Kasai Tatsuya
Kasai Dermatological Clinic, 2-40-32-105 Higashitanaka, Tagajo, Miyagi 985-0863, Japan.
Nihon Ishinkin Gakkai Zasshi. 2005;46(2):87-91. doi: 10.3314/jjmm.46.87.
To research the current status of Trichophyton tonsurans infection in Tohoku District, I sent out a questionnaire to the main dermatology clinics in the Tohoku district. The results showed this infection was found first in spring, 2001 in Miyagi prefecture, and gradually spread from southern to northern districts; the total number of patients is now 162. The number in each prefecture is as follows: Yamagata; 88, Miyagi; 68, Akita; 4, Aomori; 2. In Iwate and Fukushima, however, no cases were reported. By age distribution high school students accounted for 117 (75%), elder patients for 29 (19%), lower age children only 10, and 6 cases were uncertain. Judo players accounted for 113 (70%) and wrestlers for 39 (24%). Family infections were found in two cases. Latent infections were found in several cases, and in one case the infection continued for 2.5 years without clinical symptoms. In my clinic 30 cases were observed beginning in 2001: high school boys accounted for 11, students of a professional school 14, college student 1, adults 3, and those involved in judo 27, wrestling 2 and mixed grappling sports 2. A family infection between a father and his daughter was found. According to the observations in our cases, this fungus easily invaded the hair roots from the early stage of infection, but was not noticed by common external clinical observations. Thus, microscopic examinations are necessary throughout the therapeutic process and to make certain of a complete cure. I think also necessary is the systemic administration of terbinafine or itraconazole for 4 or 6 weeks or more even for tinea corporis. Additionally, I emphasize that culture study is indispensable to confirm the infection by this fungi.
为研究东北地区须发癣菌感染的现状，我向东北地区主要皮肤科诊所发放了调查问卷。结果显示，该感染于2001年春季在宫城县首次发现，并从南部地区逐渐蔓延至北部地区；目前患者总数为162人。各府县的患者人数如下：山形县88人；宫城县68人；秋田县4人；青森县2人。然而，岩手县和福岛县未报告病例。按年龄分布，高中生占117人（75%），老年患者占29人（19%），低龄儿童仅10人，6例情况不明。柔道运动员占113人（70%），摔跤运动员占39人（24%）。发现2例家庭感染病例。发现数例潜伏感染病例，其中1例感染持续2.5年且无临床症状。自2001年起，在我的诊所观察到30例病例：高中男生11人，职业学校学生14人，大学生1人，成年人3人，从事柔道运动的27人，摔跤运动的2人，综合格斗运动的2人。发现1例父亲与女儿之间的家庭感染病例。根据我们病例中的观察结果，这种真菌在感染早期很容易侵入发根，但普通的外部临床观察不易察觉。因此，在整个治疗过程中进行显微镜检查并确保完全治愈是必要的。我还认为，即使是体癣，全身性给予特比萘芬或伊曲康唑4周或6周以上也是必要的。此外，我强调培养研究对于确认这种真菌的感染是不可或缺的。
