Hamm H
Klinik und Poliklinik für Haut- und Geschlechtskrankheiten, Bayerischen Julius-Maximilians-Universität Würzburg.
Ther Umsch. 2002 May;59(5):223-7. doi: 10.1024/0040-5930.59.5.223.
This paper focuses on four important hair diseases mainly occurring in children. Trichotillomania is the most relevant differential diagnosis of alopecia areata in childhood. Meticulous inspection and lack of telogen hairs in the trichogram from the margin of the lesion usually are sufficient for differentiation. The trichogram also plays a significant role for the diagnosis of the loose anagen hair (loose anagen syndrome), a fairly new, but not rare entity, especially in distinguishing it from telogen effluvium. Five different types of clinical presentation are distinguished in tinea capitis. For the necessary systemic therapy; the new antimycotics terbinafine and itraconazole represent good alternatives to the well-tried griseofulvin. Several effective therapeutic options are also available for head lice, the most frequent parasitary infestation of school age. However, because of its neurotoxicity and the increasing problem of lice resistance lindane should not be used any longer for the treatment of head lice.
本文重点关注主要发生在儿童中的四种重要毛发疾病。拔毛癖是儿童斑秃最相关的鉴别诊断。仔细检查以及病变边缘毛发显微镜检查中缺乏休止期毛发通常足以进行鉴别。毛发显微镜检查对于诊断松散生长期毛发(松散生长期综合征)也起着重要作用,这是一种相当新但并不罕见的病症,尤其有助于将其与休止期脱发区分开来。头癣有五种不同类型的临床表现。对于必要的全身治疗,新型抗真菌药特比萘芬和伊曲康唑是久经考验的灰黄霉素的良好替代品。对于头虱这种学龄儿童最常见的寄生虫感染,也有几种有效的治疗选择。然而,由于林丹具有神经毒性且虱子耐药问题日益严重,不应再将其用于治疗头虱。