Trichophytosis

Description:

Source of an antroponozny trichophytosis - the sick person. Infection happens at direct contact or through the objects contaminated by pathological material. Children catch at contact with the adults suffering from a chronic trichophytosis more often. Infection with a zoonotic trichophytosis happens from an animal (from large domestic animals - T.verrucosum, from small animals - T.mentagrophytes v.gypseum. But infection and from the person is possible. Infection can occur through wool, straw, hay, special clothes. The main tank of T.mentagrophytes v.gypseum in the nature are mouse-like rodents.

Trichophytosis symptoms:

The trichophytosis is superficial. Causative agents of this mycosis are T.violaceum, T.tonsurans. Trichophytosis superficial smooth skin. On open sites of skin the hyperemia centers with a scaly peeling in the center appear accurate, an oval form. On the periphery of the center there is a valikoobraeny edge consisting of vesicles, papules, crusts. The centers increase in a size due to peripheral growth and merge among themselves, forming various figures. In a ring there can be a new center that leads to formation of Iris - forms.

The trichophytosis superficial a pilar part of the head meets in the form of a melkoochagovy and macrofocal form. The centers eritemato-squamous the wrong outlines with the indistinct borders which are poorly expressed by the inflammatory phenomena. Hair in the center break off at the different level, a thicket the 1-3rd. Hemp of the broken-off hair have an appearance of commas. A part of hair does not break off and the center is as if hidden under hair. In the center of defeats the melkoplastinchaty peeling is noted. Under a cold light lamp with Wood's filter the luminescence of the affected hair is absent. These forms of a trichophytosis are observed more often at children. During puberty there can come spontaneous treatment that is more often observed at boys. If self-healing did not occur, then the superficial trichophytosis gets a form of a chronic chernotochechny trichophytosis which is often observed at women.

The trichophytosis is chronic. This persistent infection is observed at patients with endocrinopathies, dysfunction of gonads, hypovitaminoses With and And that causes decrease in immune forces of an organism and the long course of a disease. Clinical manifestations scanty therefore remain unnoticed a long time and are found at surveys of children. On a pilar part of the head in occipital and temporal areas the scanty melkoochagovy peeling with small atrophic bald patches, and also black points on site of the broken-off hair at the level of skin is noted. Therefore this form of a disease carries the name of a chernotochechny trichophytosis. On the closed sites of an integument pinkish-violet spots with the wrong, not clear boundary, with a scanty mukovidny peeling are noted. Skin of palms and soles where the moderate hyperkeratosis and a peeling is noted is involved in pathological process. The koltsevodny peeling and the phenomena of a dyshydrosis is characteristic. At 30% of patients nails of brushes are surprised. Defeat of a nail plate begins with the advent of spots of whitish-gray coloring, in the subsequent the nail is thickened at the expense of a hyponychial hyperkeratosis and gains dirty-gray color. Nails crumble, can exfoliate from a nail bed.

The trichophytosis is infiltrative and suppurative. The main activators of this form of a trichophytosis - mushrooms of T.verrucosum, T.mentagrophytes v.gypseum  affect smooth skin, a pilar part of the head, area of moustaches and a beard. During a zoonotic trichophytosis allocate 3 phases: superficial when the erythematic spot with valikoobrazny edge appears This phase it is similar to a superficial trichophytosis of smooth skin. If specific treatment is not begun, then quickly there comes the 2nd phase - infiltrative. In the basis of the center there is an expressed cellular infiltration. The center begins to rise over the surface of skin, getting a semi-spherical or hilly shape, already in this phase the general changes conditions of the patient. There are pains in the center, regional lymph nodes increase. They become painful. Temperature to subfebrile figures rises. Febricula. If in this stage of a disease of treatment it is not begun, then there comes quickly following - a suppurative phase. The semi-spherical center becomes covered by friable purulent crusts. In the center fluctuation is noted. Surgeons quite often during this period do a wide section of the center, but do not receive pus as all center consists of mikroabotsess of hair follicles. Surgical treatment is contraindicated. When pressing on the center from the gaping openings of hair follicles together with the affected hair liquid, yellow pus like release of honey from bee cells departs. This symptom is called Kerion Celci. The disease comes to an end after a pus otkhozhdeniye together with the affected hair. There occurs self-healing with leaving on site of the former center of the involved hems. Quite often this form is followed by the disseminated secondary allergic rashes in the form of erythematic, eritemato-squamous, papulo-vesicular elements. If in initial phases treatment is carried out, then the disease breaks and hair follicles remain.

Trichophytosis reasons:

Activators - antroponozny mushrooms (Trichophyton violaceum, T.tonsurans) and zoonotic mushrooms (T.verrucosum, T.mentagrophytes v. gypseum). These mushrooms strike a pilar part of the head, smooth skin and nails. At microscopy of the affected hair antroponozny Trichophyton the large disputes located chains in a hair are found, filling it completely. Such damage of a hair is called T.endothrix. Zoonotic Trichophyton affect a hair as T.ectothrix when large disputes are located around a hair with accumulations and a small amount a dispute in the form of chains are traced in it. These mushrooms cause the infiltrative and suppurative process which is characterized by formation of perifollikulyarny inflammatory infiltrate that leads to purulent fusion of hair follicles.

Treatment of the Trichophytosis:

Griseofulvin at the rate of 22 mg/kg of body weight, but no more than 8 tablets a day. At an infiltrative purulent trichophytosis at early stages of a disease griseofulvin (within 2-3 weeks) at the rate of 20-22 mg/kg of weight a day is shown. If there comes the suppuration phase, then griseofulvin on is appointed as hair lose the touch with a follicle and the antibiotic does not get to destination. A main issue of treatment epilation of hair in the defeat center which are easily torn away from expanded mouths of hair follicles. In a suppurative phase it is necessary to remove quickly purulent crusts and necrotic fabrics from a center surface. The method of local enzymotherapy is for this purpose shown. For 2-Z days the ointment containing 30% of pepsin is imposed under a compress. After clarification of kerion for 3-4 days 30% urea ointment for the purpose of dehydration are imposed. For 6-8 days the inflammatory phenomena disappear. In the subsequent the center is processed by the antifungalny ointments containing glucocorticosteroids (Mycosolonum, травокорт, пимафукорт, тридерм, etc.). If treatment is begun in time, then in the former centers growth of hair remains, otherwise there is a cicatricial atrophy.