Microsporia: Causes, Symptoms, Diagnosis, Treatment

Microsporia, a disease that affects the skin and hair, is more common in children.

Causes and pathogenesis. The causative agents of the microspores are classified by etiologic signs into anthropophiles, zoophiles and geophiles.

Anthropophilic microsporia is often caused by microsporum audouinii and microsporum ferrugineum, the causative agent of the zoonotic microsporia is microsporum canis, s. Lanosum.

Of the zooanthropophilic group, the most frequent pathogen of microsporia is Microsporum canis (source - kittens, dogs, children). Of the anthropophilic group, the most common pathogen is Microsporum ferrugineum (rusty microsporium), less common with Microsporum audouinii. In recent years, cases of human defeat Microsporum gypseum - soil saprophyte belonging to a geophysical group - have become frequent. It affects the skin and hair, especially in persons related to soil cultivation.

Zoonotic microsporia. The source of infection are kittens with microsporia. Less often - adult cats and dogs.

There are two peaks in the incidence of zoonotic microsporia, at the end of summer and in autumn, which coincides with two offspring in cats, in which 2-3% of cases have mushroom transport without clinical manifestations. A person becomes infected by direct contact with sick animals or indirectly by contact with things, objects infected with hair and scales of animal skin.

Symptoms. The incubation period of the disease is 3-7 days. It affects the smooth skin or scalp. With the defeat of smooth skin, multiple scaly pink spots of rounded shape appear with clear boundaries. The clinical picture is very similar to the surface trichophytosis of the same localization. However, with microsporia, foci are usually greater than with trichophytosis and the disease is more acute. Pushkin hair affects almost all patients. Microsporia of smooth skin is characterized by the appearance of pink spots of round or oval shape 0.5-3 cm in diameter. In the peripheral zone of the spots there are bubbles that quickly dry out in crusts. The central part of the spots is covered with scales. Due to the centrifugal growth of the foci (with simultaneous resolution in the center), the individual elements become ring-shaped. Along with the old foci, new ones are emerging. In rare cases, new (the "target" form) appears inside the old annular foci. Microsporia of smooth skin is clinically indistinguishable from skin lesions with superficial trichophytosis.

With lesions of the scalp, several large sharply outlined foci of regular round or oval form (as if stamped) covered with whitish scales appear. Usually, inflammatory conditions are not clearly expressed. With a microsporia caused by a fluffy microsporoma, the most common damage to the hair in the outbreak is observed. Hair in the lesion is broken off high (5-8 mm above the general level of the skin) and a white case is seen at the base of the affected hair - spores of the fungus that surround the affected hair like a coupling.

For fluorescent diagnostics microspores usually use a mercury-quartz lamp - stationary or portable with a uviol filter (glass impregnated with nickel salts). This filter transmits only short ultraviolet rays. Hair damaged by microsporium (long and gun), when irradiated with short ultraviolet rays in a dark room glows bright green light, and hair, affected by a rusty microsporium, glow brighter. Given that iodine and ointments extinguish the glow, the study is repeated 3 days after washing the patient's head. Nail plates with both types of microspores are very rarely affected.

Differential diagnosis. The disease is differentiated from anthroponous microsporia, seborrheic eczema, trichophytosis, favus, pink Zhibera.

Aptroponous microsporia is considered to be a more highly contagious disease than the zoonotic disease. Infection occurs by direct contact with the patient or through his headdress, clothing, comb, hair clipper. Most often, children suffer from it. Infection is promoted by hypovitaminosis, microtrauma, immune disorders.

Symptoms. The incubation period is 4-6 weeks. It occurs mainly in children. Anthroponous microsporia of smooth skin resembles superficial trichophytosis: rounded, clearly delineated, covered with scales, nodules and blisters on the periphery foci, often form inscribed rings. On the scalp, lesions are located mainly in the occipital, temporal and parietal regions. They are small, have clear boundaries, a tendency to settle in the marginal zone of hair growth, merge and form foci of polycyclic outlines with fine-lamellar ecdysis. Hair break off at a height of 6-8 mm above the level of the skin and look as if clipped (hence the name "ringworm").

Differential diagnosis. The disease should be distinguished from zoonotic microsporia, seborrheic eczema, favus, trichophytosis, pink lichen Gilber.

Diagnostics. Clinical diagnosis of microsporia of the scalp is confirmed by positive results of microscopic examination of the hair, culture of the pathogen and a clear green glow of the affected hair during luminescent examination. The diagnosis of microsporia of smooth skin is confirmed on the basis of detection of mycelium and spores in skin scales from lesions and culture.

Treatment. Patients with multiple (more than three) foci on the skin or with a lesion of the scalp are hospitalized. Of systemic antimycotics, griseofulvin, lamizil, itraconazole are widely used.

Griseofulvin is prescribed at 22 mg / kg orally before the first negative test for fungi in a daily study, then within 2 weeks, the drug is given every other day and then 2 times a week, until the clinical manifestations and three negative analyzes for fungi are resolved at intervals in 5-7 days.

Lamisil is used in the following doses: 94 mg with a child's weight of 10-20 kg, 187 mg at a weight of 20-40 kg, which is 1.5 times higher than recommended by the manufacturer, and at a weight of 40 kg and above, and also for adults - 250 mg .

Local treatment is prescribed for single lesions on the skin and without the involvement of hair in the pathological process. For external treatment, use a 3-5% solution of iodine, 10% -un sulfuric ointment 2 times a day. A good therapeutic effect is observed when using 1% cream zalain, travogen, mycospores and other antimycotics. Of antifungal drugs, the most effective is lamizil in the form of a 1% cream or spray.

For the prevention of disease it is necessary to examine all members of the family clinically and under a fluorescent lamp. It is necessary to catch cat homeless for inspection. Quarantine is established in children's institutions for 2 weeks.

[1], [2], [3], [4], [5], [6]