Singal A, Rawat S, Bhattacharya S N, Mohanty S, Baruah M C
Department of Dermatology, University of College of Medical Sciences, New Delhi, India.
J Dermatol. 2001 Jan;28(1):22-6. doi: 10.1111/j.1346-8138.2001.tb00081.x.
There is a paucity of literature on tinea capitis from North India. The response to griseofulvin has not been studied as well. We studied 153 consecutive patients of tinea capitis for clinical patterns, causative dermatophytic species, clinico-etiological correlation, and response to griseofulvin. Culture and sensitivity were done on all patients. All patients were treated with griseofulvin for 6-8 weeks; non-responders were further treated with fluconazole. Ninety percent of the patients were less than 15 years of age, 75% belonged to poor socioeconomic groups and 19% had a family history of tinea capitis. The seborrheic variant was the commonest clinical pattern seen in 47.8% of patients, followed by grey patch, black dot, kerion, and alopecia-areata-like tinea capitis in 35.9%, 8.5%, 6.5% and 1.3% of patients, respectively. Only 66% of patients had a positive culture. T. violaceum was the commonest dermatophytic species isolated in 38% patients. M. audouinii, T. schoenleinii, T. tonsurans, M. gypseum, T. verrucosum and T. mentagrophytes were isolated in 34%, 10%, 9%, 3%, 3% and 3% of patients, respectively. Of the isolates 94% were susceptible to griseofulvin, and 100% were susceptible to fluconazole. By using griseofulvin for 6-8 weeks 97.4% of the patients were cured; nonresponders required therapy with fluconazole for cure. To conclude, tinea capitis is still a disease of younger people of poor socioeconomic status. T. violaceum and M. audouinii are the most common responsible dermatophytes. The response to griseofulvin was excellent, and it should be used as a first line therapy.
来自印度北部的头癣文献较少。对灰黄霉素的反应也尚未得到充分研究。我们对153例连续性头癣患者进行了临床模式、致病皮肤癣菌种类、临床病因相关性以及对灰黄霉素反应的研究。对所有患者进行了培养和药敏试验。所有患者接受灰黄霉素治疗6 - 8周；无反应者进一步接受氟康唑治疗。90%的患者年龄小于15岁，75%属于社会经济地位较低的群体，19%有头癣家族史。脂溢性变种是最常见的临床模式，见于47.8%的患者，其次是灰斑型、黑点型、脓癣型和斑秃样头癣型，分别见于35.9%、8.5%、6.5%和1.3%的患者。只有66%的患者培养结果呈阳性。紫色毛癣菌是最常见的分离出的皮肤癣菌，见于38%的患者。奥杜盎小孢子菌、许兰毛癣菌、断发毛癣菌、石膏样小孢子菌、疣状毛癣菌和须癣毛癣菌分别见于34%、10%、9%、3%、3%和3%的患者。分离出的菌株中94%对灰黄霉素敏感，100%对氟康唑敏感。使用灰黄霉素治疗6 - 8周后，97.4%的患者治愈；无反应者需要用氟康唑治疗才能治愈。总之，头癣仍然是社会经济地位较低的年轻人的疾病。紫色毛癣菌和奥杜盎小孢子菌是最常见的致病皮肤癣菌。对灰黄霉素的反应良好，应将其用作一线治疗药物。
