Chia Charles, Dahl Mark V
Department of Dermatology, Mayo Clinic, Scottsdale, Arizona 85259, USA.
Cutis. 2013 Feb;91(2):73-7.
Erosive pustular dermatosis of the scalp typically occurs in elderly patients; a diagnosis of fungal kerion infection in this patient population may seem unlikely. We present 3 elderly patients who developed pustular eruptions on the scalp that were suggestive of erosive pustular dermatosis. Culture and/or biopsy findings initially excluded kerion fungal infections. Later, cultures isolated Trichophyton species from 1 patient and Microsporum species from 2 patients, and the correct diagnosis of kerion was made. All patients were treated successfully with oral terbinafine hydrochloride. Fungal infection can be suspected in some elderly patients with erosive pustular dermatoses of the scalp. Repeated cultures and biopsies of hair-bearing skin, scale, and cut hair samples may be required to establish the correct diagnosis of kerion.
头皮糜烂性脓疱性皮肤病通常发生于老年患者；在这一患者群体中诊断为真菌性脓癣感染似乎不太可能。我们报告了3例老年患者，他们头皮出现脓疱性皮疹，提示为头皮糜烂性脓疱性皮肤病。培养和/或活检结果最初排除了脓癣真菌感染。后来，从1例患者中分离出毛癣菌属，从2例患者中分离出小孢子菌属，从而做出了脓癣的正确诊断。所有患者口服盐酸特比萘芬治疗均成功。对于一些患有头皮糜烂性脓疱性皮肤病的老年患者，可能怀疑有真菌感染。可能需要对有毛发的皮肤、鳞屑和剪下的毛发样本反复进行培养和活检，以确立脓癣的正确诊断。
