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Ousmane SY, Ousmane B, Ball MD. Inflammatory ringworm due to Microsporum audouinii, case of a severe form in an immunocompetent girl in Mauritania. IDCases 2023; 32:e01766. [PMID: 37122595 PMCID: PMC10140798 DOI: 10.1016/j.idcr.2023.e01766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/10/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Ringworms of the scalp are very commons in Mauritania and among them; inflammatory ringworms are representing very rare forms. We present the case of a severe inflammatory ringworm caused by an anthropophilic dermatophyte, Microsporum audouini. Observation This is an 8-years-old girl with ulcerative lesions on the scalp without adenopathy, without fever and in a good general condition. Direct examination of the mycological sample of hair and scales showed the presence of ecto-trix spores. Culture in SCA media allowed the identification of Microsporum audouini. The establishment of an antifungal treatment orally and a local antiseptic allowed to have a clinical and mycological remission after 30 days. Conclusion Microsporum audouinii is most often responsible for very soft trichophytia, but under certain conditions, it can cause inflammatory ringworm.
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Affiliation(s)
- SY Ousmane
- Hospital Center of Speciality(CHS) in Nouakchott, Mauritania
- Corresponding author.
| | - Ba Ousmane
- Hospital Center of Speciality(CHS) in Nouakchott, Mauritania
- National Institute of Research in Public Health, Mauritania
- Fundamental Department of Sciences of Medecin Faculty in Nouakchott University, Mauritania
| | - Mamadou D. Ball
- Dermatology Service of National Hospital Center, Mauritania
- Dermatology Service of Medecin Faculty at Nouakchott University, Mauritania
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2
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Rajkumar A, Britton PN. Kerion: a great mimicker. Med J Aust 2022; 216:563-567. [DOI: 10.5694/mja2.51588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/27/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022]
Affiliation(s)
| | - Philip N Britton
- Children’s Hospital at Westmead Sydney NSW
- University of Sydney Sydney NSW
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3
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Friedland R, Sabbah F, Reiss-Huss S, Ben Amitai D. Epidemiologic features and risk of scarring in pediatric patients with kerion celsi. Pediatr Dermatol 2022; 39:215-219. [PMID: 35028962 DOI: 10.1111/pde.14916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Kerion celsi represents the inflammatory extreme of tinea capitis, as a delayed hypersensitivity reaction to the causative dermatophyte. Data regarding prevalence, trends in pathogens, and risk factors for scarring are limited. OBJECTIVE The main objective of the study is to assess clinical and epidemiologic features of children with kerion celsi and risk factors for scarring. METHODS We reviewed medical records of pediatric patients with kerion celsi treated between January 2006 and July 2020. RESULTS Among 80 patients, the prevalence of permanent alopecia was 27.5%. Patients with remaining alopecia presented to our clinic at a mean 1.3 months earlier than those with complete response to treatment (2.2 ± 2.1 and 3.4 ± 4.8, respectively; p < .05). Patients of Ethiopian ethnicity were more represented than in the general population; however, scarring was observed in only 11% (p = 0.08). Outcomes did not differ by pathogen, antifungal treatment prescribed, duration of treatment, or the use of prednisone or antibiotics. CONCLUSIONS Scarring alopecia is a common complication of kerion celsi. Host innate immune response, pathogen virulence, and treatment timeline should be considered as possible variables affecting risk of scarring in the future studies.
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Affiliation(s)
- Rivka Friedland
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Fareed Sabbah
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shiran Reiss-Huss
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dan Ben Amitai
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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4
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Deh A, Diongue K, Diadie S, Diatta BA, Diop K, Ndour N, Ndiaye M, Diallo M, Niang SO. Kerion celsi due to Microsporum audouinii: a severe form in an immunocompetent girl. Ther Adv Infect Dis 2021; 8:20499361211020879. [PMID: 34123381 PMCID: PMC8175834 DOI: 10.1177/20499361211020879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
A 9-year-old girl presented a large inflammatory cup-shaped scalp lesion with alopecia surrounded by pustules, dander, and suppuration associated with an occipital inflammatory lymphadenopathy for 1 month. Wood's light exam was positive as well as KOH mount showing ectothrix type hair involvement. Hair and pus culture on Sabouraud dextrose agar (SDA) added with chloramphenicol and supplemented with cycloheximide isolated a dermatophyte species identified as Microsporum audouinii according to the colonies features. Species identification was confirmed by matrix-assisted laser desorption-ionization-time of flight mass spectrometry (MALDI-TOF MS) and the patient was treated for kerion celsi with terbinafine tablets 125 mg per day associated with a ketoconazole-based shampoo. The evolution was favorable, with hair regrowth after 2 months.
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Affiliation(s)
- Aminata Deh
- Clinic of Dermatology, Aristide Le Dantec Hospital, Dakar, Senegal
| | - Khadim Diongue
- Service of Parasitology and Mycology, Faculty of Medicine, Pharmacy and Odontology, Cheikh Anta Diop University of Dakar, Avenue Cheikh Anta Diop, Dakar BO 3005, Senegal
| | - Saer Diadie
- Clinic of Dermatology, Aristide Le Dantec Hospital, Dakar, Senegal
| | | | - Khadim Diop
- Clinic of Dermatology, Aristide Le Dantec Hospital, Dakar, Senegal
| | - Niar Ndour
- Clinic of Dermatology, Aristide Le Dantec Hospital, Dakar, Senegal
| | - Maodo Ndiaye
- Clinic of Dermatology, Aristide Le Dantec Hospital, Dakar, Senegal
| | - Moussa Diallo
- Clinic of Dermatology, Aristide Le Dantec Hospital, Dakar, Senegal
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5
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Zhao R, Jiang Y, Zhao S, Zhao H. Multiomics Analysis Reveals Molecular Abnormalities in Granulosa Cells of Women With Polycystic Ovary Syndrome. Front Genet 2021; 12:648701. [PMID: 34084179 PMCID: PMC8168535 DOI: 10.3389/fgene.2021.648701] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/06/2021] [Indexed: 01/15/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common complex endocrine and metabolic disease in women of reproductive age. It is characterized by anovulatory infertility, hormone disorders, and polycystic ovarian morphology. Regarding the importance of granulosa cells (GCs) in the pathogenesis of PCOS, few studies have investigated the etiology at a single “omics” level, such as with an mRNA expression array or methylation profiling assay, but this can provide only limited insights into the biological mechanisms. Here, genome-wide DNA methylation together with lncRNA-miRNA-mRNA profiles were simultaneously detected in GCs of PCOS cases and controls. A total of 3579 lncRNAs, 49 miRNAs, 669 mRNAs, and 890 differentially methylated regions (DMR)-associated genes were differentially expressed between PCOS cases and controls. Pathway analysis indicated that these differentially expressed genes were commonly associated with steroid biosynthesis and metabolism-related signaling, such as glycolysis/gluconeogenesis. In addition, we constructed ceRNA networks and identified some known ceRNA axes, such as lncRNAs-miR-628-5p-CYP11A1/HSD17B7. We also identified many new ceRNA axes, such as lncRNAs-miR-483-5p-GOT2. Interestingly, most ceRNA axes were also closely related to steroid biosynthesis and metabolic pathways. These findings suggest that it is important to systematically consider the role of reproductive and metabolic genes in the pathogenesis of PCOS.
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Affiliation(s)
- Rusong Zhao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China
| | - Yonghui Jiang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China
| | - Shigang Zhao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China
| | - Han Zhao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China
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6
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Kerion Celsi with erythematous tumefaction on the groin due to Trichophyton mentagrophytes. Rev Iberoam Micol 2017; 34:249-250. [DOI: 10.1016/j.riam.2017.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/24/2017] [Accepted: 03/20/2017] [Indexed: 11/20/2022] Open
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7
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La dermatophytide exanthématique et pustuleuse généralisée (DEPG), une présentation clinique rare de dermatophytide. Ann Dermatol Venereol 2015; 142:270-5. [DOI: 10.1016/j.annder.2015.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/15/2014] [Accepted: 01/06/2015] [Indexed: 11/19/2022]
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8
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Abstract
UNLABELLED We report on a 5-year-old girl with a severe kerion celsi, caused by Trichophyton mentagrophytes, probably acquired from a pet guinea pig. The lesions had started as small irritating squamous lesions that had been accurately diagnosed as skin infection, but had only been treated with local antifungal agents. The lesions progressed and developed into a kerion celsi that had to be treated with long-term systemic griseofulvin. Nevertheless, reinfection occurred and treatment had to be restarted. The girl is left with areas of alopecia, as a result of which she is required to wear a wig. CONCLUSION Tinea capitis is a common skin infection that should be considered in any type of scalp lesion. It requires systemic treatment, and inappropriate and delayed treatment can result in the development of kerion celsi, with sometimes devastating consequences.
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Affiliation(s)
- Gerald J Jaspers
- Department of Pediatrics, Viecuri Medical Centre, Venlo, The Netherlands.
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9
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Zhang R, Ran Y, Dai Y, Zhang H, Lu Y. A case of kerion celsi caused by Microsporum gypseum in a boy following dermatoplasty for a scalp wound from a road accident. Med Mycol 2010; 49:90-3. [PMID: 20662636 DOI: 10.3109/13693786.2010.503196] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We report a rare case of kerion celsi of the scalp caused by Microsporum gypseum in a boy 1 month after he received dermatoplasty for a scalp injury from a road accident. Species identification was performed by observation of morphologic and biochemical characteristics and sequencing of the internal transcribed spacers (ITS) 1 and 2. Treatment with oral terbinafine and topical naftifine-ketoconazole cream after washing the hair with ketoconazole shampoo was effective.
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Affiliation(s)
- Ruifeng Zhang
- Department of Dermatovenerology, West China Hospital, Sichuan University, Chengdu
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10
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Bonifaz A, Isa-Isa R, Araiza J, Cruz C, Hernández MA, Ponce RM. Cytobrush-culture method to diagnose tinea capitis. Mycopathologia 2007; 163:309-13. [PMID: 17520340 DOI: 10.1007/s11046-007-9019-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2007] [Accepted: 04/05/2007] [Indexed: 10/23/2022]
Abstract
This is a comparative study to isolate the dermatophytes of tinea capitis using the cytobrush and comparing it versus the standard method. A prospective, observational, comparative trial of 178 probable cases of tinea capitis was conducted in two dermatological centers. Each patient underwent mycological tests that included direct exam with KOH and cultures with either of two methods: scraping the scalp to remove hair and cell debris, and the cytobrush. A total of 135 clinically and mycologically proven cases of tinea capitis were included; 119 were non-inflammatory and 16 inflammatory tinea. A total of 131 had a positive direct exam and subsequent primary isolation cultures were obtained in 135 cases. The main dermatophytes isolated were Microsporum canis (68%) and Trichophyton tonsurans (20%). A total of 115/135 (85.1%), were detected with the traditional method, with an average of 11.2 days until positive, while the number detected with the cytobrush was 132/135 (97.7%) with an average of 8.5 days until positive. The chi-square statistical method showed that the cytobrush culture was superior to the standard one with a chi-square of 5.078 (P = 0.025), with a statistically significant difference versus the standard method.
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Affiliation(s)
- Alexandro Bonifaz
- Dermatology Service & Mycology Department, Hospital General de México OD, Sanchez Azcona 317 int 202, Col del Valle, Mexico, DF, Mexico.
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11
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Barile F, Filotico R, Cassano N, Vena GA. Pubic and vulvar inflammatory tinea due to Trichophyton mentagrophytes. Int J Dermatol 2006; 45:1375-7. [PMID: 17076734 DOI: 10.1111/j.1365-4632.2006.02793.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Van Rooij P, Detandt M, Nolard N. Trichophyton mentagrophytes of rabbit origin causing family incidence of kerion: an environmental study. Mycoses 2006; 49:426-30. [PMID: 16922797 DOI: 10.1111/j.1439-0507.2006.01266.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Our laboratory was contacted by a family living directly above a rabbit farm. Both their children had developed a kerion, in consequence of a misdiagnosed superficial mycosis. This study was designed to demonstrate a link between the two kerion cases and the environmental contamination. The degree of contamination was estimated and factors favourising the spread of infection were determined. Dermatophytes were isolated from various environmental sites using Rodac plates. For direct sampling of scalp and fur the brushing technique was used. The farm and home environment initially showed a severe contamination by Trichophyton mentagrophytes. At the farm, cages and surfaces covered with rabbit hair were strongly contaminated. As for the home environment, the dog's basket and clothes from the mother carried a large number of spores. Trichophyton mentagrophytes was identified as responsible agent for the children's kerions and the lesions of the rabbits. Mother, eldest child and dog seemed to be excellent carriers. Cleaning and disinfection measures resulted in a reduction of the overall contamination. The home environment was no longer a source of contamination. Nevertheless, on the farm a fair number of dermatophytes could still be isolated from the wire meshes and roof beams covered with fluff.
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Affiliation(s)
- P Van Rooij
- Department Microbiology, Mycology Section, Scientific Institute of Public Health (IPH), Juliette Wytsmanstraat 14, B-1050 Brussels, Belgium.
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13
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Nikkels AF, Nikkels-Tassoudji N, Piérard GE. Oral antifungal-exacerbated inflammatory flare-up reactions of dermatomycosis : case reports and review of the literature. Am J Clin Dermatol 2006; 7:327-31. [PMID: 17007544 DOI: 10.2165/00128071-200607050-00007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Inflammatory flare-up reactions of some dermatomycoses, particularly those caused by zoophilic fungi, are typical and potentially severe adverse effects following the intake of some oral antifungals. However, this condition has not previously been reported with the most frequently used antifungals in dermatology, namely fluconazole, itraconazole, and terbinafine. In this report, we describe five patients, observed over a 10-year period, who presented with inflammatory exacerbations following oral antifungal therapy for dermatomycoses. We also review the literature on inflammatory reactions exacerbated by oral antifungal agents. Details of the patients' age, sex, occupation, and atopic background; the site of the lesion, its clinical and histologic features, and any systemic signs; the identity of the fungal pathogen; the antifungal agent taken by the patient; the time between drug intake and occurrence of the flare-up; the approach to management; and the outcome were documented for each patient. A PubMed literature search was also conducted, focusing on inflammatory exacerbations induced by griseofulvin, ketoconazole, itraconazole, fluconazole, and terbinafine. The patients were four farmers and one veterinarian (all male). All primary lesions were inflammatory dermatophytoses, including one kerion. Inflammatory exacerbation of the skin lesions started 12-24 hours after the intake of oral antifungals. Mild systemic changes, including slight fever and malaise, occurred in two cases. Itraconazole 400 mg/day was implicated as the causative agent in four cases and terbinafine 250 mg/day in one case. Mycologic cultures grew Trichophytonverrucosum in four cases. Antifungal treatment was discontinued in all patients. Oral and topical corticosteroids were administered to the two patients with systemic changes; the other three patients were treated with topical corticosteroids only. Two days after the onset of corticosteroids, lower doses of itraconazole (100 mg/day) and terbinafine (125 mg/day) were reintroduced. All lesions healed after 4-5 weeks. The PubMed search did not identify any articles that described inflammatory exacerbations of dermatomycoses induced by oral antifungals. Inflammatory flare-up of dermatomycoses is a rare but potentially severe cutaneous complication of oral antifungal use. Occupational contact with animals, inflammatory dermatomycoses, and zoophilic fungi represent common features in these patients. Although evidence-based data are not available, clinical experience shows that, in addition to antifungal therapy, topical and/or systemic corticosteroids are helpful to reduce the inflammatory reactions. The cases described in this article represent the first published report of oral antifungal-exacerbated inflammatory flare-up reactions of dermatomycosis in patients taking itraconazole or terbinafine.
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Affiliation(s)
- Arjen F Nikkels
- Department of Dermatopathology, University Hospital of Liège, Liège, Belgium.
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14
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Sioud Dhrif A, Dhaoui MR, Doss N. [Inflammatory lesion of the scalp]. Ann Dermatol Venereol 2005; 132:707-9. [PMID: 16230927 DOI: 10.1016/s0151-9638(05)79425-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A Sioud Dhrif
- Service de Dermatologie, Hôpital Militaire de Tunis, 1008 Montfleury, Tunis, Tunisie.
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15
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Aste N, Pinna AL, Pau M, Biggio P. Kerion Celsi in a newborn due to Microsporum canis. Fallbericht. Durch Microsporum canis verursachtes Kerion Celsi bei einem Neugeborenen. Mycoses 2004; 47:236-7. [PMID: 15189191 DOI: 10.1111/j.1439-0507.2004.00967.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The present study deals with a case of a 40-day-old girl with kerion Celsi caused by Microsporum canis. The source of the infection were the parents who presented tinea corporis caused by M. canis. Systemic treatment was carried out with terbinafine and complete recovery was achieved. Tinea capitis is unusual in children during their first year of life and its evolution towards kerion is very rare in newborns.
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Affiliation(s)
- Nicola Aste
- Department of Dermatology, University of Cagliari, Cagliari, Italy.
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