii
Prevention is the early detection, isolation and treatment of patients with this disease. The need for periodic medical examinations in child care centers. Be sure to relatives and are examined in contact with the sick person. Particular attention should be given to pets (cows and calves), as they are often the source of infection.
