Rutecki GW, Wurtz R, Thomson RB
Departments of Medicine and Pathology, Evanston Hospital, 2650 Ridge Avenue, Evanston, IL 60201, USA.
Curr Infect Dis Rep. 2000 Oct;2(5):433-437. doi: 10.1007/s11908-000-0073-1.
Dermatophytic fungi cause human infection worldwide. One clinical syndrome--tinea barbae, which closely resembles tinea capitis--is a trichophytosis involving the beard and mustache areas of the face. The fungal agents responsible for tinea barbae (Trichophyton verrucosum and Trichophyton mentagrophytes) are contracted through occupational exposure to animals infected with zoophilic dermatophytes. Tinea barbae may be confused with other facial infections, especially those caused by Staphylococcus aureus or other facial dermatophytes (usually anthrophilic). In an afebrile patient without leucocytosis, a distinctive facial lesion, called a kerion, can be the essential diagnostic finding. Diagnosis requires suspicion based on appropriate exposure. Definitive diagnosis requires a combination of clinical examination, direct microscopic examination using potassium hydroxide, and culture confirmation. Topical treatment is not effective. Oral therapy with an antifungal (eg, terbinafine) or an azole is recommended. This article reviews these factors, as well as germane epidemiologic and prevention measures.
皮肤癣菌在全球范围内都会引发人类感染。一种临床综合征——须癣，与头癣极为相似——是一种累及面部胡须和髭区的毛癣菌病。引发须癣的真菌病原体（疣状毛癣菌和须癣毛癣菌）是通过职业接触感染亲动物性皮肤癣菌的动物而感染的。须癣可能会与其他面部感染相混淆，尤其是由金黄色葡萄球菌或其他面部皮肤癣菌（通常是亲人性的）引起的感染。在无发热且无白细胞增多的患者中，一种独特的面部病变，称为脓癣，可能是关键的诊断依据。诊断需要基于适当接触史的怀疑。确诊需要结合临床检查、使用氢氧化钾进行直接显微镜检查以及培养确认。局部治疗无效。建议使用抗真菌药（如特比萘芬）或唑类进行口服治疗。本文将对这些因素以及相关的流行病学和预防措施进行综述。
