Dermatophytid: Aktuelle Bestandsaufnahme

A case of kerion celsi caused by Trichophyton tonsurans with dermatophytid reaction mimicking a drug eruption and endothrix infection confirmed in pathological tissue

We report a case of kerion celsi caused by Trichophyton tonsurans in a teenage male judo athlete, presenting with a lesion in the occipital region. Following the initiation of systemic antifungal therapy, the patient developed a dermatophytid reaction, necessitating differentiation from a drug eruption. Direct microscopy of the affected area confirmed the presence of fungal elements, and histopathological examination revealed endothrix invasion, supporting the continuation of treatment. A drug-induced lymphocyte stimulation test for terbinafine, conducted post-treatment, was negative. This case highlights the importance of distinguishing dermatophytid reactions from drug eruptions to ensure uninterrupted antifungal therapy.

S1 guidelines: Tinea capitis

Tinea capitis describes a dermatophyte infection of scalp and hair that predominately occurs in children. The diagnostic workup includes microscopic examination, culture and/or molecular tests. Treatment is guided by the specific organism involved and should consist of systemic agents as well as adjuvant topical treatment. The aim of the present update of the interdisciplinary German S1 guidelines is to provide dermatologists, pediatricians and general practitioners with a decision tool for selecting and implementing appropriate diagnostic and therapeutic measures in patients with tinea capitis. The guidelines were developed based on current international guidelines, in particular the 2010 European Society for Pediatric Dermatology guidelines and the 2014 British Association of Dermatologists guidelines, as well as on a review of the literature conducted by the guideline committee. This multidisciplinary committee consists of representatives from the German Society of Dermatology (DDG), the German-Speaking Mycological Society (DMykG), the German Society for Hygiene and Microbiology (DGHM), the German Society of Pediatric and Adolescent Medicine (DGKJ) and the German Society for Pediatric Infectious Diseases (DGPI). The Division of Evidence-based Medicine (dEBM) provided methodological assistance. The guidelines were approved by the participating medical societies following a comprehensive internal and external review.