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Microsporia is a highly contagious dermatophytosis caused by fungi of the genus Microsporum.

Etiology and epidemiology of microsporia

The most commonly isolated causative agents of microsporia are fungi Microsporum canis, which are zoophilic fungi that are ubiquitous in the world, causing dermatophytes in cats (especially kittens), dogs, rabbits, guinea pigs, hamsters, in more 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 infected with their hair. Infection of a person from a person is extremely rare, on average in 2% of cases.

Microsporum audouinii is a common anthropophilic pathogen that can cause predominantly damage to the scalp in humans, less often smooth skin. 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. The peaks of detection of microsporia are observed in May-June and in September-November. Various endogenous factors can contribute to the onset of the disease: the chemistry of sweat, the state of the endocrine and immune systems. In addition, children have insufficient density and compactness of epidermal and hair cell keratin, which also contributes to the introduction and development of fungi of the genus Microsporum.

Microsporia is a disease with the highest contagiousness of the entire group of dermatophytosis. Mostly children are ill, often newborns. Adults get sick less often, while the disease is often recorded in young women. The rarity of microsporia in adults is associated with the presence of fungistatic organic acids (in particular, undicylenic acid) in the skin and its appendages.

In recent years, there has been an increase in the number of patients with chronic mycosis against the background of severe systemic lesions - lupus erythematosus, chronic glomerulonephritis, immunodeficiency states, and intoxications.

Microsporia classification

• 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, they distinguish:

• 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 both on open and closed parts of the body. The incubation period of the disease is 5-7 days.
On smooth skin, lesions have the appearance of edematous, raised erythematous spots with clear boundaries, rounded or oval outlines, covered with grayish scales. Gradually, the spots increase in diameter, and along their periphery a raised roller is formed, covered with vesicles and serous crusts. In 80-85% of patients, vellus hair is involved in the infectious process. Eyebrows, eyelids and eyelashes may be affected. With microsporia of smooth skin, there are no subjective sensations, sometimes patients may be disturbed by moderate itching.

With microsporia of the scalp, lesions are located more often in the occipital, parietal and temporal regions. In the initial period of the disease, a focus of peeling occurs at the site of the introduction of the pathogenic fungus. In the future, the formation of one or two large foci of round or oval outlines with clear boundaries ranging in size from 3 to 5 cm in diameter and several small foci - screenings, ranging in size from 0.3-1.5 cm is characteristic. The hair in the foci is broken off and protrudes above the level skin by 4-5 mm.

Along with the typical clinical symptoms of zooanthroponotic microsporia, atypical variants of it have often been observed in recent years. These include infiltrative, suppurative (deep), exudative, rosacea-like, psoriasiform and seboroid (flowing like asbestos lichen), trichophytoid, exudative forms, as well as a "transformed" variant of microsporia (with a modification of the clinical picture as a result of the use of topical corticosteroids) .

With the infiltrative form of microsporia, the lesion on the scalp rises somewhat above the surrounding skin, is hyperemic, the hair is often broken off at the level of 3-4 mm. Weakly expressed sheath of fungus spores at the root of broken hair.

With an infiltrative-suppurative form of microsporia, the lesion usually rises significantly above the skin surface 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. Scabs and melted hair are easily removed, exposing the gaping mouths of the hair follicles, from which, like a honeycomb, a light yellow pus is released. The infiltrative-suppurative form is more common than other atypical forms, sometimes proceeding in the form of Celsus kerion - inflammation of the hair follicles, suppuration and the formation of deep painful nodes.

Due to the absorption of decay products of fungi 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 concomitant diseases, as well as late seeking medical help.

The exudative form of microsporia is characterized by severe hyperemia and swelling, with small vesicles located against this background. Due to the constant impregnation of the scales with serous exudate and gluing them together, dense crusts are formed, the removal of which exposes the moist eroded surface of the focus.

microsporia exudative form

With the trichophytoid form of microsporia, the lesion process can cover the entire surface of the scalp. The centers are numerous small, with a weak pityriasis peeling. The borders of the foci are indistinct, 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 sparse or there are areas of focal alopecia.

trichophytoid form

With the seborrheic form of microsporia of the scalp, hair is mainly thinned. The foci of rarefaction are abundantly covered with yellowish scales, upon removal of which a small amount of broken hair can be found. Inflammatory phenomena in the foci are minimal, the boundaries of the lesion are fuzzy.

seborrheic form

Diagnosis of microsporia

The diagnosis of microsporia is based on the data of the clinical picture and the results of laboratory and instrumental studies:

• microscopic examination for fungi (at least 5 times);
• inspection under a fluorescent filter (Wood's lamp) (at least 5 times);
• cultural studies to identify the type of pathogen in order to properly conduct anti-epidemic measures;

When prescribing systemic antimycotic drugs, it is necessary to:

• general clinical blood test (1 time in 10 days);
• general clinical analysis of urine (1 time in 10 days);
• biochemical study of blood serum (before treatment and after 3-4 weeks) (ALT, AST, total bilirubin).

Differential diagnosis of microsporia

Microsporia is differentiated with trichophytosis, pink lichen Zhiber, seborrhea, 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 thinning of the hair. The presence in the lesions of short, gray hairs broken off 1-3 mm above the level of the skin is characteristic. Sometimes the hair breaks off above the level of the skin and looks like so-called "black dots". In differential diagnosis with microsporia, attention is paid to highly broken hair, having muff-like caps covering fragments of hair, asbestos-like peeling. Of decisive importance in the diagnosis is the fluorescence of the emerald color in the rays of the Wood's lamp of the affected hair, the detection of elements of the pathogenic fungus and the isolation of the pathogen in the cultural study.

Zhibera pink lichen is characterized by more pronounced inflammation, a pink tint of foci, the absence of sharp boundaries, peeling in the form of “crumpled tissue paper”, the absence of a characteristic emerald glow and the detection of elements of a pathogenic fungus during microscopic examination.

For psoriasis, the clarity of the boundaries, the dryness of the lesions, the silvery nature of the scales, and the absence of muff-like layers of scales on the affected hair are more characteristic.

Treatment of microsporia

Treatment Goals

• clinical cure;
• negative microscopic examination results for fungi.

General notes on therapy

With microsporia of smooth skin (less than 3 lesions) without damage to vellus hair, external antimycotic agents are used.

Indications for the appointment 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 lesions is shaved once every 5-7 days or epilated.

Indications for hospitalization

• lack of effect from outpatient treatment;
• infiltrative suppurative form of microsporia;
• multiple foci with lesions of vellus hair;
• severe comorbidity;
• 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 people living in boarding schools, orphanages, hostels, children from large and asocial families).

Microsporia treatment regimens:

• Griseofulvin orally with a teaspoon of vegetable oil 12.5 mg per kg of body weight per day

Additionally, therapy with locally acting drugs is carried out:

• ciclopirox, cream
• ketoconazole cream, ointment
• isoconazole cream
• bifonazole cream
• 3% salicylic acid and 10% sulfur ointment
• sulfur (5%) - tar (10%) ointment

In the treatment of the infiltrative-suppurative form, antiseptics and anti-inflammatory drugs are initially used (in the form of lotions and ointments):

• Ichthyol, ointment 10%
• potassium permanganate, solution 1:6000
• ethacridine, solution 1: 1000
• furatsilin, solution 1:5000

Then the 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 antimycotic drugs during pregnancy and lactation is contraindicated.

Treatment of all forms of microsporia during pregnancy is carried out only with locally acting drugs.

Treatment of children with microsporia:

Griseofulvin orally with a teaspoon of vegetable oil 21-22 mg per kg of body weight per day

Treatment is considered complete with three negative results of the study, conducted at intervals of 5-7 days.

Additionally, therapy with locally acting drugs is carried out:

• ciclopirox, cream
• ketoconazole cream, ointment
• isoconazole cream
• bifonazole cream
• 3% salicylic acid and 10% sulfuric ointment, alcohol tincture of iodine
• sulfur (5%) - tar (10%) ointment

Alternative treatment regimens

• terbinafine: children weighing >40 kg - 250 mg once a day orally after meals, children weighing 20 to 40 kg - 125 mg once a day orally after meals, children with body weight<20 кг — 62,5 мг 1 раз в сутки
• itraconazole: children over the age of 12 years - 5 mg per 1 kg of body weight

Requirements for treatment outcomes

• resolution of clinical manifestations;
• lack of hair glow under a fluorescent filter (Wood's lamp);
• three negative control results of 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).

In view of the possibility of relapses, after the end of treatment, the patient should be under dispensary observation: with microsporia of the scalp and microsporia of smooth skin with damage to vellus hair - 3 months, with microsporia of smooth skin without damage to vellus hair - 1 month.

Control microscopic studies during dispensary observation should be carried out: with microsporia of the scalp and microsporia of smooth skin with involvement of vellus hair in the process - 1 time per month, with microsporia of smooth skin - 1 time in 10 days.

The conclusion about recovery and admission to an organized team is given by a dermatovenereologist.

Prevention of microsporia

Preventive measures for microsporia include sanitary and hygienic, 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 in the detection of microsporia:

• For a patient with microsporia, identified for the first time, a notice is submitted within 3 days to the department of registration and registration of infectious diseases of the FBUZ "Center for Hygiene and Epidemiology" and its branches, to territorial skin and venereal 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 in the register of infectious diseases.
• The journal is maintained 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 organizations of state sanitary and epidemiological supervision.
• The patient is isolated.

• If a disease is detected in children's institutions, a patient with microsporia is immediately isolated and current disinfection is carried out before being transferred to a hospital or home.
• Until the recovery of a patient with microsporia, a child is not allowed to enter a preschool educational institution, school; an adult patient is not allowed to work in children's and communal institutions. The patient is forbidden to visit the bath, pool.
• In order to maximize isolation, the patient is allocated a separate room or part of it, items for individual use (linen, towel, washcloth, comb, etc.).
• In the first 3 days after the identification of the patient in preschool educational institutions, schools, higher and secondary specialized educational institutions and other organized groups, the medical personnel of these institutions conduct an examination of contact persons. Examination of contact persons in the family is carried out by a dermatovenereologist.

• Inspection is carried out before the final disinfection.
• Further medical supervision with a mandatory examination of the skin and scalp using a fluorescent lamp is carried out 1-2 times a week for 21 days with a mark in the documentation (observation sheet is being maintained).
• The current disinfection in the foci is organized by the medical organization that established the disease. Current disinfection before hospitalization, recovery is carried out either by the patient himself or by the person caring for him.
• Responsibility for the implementation of current disinfection in organized groups and medical organizations rests with its medical staff. Current disinfection is considered timely organized if the population begins to carry it out no later than 3 hours from the moment the patient is identified.
• The final disinfection is carried out in the foci of microsporia after the patient leaves the foci for hospitalization or after the recovery of the patient who was treated at home, regardless of the duration of hospitalization or recovery.

• In some cases, the 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 institution or school falls ill, the final disinfection is carried out in the preschool institution (or school) and at home. In a secondary school, the final disinfection is carried out according to epidemiological indications. The final disinfection in the outbreaks is carried out by the disinfection station. Bedding, outerwear, shoes, hats, carpets, soft toys, books, etc. are subject to chamber disinfection.
• An application for final disinfection in home outbreaks and isolated cases in organized groups is submitted by a medical worker of a medical organization of a dermatovenereological profile.
• When registering 3 or more cases of microsporia in organized groups, as well as for epidemiological indications, a medical worker of a medical organization of a dermatovenereological profile and an epidemiologist of institutions of state sanitary and epidemiological supervision are organized. At the direction of the epidemiologist, final disinfection is prescribed, the volume of disinfection is determined.

• The medical worker who established the disease is working to identify the source of infection (the presence of contact with sick animals). Animals (cats, dogs) are sent to a veterinary clinic for examination and treatment, followed by the presentation of a certificate at the place of treatment and observation of the patient with microsporia. In case of suspicion of a homeless animal, information is transferred to the relevant animal trapping services.

IF YOU HAVE ANY QUESTIONS REGARDING THIS DISEASE, PLEASE CONTACT DERMATOVENEROLOGIST ADAEV KH.M:

Email: [email protected]

INSTAGRAM @DERMATOLOG_95

This disease is characterized by damage to the skin and hair, in more rare cases, the fungus also affects the nail plates. This disease was named after the name of the causative agent of the disease - a fungus of the genus Microsporum. This disease is also known as ringworm ” due to a number of characteristic features of its manifestation.

After contact with human skin, the fungus is introduced into the skin, after which its active reproduction begins. If there are hair follicles near the place where the fungus has entered, then the spores of the fungus germinate, and as a result, the hair is affected. The fungus spreads very quickly through the hair, as a result of which the cuticle is destroyed, and spores accumulate between its scales. As a result, the fungus completely surrounds the hair and fills the bulb.

After foot fungus, microsporia is considered the most widespread fungal-type infection. This disease can be found often, because microsporia is very contagious. That is why microsporia in children is a common occurrence. In adulthood, microsporia is more often manifested in young women. However, due to the presence of organic acids in the hair of an adult, which significantly slow down the growth of the fungus, microsporia is less common in them.

The main source of the spread of the disease are cats, more rarely - dogs. A person becomes infected with the disease during close contact with a sick animal or with those objects that it has infected with scales or wool. After entering the soil with wool or scales, the fungus can remain viable for 1-3 months.

Symptoms of microsporia

In a sick animal, microsporia is manifested by characteristic areas of baldness on the muzzle, outside the auricles, sometimes on the paws. However, even cats that look healthy on the outside can be carriers of the infection.

The disease is characterized by a certain seasonality, which is associated with frequent contacts between children and animals in the summer. Therefore, the peak incidence of microsporia in children occurs in the autumn months, and a decrease in the incidence is observed in the spring.

The incubation period for microsporia lasts 5-7 days. The course of the disease and its manifestations depend on where exactly the lesions are located and how deeply the pathogen has penetrated. It is customary to allocate smooth skin microsporia and microsporia of the scalp .

At microsporia of smooth skin at the place where the fungus has penetrated, a towering red edematous spot appears. It has clear boundaries, and over time, its diameter increases. The edge of the spot forms a roller that rises above the skin. It consists of small nodules, vesicles, crusts. Gradually, the center of the spot becomes pale pink due to the resolution of inflammation. Peeling is observed on the surface. The focus of the disease looks like a ring. With microsporia of smooth skin, there are mainly from one to three such foci. Most often they appear on the skin of the face, neck, shoulders, forearms. Sometimes the patient feels moderate itching of these places. Microsporia in children, as well as in young women, is sometimes manifested by severe inflammation and very slight peeling.

People who are prone to , the fungus is difficult to diagnose due to its masking by the symptoms of the main process. At the same time, the use of local hormonal drugs can only increase the manifestations of a fungal infection.

A variety of microsporia, in which the skin of the palms, nail plates, soles is affected, is an extremely rare phenomenon. When the nails are affected, as a rule, only the outer edge of the nail is affected. First, a dull spot appears, which later acquires a white tint. Later, the nail in this place becomes very soft and can collapse.

Microsporia of the scalp mostly children suffer. Microsporia appears in children aged 5–12 years. Sometimes this disease goes away on its own during puberty of adolescents, which is characterized by a change in the composition of sebum. Microsporia of the scalp almost does not affect children who have red hair.

With this form of microsporia, its foci appear on the crown, crown and temples. As a rule, there are two lesions on the head, the diameter of which is from 2 to 5 cm. They have clear boundaries and a round or oval outline. Sometimes screenings appear on the edge of a large lesion - small foci, the diameter of which is 0.5–1.5 cm. At the very beginning of the disease, a scaly area appears at the site of infection. At first, the fungus is located exclusively at the mouth of the hair follicle. Up close, you can even see a white scale that surrounds the hair in the form of a ring. After about a week, microsporia affects the hair, after which they become very fragile and brittle. The hair breaks off and at the site of the lesion, they look as if they were cut. It is this phenomenon that gave the name "ringworm". At the site of the microsporia lesion, the skin looks edematous, red, and small scales of a grayish-white color are observed on its surface.

If a person develops suppurative form of microsporia , then there is severe inflammation, due to which soft red-blue nodes appear with pustules on the surface. If you press on them, then pus comes out. The suppurative form of microsporia occurs with improper treatment, the presence of other serious diseases, and also with too late access to a specialist.

Diagnosis of microsporia

Diagnosis of this disease is carried out by a dermatologist. To confirm the appropriate diagnosis, special studies are used - luminescent , cultural and microscopic .

A fluorescent study reveals the glow of hair affected by the fungus in a bright green color under a Wood's lamp. It is carried out in a dark room. In this way, you can determine the pathogen, find the affected hair, evaluate the effectiveness of treatment, monitor those who have had contact with patients, and also determine whether the animal is the carrier of the infection.

In a microscopic examination under a microscope, scales taken from foci with lesions of smooth skin are examined. If there is a lesion of the scalp, then parts of the hair are studied. With such a study, mycelium filaments and small spores of the fungus are found.

In a cultural study, it is possible to identify the pathogen fungus. This study is used in case of positive results of luminescent and microscopic examinations. Determining the genus and type of pathogen allows you to prescribe the most effective treatment for the disease. In the process of this type of study, scales or hair are placed on a nutrient medium. After sowing, the growth of Microsporum colonies begins on the third day.

Treatment of microsporia

For effective treatment of microsporia of smooth skin, antifungal drugs are prescribed externally. The treatment regimen may be as follows: in the morning, 2–5% tincture is applied to the foci of the disease, and in the evening, an antifungal ointment. Today, there are many drugs for the treatment of microsporia. It's traditional sulfuric , ; modern drugs , . The drug is produced in the form of tablets, the course of treatment, as a rule, lasts up to two months. Throughout the entire period, you should shave your hair every week and wash your hair twice a week. In parallel with taking the tablets, you need to rub an antifungal ointment into the lesion. Often used as an alternative drug terbinafine (). It is also available in tablet form.

The doctors

Medications

Prevention of microsporia

As a preventive measure of microsporia, timely detection and effective treatment of patients is very important. To do this, children's institutions need to regularly conduct medical examinations. If a sick child is found, it should be isolated from other children and measures should be taken to urgently treat microsporia. It is also important to disinfect things of sick people in time and with high quality. A thorough examination of all those who have been in contact with a person who has become ill with microsporia is carried out. It is also important to periodically examine pets to identify foci of the disease in them and take measures to treat them.

This infectious disease of a fungal nature is often found among patients of dermatologists. The causative agents of microsporia in humans, as a rule, affect the hair and skin, less often the nail plates, while the foci of infection become inflamed and itchy. The prevalence of ringworm is explained by the fact that the infection is resistant to various factors and is able to live for a long time in the environment.

What is microsporia

This is a skin pathology of a group of mycoses caused by a fungus of the genus Microsporum. Lesions can occur on both smooth and hairy skin. Penetrating into the layers of the epidermis, a fungal infection forms colonies in the hair follicles, but occasionally the disease can also affect areas of the skin that are devoid of vegetation - palms, feet, nails. Ringworm is highly contagious, with sick animals being the main carriers of the pathology.

Cats, dogs, rabbits, horses, goats can get sick. pigs, sheep and various wild animals (foxes, monkeys, tigers, etc.). At the same time, contact with a sick animal is not necessary for infection: it is enough for wool or scales to get on the human body through care items or other equipment. The transmission of the disease from a sick person to a healthy one is not excluded, and infection can occur when interacting with untreated clothes of a sick person some time ago.

What does a person look like - photo

First, a reddish, round-shaped spot appears on the human body, which has clear boundaries and somewhat rises above the skin. Soon after, a roller forms along the periphery, which is covered with crusts and tiny bubbles. The fungus grows up to 3 cm in diameter, the center of the edematous spots turns pale and becomes covered with pityriasis scales. As a rule, microsporia in humans is manifested by the formation of 1 to 3 foci with localization on the face, neck or upper limbs.

Causes of the disease

The disease is caused by anthropophilic microorganisms - fungi Microsporum canis. There are several types of infectious agents, but only two are dangerous for humans - rusty and canine microsporum. The causes of the disease are due to the ways of its transmission:

1. Interaction with infected animals. Both pathogens can enter the body through contact with sick animals, especially cats, dogs, pigs or sheep. In these cases, a zoophilic form of the disease is manifested, which is transmitted from person to person, but with a lesser probability, therefore, there are practically no collective outbreaks of ringworm caused by canine microsporum.
2. Contact with a sick person. As a rule, rusty microsporum is transmitted between people. This pathogen belongs to the group of anthropophilic microsporia bacteria, that is, fungi that live on the human body. This form can cause collective outbreaks of the disease.
3. interaction with things. You can become infected with anthropophilic or zoonotic microsporia by contact with objects that contain fungal spores. However, contact with the skin of the pathogen does not always cause the development of the disease, especially in adults. The probability of damage to the body by a fungus depends on immunity, the presence of predisposing factors such as increased skin sweating, various skin diseases, and non-compliance with hygiene rules.

Developmental mechanisms and risk factors in children

The rapid spread of infection in children's groups is associated with their high susceptibility to fungi due to an underdeveloped immune system, as well as a lack of personal hygiene skills. Risk factors for the onset of the disease in a child are:

• weakened immunity due to frequent colds;
• contact with homeless animals;
• non-compliance with the rules of hygiene - eating without prior washing of hands;
• poorly developed skin immunity (in adults, sebum contains special organic acids that inhibit the reproduction of fungi);
• frequent skin injuries (abrasions, cuts, wounds, scratches) that contribute to the spread of the infectious agent throughout the body.

Characteristic symptoms

This disease is of different types, each of which has a different incubation period. So, zoophilic and geophilic forms of the disease do not show symptoms for 5-14 days. When infected with an anthropophilic type of lichen, the incubation period lasts much longer - 4-6 weeks. Pathology has a pronounced inflammatory reaction. If anthropophilic fungi are the causative agent, the first symptoms will become noticeable after 35-45 days, while the lesions will be of a moderate nature.

On smooth skin

Ringworm often affects the skin of the shoulders, neck, face, and forearms. At the same time, 1-3 foci with a diameter of 2-3 cm appear in a person. An edematous spot of a red tone with clear edges appears in the area of ​​infection. Over time, the place of localization of the lichen grows and a cover (roller) is formed along its edges, the surface of which is covered with small nodules, crusts and vesicles. The center of the focus acquires a pink color, becoming covered with bran-like scales and becoming like a ring (only the outline remains rich red).

On the scalp

As a rule, foci of the fungus appear in the temporal regions, on the crown or crown. The colony looks like this: a central spot up to 5 cm in diameter and smaller (up to 1.5 cm) around its circumference. During its growth, the diseased focus can absorb closely spaced small spots. Microsporia of the scalp in the initial stage forms a zonal peeling.

On closer examination of the lesion, you can see a whitish "cuff" around the hairs growing inside the focus. This indicates the multiplication of infection in the hair cuticles, which in a week leads to their breaking off. Damaged short hairs with a grayish coating serve as a haven for fungal spores. The altered location of such hair "stumps" is preserved when stroking, unlike healthy hair.

The scalp in the affected areas is hyperemic, edematous and covered with small grayish or white scales. During the week, the disease progresses and the hairs break off at a distance of 4-6 mm from the skin. In the areas where the focus of the disease is located, the hair looks cut, so the pathology is called ringworm.

On nails

This type of fungus is extremely rare. This form of the disease has different symptoms from others, due to the specific location of the lesion:

• a gray spot forms on the edge of the nail;
• gradually it changes color, becoming whitish;
• the nail affected by mycelium becomes brittle and quickly collapses.

Features of the course of the disease

Infection occurs instantly. Once on the skin, the fungus is introduced into it and begins the process of active reproduction. When the infection is localized near the hair follicles, the spores begin to germinate, gradually destroying it (this explains the rapid hair loss of the sick). If symptoms are detected, it is important to immediately begin therapy for the infection.

Microsporia in humans manifests itself in the same way in all cases. The first sign of the disease is the formation of inflammatory foci on the skin. They look like this:

• convex, as if slightly swollen;
• pink or red;
• with clear rounded borders.

Subjective sensations in such a disease are almost always absent, but in some people the disease is accompanied by moderate itching. In patients with certain skin characteristics, for example, those with atopic dermatitis, the signs of lichen may be blurred - the fungus, as a secondary infection, masquerades as an exacerbation of dermatitis for a long time, so it is difficult to diagnose.

suppurative form

This is a serious disease caused by zoophilic fungi that usually affect animals - dogs or cats. With untimely, improper treatment, the lesion extends to the deep layers of the epidermis and is accompanied by an active inflammatory reaction with the formation of purulent infiltrates. In severe pathology, a large purulent focus is formed in a person, the temperature rises, and a general malaise develops. Symptoms of the suppurative form of the disease:

• severe inflammation in the focus of infection;
• the formation of soft nodes of a bluish-reddish hue;
• covering their surface with abscesses, under pressure on which their contents flow through the holes.

Aggravated course of the disease

Kerion is a form of the disease in which the fungus affects the deep layers of the epidermis, inflammation develops with the formation of a purulent focus. As a result, a large, elevated spot of an edematous type with a shiny surface appears above the skin. The pores are enlarged, when pressed, a pale yellow pus oozes through them. The disease accompanies the syndrome of intoxication, high fever, headaches. If a pathology occurs in a child, he may complain of pain in the area of ​​​​the infection. Lymph nodes become inflamed, painful on palpation.

Diagnostics

Pathology is accompanied by specific symptoms, therefore, already during the examination, the doctor makes a presumptive diagnosis. However, further studies are required to clarify it, including:

1. luminescent method. In a darkened room, the affected areas of the body are illuminated with a special Wood's lamp. In the foci, a glow of a bright green color is visible, which indicates the activity of fungi.
2. Microscopic studies. If microsporia of smooth areas of the skin is suspected, the doctor takes flakes of dead skin for analysis, in case of a disease of the scalp, the hairs are studied. Through microscopy of scrapings, mycelium and fungal spores can be detected.
3. Cultural diagnostics. Such a study helps to accurately determine the type of pathogen and determine its sensitivity to certain groups of drugs.

How to treat

The therapy is carried out under the supervision of a dermatologist. As a rule, pathology does not require hospitalization, therefore, outpatient treatment is carried out. To control the course of the disease, you need regular visits to your doctor. hospitalization may be necessary only in the presence of concomitant ailments. The therapeutic course can last a long time, which is associated with increased resistance of the fungus to antibiotics and other types of drugs. In this regard, the treatment regimen for a bacterial infection is complex.

Thanks to the use of various therapeutic methods, it is possible to quickly destroy the causative agent of the disease and prevent possible relapses. A cosmetic defect after a disease can remain for a long time, sometimes requiring additional help from a cosmetologist. The main methods of treatment are:

• the use of systemic drugs;
• use of local funds;
• folk methods of treatment.

Features of the treatment of the scalp are the need to gradually shave off the vegetation on the affected area once every 7-10 days. Thanks to this, better access to the focus of infection will be achieved. In addition, the patient must comply with hygiene and other rules:

• regardless of the location of the spots, wash the scalp around it several times a day;
• avoid hypothermia or direct exposure to sunlight on the lesions;
• limit physical activity, since sweat on the treatment area is undesirable;
• take vitamins, balance the diet to strengthen the immune system;
• use only personal hygiene products - a towel, a washcloth, a comb.

Treatment of microsporia in a deep form involves the immediate complex therapy of the disease. A patient with such a diagnosis is shown drugs that include dimexide, for example. In these cases, a 10% solution of chinosol is used. With the defeat of long or vellus hair, systemic antifungal therapy of skin disease is necessary.

How to treat

The selection of suitable medications is carried out exclusively by a dermatologist after the diagnosis of the pathology. If the fungus affects exceptionally smooth skin, the use of topical agents will be sufficient therapy. Assigned lotions, solutions, ointments and sprays are applied to the skin until it is completely cleansed of stains. Treatment of microsporia in humans with localization on the scalp implies a different tactic. In this case, antifungal drugs are taken orally and the simultaneous use of local agents.

Antimycotic Griseofulvin in systemic treatment

With therapy on the scalp, this remedy is the drug of choice. The antibiotic is produced by a fungus. It is taken 3-4 times a day with meals, washed down with a teaspoon of vegetable oil, which is necessary to improve the solubility of the drug and increase its duration of action. For children under 3 years old, it is better to give Griseofulvin in the form of a suspension. Continuous administration of the drug is carried out until the first negative result of the analysis for microsopriation, after which the medicine is taken every other day for 2 weeks and another 14 days twice a week.

Systemic treatment involves the oral administration of an antifungal agent, which is absorbed through the mucosa of the gastrointestinal tract and is carried along with the bloodstream throughout the body. So the drug enters the deep layers of the epidermis and kills pathogenic microorganisms. The internal action of Griseofulvin helps to eliminate the external manifestations of the disease, but does not exclude relapses. The advantage of the drug is its high efficiency.

The general course of therapy with Griseofulvin is 1.5-2 months. At this time, you should shave off 0.5-1 cm of hair on the affected areas of the head weekly and wash your hair often, trying to avoid getting water on the infection foci. The disadvantage of the drug is the side effects that sometimes occur in patients - these are headaches, allergic reactions, discomfort in the pancreas. In addition, Griseofulvin has a toxic effect on the liver, therefore it is contraindicated in children with hepatitis or other organ pathologies.

Terbinafine and Tolnaftat

These medicines have a fungistatic and fungicidal effect on the fungus. Due to the direct effect on the causative agent of the disease, they serve as the basis for the treatment of microsporia in humans. Consider each drug in more detail:

1. Terbinafine. A broad-spectrum antifungal agent is intended for the treatment of various types of fungi and lichen. Terbinafine can be used for both local and systemic therapy. The fungistatic effect of the drug is due to a deficiency of ergosterol, which leads to a defect in the cytoplasmic membrane and the loss of the ability of the fungal cell to grow. The fungicidal action is carried out due to the accumulation in the cell of ergosterol precursors - squalenes, which extract lipids from the cell wall. Due to the increase in the volume of lipid granules, simultaneously with the development of membrane inferiority, the fungal cell ruptures. Internal reception of the remedy is carried out if the disease cannot be cured with the help of local remedies. The required dose of the drug is calculated taking into account the patient's body weight. The advantages of Terbinafine are that it is relatively safe in systemic treatment and is versatile, as it is effective against many types of pathogenic fungi. The disadvantage of the drug can be considered the likelihood of developing side effects - allergies, gastrointestinal disorders, dysfunction of the biliary tract, liver, etc.
2. Tolnaftat. This is the active ingredient of the local antifungal agent Khinofungin, which is available in the form of an ointment, powder, cream, solution and spray. Tolnaftat is prescribed for various dermatomycosis, lichen. Apply the remedy twice a day, covering the foci of depriving with a thin layer and rubbing into the skin. As a rule, treatment takes 2-3 weeks, after the disappearance of symptoms, the use of the drug is continued for another couple of weeks. The advantages of tolnaftate are efficiency, an extremely rare manifestation of side effects. The downside of the remedy is a ban on use during pregnancy, lactation.

Topical antifungals

There are a lot of means for the local treatment of microsporia, while they are available in the form of gels, ointments, creams, solutions for lotions. Such medicines have a similar effect - they cleanse the skin, preventing the development of microorganisms, create optimal conditions for skin restoration, and have an antifungal effect. Regular use of these drugs contributes to the accumulation of active substances in the skin, as a result of which the drug penetrates into the deeper layers of the epidermis. For the treatment of lichen is used:

• Tolmitsen - a derivative of thiocarbamates, destroys trichophytes, microsporums and other pathogens of skin diseases;
• Travogen - an isoconazole-based remedy is often used to treat lichen, various mycoses and other fungal-bacterial pathologies;
• cream Triderm - a local hormonal drug, which includes dipropionate, gentamicin and clotrimazole in the composition of betamethasone, is used for mycoses and microsporia, relieves swelling and hyperemia of the skin;
• Lamisil - a drug based on terbinafine effectively destroys many types of fungi, including the causative agent of lichen, disrupting their biochemical processes at the cellular level.

Sulfur based ointments

Local remedies containing sulfur have anti-inflammatory and antiseptic effects. Such drugs are available in tubes and glass vials that do not let in sunlight. For the treatment of lichen are used:

1. Ointment Yam. Combined remedy with acarcidal and antifungal properties. The composition of the drug, in addition to sulfur, includes salicylic acid, lysol, tar, zinc oxide, lanolin, turpentine, etc. Ointment Yam destroys pathogens of trichophytosis, scabies, microsporia.
2. Sulfuric ointment. It has an antiseptic, anti-inflammatory effect, due to which it destroys fungi and promotes the speedy regeneration of the skin.
3. Sulfur-salicylic ointment. A topical antimicrobial medication used to treat various dermatological conditions, including ringworm. The ointment has fungicidal, bacteriostatic and keratolytic properties.

Vidal milk and Lassar paste

Both local drugs are used as part of the complex treatment of lichen in adults and children. The funds are applied to the skin several times during the day, rubbing into the affected areas of the dermis with massage movements. Despite the similar action, each drug has its own characteristics:

1. Pasta Lassara. This is a salicylic-zinc paste with an antiseptic, antimicrobial, anti-inflammatory and drying effect. Like other products with zinc oxide in the composition, Lassar paste is used as a local anti-inflammatory drug that reduces irritation, inflammation of tissues and forms a local defense against penetration into the foci of secondary infections.
2. Milk Vidal. The tool is a mixture of boric, salicylic acid, camphor, sulfur and glycerin. The drug destroys pathogenic microorganisms, normalizes the pH of the skin, has an itching, keratolytic, anti-inflammatory effect.

Vitamin therapy and taking immunomodulators

For a speedy recovery and prevention of recurrence of the disease, doctors recommend that patients supplement their diet with foods rich in vitamins and minerals, due to the lack of which problems with skin and hair regeneration may occur. Avitaminosis often becomes the main cause of microsporia and mycoses in a child and an adult, which is caused by a decrease in immunity with a lack of vitamins.

To quickly eliminate the deficiency of certain substances in the body, long-term intake of vitamin complexes can be prescribed. In addition, doctors often prescribe immunomodulators to patients with skin pathology to help activate the immune system. At the same time, the dosage and treatment regimens are selected exclusively by a specialist, since the independent use of such drugs is dangerous due to the occurrence of severe adverse reactions.

How long does the treatment last

Depending on the severity of the disease transmitted by contact, therapy can last from several weeks to a couple of months. After the end of the course of treatment, depriving the patient is again scraped for bacterial culture, collecting material from the skin areas where the focus of the disease used to be. Such a study is carried out three times - immediately after the completion of treatment, after another week and after 2-3 months. If all three tests show a negative result, the disease is considered cured.

Prevention of microsporia in children

To prevent ringworm, preventive measures are extremely important, because without proper hygiene rules, the risk of a rapid spread of infection is high. Since there is no vaccination against this type of skin pathology, it is important to detect lichen in a child in a timely manner and isolate him for the duration of treatment. Disease prevention should include:

• periodic examinations in children's groups;
• disinfection of household items, things on which spores of the fungus can live;
• raising a child, including an explanation of why you can not touch homeless animals;
• regular visits to the veterinarian for examination of pets.

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microsporia is a highly contagious (highly contagious) infectious disease of smooth skin, scalp and nails caused by pathogenic fungi genus Microsporum. It was on the basis of the Latin name of the causative agent of infection (Microsporum) that the name of the disease itself (microsporia) was adopted. Microsporia looks like rounded, red, scaly patches on skin, bald spots on the scalp or white and dull circles on the nails.

Microsporia and ringworm (microsporia and trichophytosis)

However, with the development of science and technological progress, doctors were able to identify not only the signs of diseases, but also to isolate their pathogens, which was literally a breakthrough. During this period, it was possible to establish that the disease, which has always been called ringworm, can be caused by two types of pathogenic fungi - Trichophyton and Microsporum. And then a variety of ringworm caused by fungi of the genus Trichophyton began to be called trichophytosis, and Microsporum, respectively, microsporia. But since the external signs and course of trichophytosis and microsporia are the same, these two infections have the same common name - ringworm.

Thus, according to modern concepts, microsporia is a fungal infection ( mycosis ), affecting the skin, hair and nails, and at the same time is considered one of the varieties of ringworm.

The causative agent of the infection

• M. distorum;
• M. rivalieri;
• M. langeronii;
• M. canis;
• M. nanum;
• M. persicolor;
• M. gypseum;
• M. cookii;
• Keratynomyces ajelloii.

Methods of transmission of microsporia (how you can get infected)

So, depending on the main host, all types of Microsporum fungi are divided into three varieties:
1. zoophilic fungi - the main hosts are animals (most often kittens, less often dogs);
2. Anthropophilic fungi - people are the main hosts;
3. geophilic fungi - the main habitat is the soil.

Zoophilic, atropophilic and geophilic fungi, when they enter the human skin, cause the same infectious disease - microsporia, but the ways of their transmission and, accordingly, the methods of infection are different.

Yes, transfer zoophilic fungi of the genus Microsporum occurs through direct household contact with infected cats or dogs. And since kittens are most often carriers of microsporia, there are two seasonal peaks in the increase in the incidence of this infection - in the middle of summer and in autumn, when cats give birth. To become infected with microsporia, it is enough to stroke a cat or dog that has an infection or is asymptomatic carriers. People usually get infected from their pet cats or dogs that are in constant contact with their owners, sit on their laps, crawl under the covers, etc.

However, zoophilic fungi of the genus Microsporum can be transmitted to humans not only as a result of direct contact with a sick animal, but also indirectly through pieces of its wool. The fact is that cats and dogs that are sick with microsporia or are carriers of the fungus can leave small and inconspicuous pieces of wool on various household items (furniture, carpets, beds, sofas, armchairs, clothes, shoes, etc.), in which contains fungal spores. A person, touching such pieces of wool containing spores of the fungus, also becomes infected with microsporia.

Thus, the transmission of zoophilic microsporia can be carried out both by direct contact with a sick animal, and by touching objects that have hair and skin scales of an infected animal.

Anthropophilic fungi of the genus Microsporum are transmitted from a sick person to a healthy person through direct close contact (hugs, kisses, etc.) or through the use of various objects that contain scales of the skin of an infected person (for example, when using a comb, hat, scissors for cutting hair belonging to a person with microsporia). That is, anthropophilic fungi are transmitted in exactly the same way as zoophilic ones, but from person to person, and not from animals.

Infection geophilic fungi of the genus Microsporum occurs through direct contact with soil contaminated with these microbes.

When a person becomes infected with any kind of fungus Microsporum (zoophilic, anthropophilic or geophilic), then in the future he is a source of infection for others who can be infected with microsporia already from him. However, despite the hypothetical possibility of infecting other people, family members of patients with microsporia are very rarely infected.

The ways of transmission of microsporia described above do not fully reflect the picture of how a fungal infection occurs. So, with a simple hit of the fungus on the skin, a person will not get sick with microsporia, since the pathogenic microbe will be destroyed by normal microflora and immune system or simply washed away during hygiene measures. This means that for the disease of microsporia, it is necessary not only for the fungus to get on the skin, but also for the presence of certain predisposing factors that will allow it to penetrate the skin and provoke an infection.

To such predisposing factors include the following:
1. Traumatic damage to the skin;
2. Skin maceration;
3. Reduced immunity.

Thus, microsporia is transmitted from an animal or person to another person only if he has these predisposing factors.

Microsporia in children

Clinical manifestations, course and principles of treatment of microsporia in children do not differ from those for adults. Therefore, it is not advisable to consider separately the characteristics of microsporia in childhood.

Types of microsporia (classification)

So, depending on the predominant area of ​​​​damage, microsporia is divided into three main types:
1. Microsporia of smooth skin;
2. Microsporia of the scalp;
3. Microsporia of nails.

In addition, specialist doctors distinguish three forms of microsporia, depending on what kind of pathogen caused the infection:
1. Zoonotic microsporia - caused by species of Microsporum fungi that are zoophilic (the main hosts are animals);
2. Anthroponotic microsporia - caused by species of Microsporum fungi related to anthropophiles (the main host is a person);
3. Geophilic microsporia - caused by species of Microsporum fungi related to geophilic (the main habitat is soil).

The division into zoonotic, anthroponotic, and geophilic microsporia is of no clinical significance, since they all have the same symptoms, a similar course and are treated according to the same principles. This classification is important for epidemiologists, as it allows them to identify the primary sources of infection and take appropriate anti-epidemic measures if necessary.

It is also clinically important to classify microsporia according to the type of course, the depth of tissue damage and the reaction of the immune system to infection. According to these criteria, the following types of microsporia are distinguished:

• surface form (foci are located on the surface of smooth skin or under the hair);
• exudative form (foci are located on any parts of the body and liquid discharge oozes out of them);
• Infiltrative suppurative form (foci penetrate deep into the tissues, at the site of the lesion there is a strong edema with the addition of a secondary bacterial infection, which gives suppuration);
• nail shape(foci are located on the nails);
• Chronic form (a variant of a long-existing surface form).

The incubation period of the disease

Symptoms (signs) of microsporia

The very first symptoms of beginning microsporia are red spots formed on the scalp or body. If microsporia has affected the scalp, then spots can appear not only under the hair, but also in the area of ​​\u200b\u200bthe eyebrows and eyelashes. With microsporia of smooth skin, spots form on any part of the body.

A few days after the appearance of the spots become pink and rather pale, and their surface is covered with whitish scales. At the same time, the hair loses color and breaks off at a height of several millimeters from the skin surface, creating the effect of a short haircut. Because of this, characteristic and clearly visible bald spots form on the scalp, on which skin with scales and short hair resembling stiff bristles are visible. In some cases, black dots form on the bald spots.

Sometimes microsporia of the scalp does not cause the formation of bald spots due to hair breaking, but provokes the formation of a large number of scales, which people take for abundant dandruff, which appeared completely unexpectedly for them. Also, in rare cases, microsporia has the appearance of a gray spot on the scalp, in the area of ​​\u200b\u200bwhich intense hair fall out.

If the lichen affects smooth skin, then the initial spots simply turn pale, acquire a grayish color and become covered with scales. Outside the spot, a well-defined and elevated roller is formed, as if delimiting the affected area from healthy areas. Another spot may form inside the spot, smaller in size, but exactly the same in structure, due to which the affected area takes on the appearance of a target.

Over time, microsporia foci on smooth skin and scalp increase in size and take the form of a regular circle or oval. The size of the lesions can reach 10 cm in diameter. However, their surface is covered with a dense layer of gray scales, which give them the appropriate color. As a result, the border of the spot looks like a red rim, and the inside is painted in a pale gray-pinkish color.

If two or more foci of microsporia are located nearby, then they can merge into a spot. Spots, covered with scales, peel off with varying degrees of intensity. Sometimes peeling accompanied by strong itching, and in other cases, the stain does not cause any discomfort in principle.

In children and adults, with the localization of foci of microsporia on the scalp, on the face, neck or upper half of the body, rise in temperature body and increase cervical lymph nodes.

In severe cases of microsporia in the area of ​​the lesion, a strong inflammation of the skin develops with swelling, exudation and suppuration, which is called scab.

In general, microsporia in children and adults proceeds as described. Consider the features and more accurate characteristics of the spots characteristic of various forms of fungal infection.

Skin microsporia (smooth skin microsporia) in adults and children

However, the fungus can re-infect an area that is already inside the outer ring. In this case, another ring is formed inside, as a result of which the lesion takes on a bizarre appearance of the target. Such affected areas of the "ring in the ring" type are characteristic mainly of anthroponous microsporia.

The total number of foci of microsporia on smooth skin is usually small and amounts to 1-3 spots. The diameter of the spots is most often 0.5 - 3 cm, but sometimes the lesions can increase up to 5 cm in radius. Closely spaced spots can merge into one. Lesions can be located on any part of the body, but most often they are located on the face, neck, forearms and shoulders.

As a rule, non-inflamed spots of microsporia do not cause any unpleasant sensations. Sometimes it can be moderately itchy. If there is a pronounced inflammation in the lesions, then they are very itchy and sore.

In people with reduced reactions of delayed sensitivity, microsporia can occur in the so-called abortive form. In this case, the lesion has the appearance of a pale pink spot without clear boundaries and bubbles forming a peripheral roller.

At newborns and children under 3 years of age, microsporia occurs in an erythematous-edematous form, in which the lesion is red, inflamed and swollen with a minimum number of scales and peeling.

In people who are prone to atopy (for example, those suffering from atopic dermatitis), microsporia proceeds in a papular-squamous form. In this case, spots appear on areas of the skin characterized by the production of a large amount of sebum, such as the face, chest and back. The foci are abundantly infiltrated (dense, swollen) and lichenified (the skin on them is dense and thickened, with a pronounced pattern and pigmentation disorders).

In young women (up to 30 years old), suffering from increased hair growth on the legs, foci of microsporia usually appear as red and inflamed nodes with a diameter of 2–3 cm. This is a deep form of microsporia.

Microsporia of the head (microsporia of the scalp)

A characteristic feature of childhood microsporia is that the infection almost never occurs in babies with red hair.

Microsporia of the scalp is round or oval lesions with a clear border, most often located on the crown, crown or temples. Usually there are 1-2 foci on the head with a diameter of 2-5 cm. Small secondary lesions 0.5-1.5 cm in diameter may appear on the borders of the foci, which are screenings.

At the initial stages of the disease, a scaly patch of skin is formed in the affected area. In this area, at the roots of the hair, you can see ring-shaped scales surrounding the hairs around the entire perimeter. A week later, the hair itself is also affected, which lose their color, become dull, brittle and brittle, and as a result break off at a distance of 5 mm from the skin surface. A short "brush", left in place of broken hairs, dull and covered with a grayish coating, is an accumulation of fungal spores. If the roots of broken hair are smoothed in any direction, they will remain in the position that they were given. The skin under the hair fragments is moderately reddish, dense and covered with a large number of grayish scales.

In the anthroponotic form of microsporia, a characteristic feature is the location of the lesions at the border of hair growth, when one half of the spot is on the hairy part, and the second on smooth skin.

The picture described above is a typical course of microsporia. However, in rare cases, the infection occurs in atypical forms, such as:

• Infiltrative form microsporia of the head is characterized by the elevation of the lesion above the rest of the skin. The skin of the focus is red and edematous, and the hair is broken off at the level of 4 mm.
• suppurative form microsporia is characterized by a strong inflammatory process, as well as thickening and thickening of the skin in the lesion. In this case, bluish-red nodes are formed with pustules on the surface, through which pus comes out when pressed on the affected area.
• exudative form microsporia is characterized by severe redness, swelling and small blisters in the affected area. Due to the released inflammatory fluid, the skin flakes stick together and form a dense crust covering the lesion.
• Trichophytoid form microsporia is characterized by multiple small lesions with weak peeling. The foci are vague, without clear boundaries and signs of inflammation, and the hair is broken off at the level of 1-2 mm.
• seborrheic form microsporia is characterized by thinning hair in some areas of the head. In the area of ​​\u200b\u200bsuch hair thinning, skin is visible, covered with a large number of yellowish scales. If the scales are removed, then fragments of a small amount of hair become visible under them.

These rare forms of microsporia of the scalp are almost always associated with an increase in body temperature, inflammation of the lymph nodes neck and symptoms intoxication (headache, weakness, lethargy, etc.).

Anthroponous microsporia

On the scalp, lesions are located on the border of hair growth in the back of the head, crown and temples. As a rule, part of the lesion is located in the hair growth zone, and part is on smooth skin. Such foci are small, vague, with clear boundaries and peeling inside the spot. When located close to each other, the foci can merge, forming one large area of ​​\u200b\u200blesion of a bizarre shape. In the area of ​​the foci, the hair breaks off at a level of 4-6 mm and looks short-cut.

Zoonotic and geophilic microsporia

When the scalp is affected, large foci are formed, located strictly in the hair growth zone. The lesions are round or oval, well-defined, and covered with whitish scales. The hair in the lesion is broken off at a height of 6-8 mm, and the protruding fragments are covered with a white sheath of fungal spores.

Nail microsporia

Microsporia - photo

This photo shows a microsporia lesion in a child.

This photo shows a focus of microsporia of the scalp.

Diagnosis of microsporia

The method of diagnosing microsporia through a fluorescent lamp (Wood's lamp) is very simple - a doctor in a darkened room examines the affected area illuminated by such a device. Skin and hair affected by the fungus in the light of the Wood's lamp flicker bright green. The reason for this phenomenon has not been elucidated, but it allows you to quickly and accurately diagnose microsporia.

If necessary, the doctor can gently scrape off a small amount of scales from the affected area with a blunt scalpel and examine them under a microscope, conducting a microscopic examination accordingly. Before scraping off the scales, the skin in the affected area is wiped with 96% alcohol. After that, only scales are scraped off the smooth skin, and fragments of hair are scraped off the scalp. All collected material is placed on a glass slide, poured with a drop of 20% potassium hydroxide solution and examined under a microscope after 30 minutes.

With microsporia, convoluted filaments of mycelium are visible in the scales, and on the surface of the hair there are numerous spores attached to it like small balls around the entire outer perimeter. Due to spores, the border of the hair is not clear, but blurry.

The cultural method for diagnosing microsporia is used with positive results of microscopic and luminescent in order to identify the type of pathogen fungus. Sometimes it is necessary to determine the optimal treatment tactics. For the cultural method, scales are removed from the affected area and placed on a nutrient medium. In the presence of microsporia on the medium, a colony grows in the form of a flat disk with a fluff on the surface.

In most cases, to diagnose microsporia, it is sufficient to examine the affected area through a Wood's lamp and subsequent microscopic examination.

Microsporia - treatment

General principles of therapy

If the foci of microsporia are located on the scalp or fluffy hairs of smooth skin are involved in the process, then the treatment consists of taking antifungal drugs inside and their external application to the affected area.

Most effective for oral administration for the treatment of microsporia, antifungal preparations containing the following active substances:

• Griseofulvin;
• Terbinafine (Terbizil, Lamisil, etc.);
• Itraconazole ( Orungal , Irunin and etc.).

• Ointments with terbinafine (Lamisil, Terbizil, etc.), clotrimazole, isoconazole and bifonazole;
• Iodine tincture 2 - 5%;
• Sulfur ointment 10 - 20%;
• Sulfur-salicylic ointment;
• Sulfur-tar ointment.

During the entire period of therapy, a sick person should use separate towels, sponges, combs and other personal items. hygiene and household purposes, and do not pass them on to other people. All things worn by a person suffering from microsporia should be washed with ordinary powder at a water temperature of 60 o C, which is enough to kill the spores of the fungus. And boil all the items that he used for 15 minutes in ordinary water. Boxes, boxes and other containers where the things of a person suffering from microsporia were stored should be treated with an antifungal disinfectant Terralin.

Microsporia of smooth skin and scalp - treatment

So, inside for the treatment of microsporia, the following drugs should be taken:

• Griseofulvin. The dosage is calculated individually from the ratio of 22 mg per 1 kg of body weight. The calculated amount is divided by 3 and taken 3 times a day with a spoonful of oil for 2 to 6 weeks. Once a week, a scraping from the affected area is taken for analysis. After the result of scraping for fungi is negative, Griseofulvin is taken for another 2 weeks at the same dose every other day. Then another 2 weeks at the same dose, the tablets are taken every 3 days.
• Terbinafine. Take 250 - 500 mg 1 time per day for 4 - 6 weeks.
• Itraconazole. Take 100 - 200 mg 1 time per day for 4 weeks.

If there is a pronounced inflammation on the skin, then in the first 3-5 days of therapy it is necessary to treat them once a day with Travocort ointment, which contains hormone with a powerful anti-inflammatory effect. When the inflammation decreases, you should switch to the use of any other antifungal ointment (Travogen, Zalain, Lamisil, Terbizil, Terbinafine, etc.).

Hair from smooth skin should be shaved once a week or epilated with a special patch with griseofulvin. With microsporia of the scalp, before starting treatment, you should shave off the hair from the affected area, and do this 1-2 times a week until the end of the course of therapy. The head should also be washed 1-2 times a week with tar soap or pharmacy shampoo containing selenium sulfide, ketoconazole or povidone-iodine.

Treatment of microsporia in children

• Children weighing 10 - 20 kg - take 3/4 tablets (94 mg) of Terbinafine 125 mg 1 time per day;
• Children weighing 20 - 40 kg - take 1.5 tablets (187 mg) of Terbinafine 125 mg 1 time per day;
• Children weighing over 40 kg - take 2 tablets (250 mg) of Terbinafine 1 time per day.

Itraconazole and Griseofulvin are not recommended for use in children due to their high toxicity.

External treatment of affected areas in the treatment of microsporia in children is carried out with the same drugs as in adults. The optimal ointment for children is clotrimazole or Lamisil.

Disease prevention

Microsporia: pathogens, ways of infection, signs (symptoms), treatment and prevention - video