Department of Dermatology, Chelsea and Westminster Hospital, Fulham Road, London, SW10 9NH, UK.
J Infect. 2017 Jun;74 Suppl 1:S54-S60. doi: 10.1016/S0163-4453(17)30192-5.
Tinea capitis is the most important superficial fungal condition in children. It is often unrecognised but the presence of alopecia, scale and lymphadenopathy, especially in inner-city children should prompt investigation. An understanding of changing epidemiology and prevalence of causative organisms is important in deciding appropriate therapy. The use of diagnostic aids including dermoscopy is increasing and is reported to be helpful in identifying subtle signs. Trichophyton tonsurans accounts for the majority of cases in the UK and terbinafine is increasingly advocated as a safe and effective therapy. Exclusion from school is unnecessary provided the child is receiving appropriate systemic and topical therapy, but family members should be screened and carriers should receive treatment. Steroids and surgical treatments should be avoided. Treatment failure is common and may be multifactorial. Mycological cure after completing treatment should be sought and therefore follow up is necessary for Tinea capitis cases. Development of molecular diagnostic methods may improve our ability to diagnose Tinea capitis accurately and quickly in the future. Emerging new dermatophytoses affecting other anatomical sites are discussed which, although not common in the UK, may be seen due to increasing travel worldwide.
头癣是儿童中最重要的浅部真菌病。它常常未被识别，但存在脱发、鳞屑和淋巴结病，特别是在城市内的儿童中，应提示进行调查。了解不断变化的流行病学和致病微生物的流行情况，对于决定适当的治疗方法很重要。诊断辅助工具的使用包括皮肤镜检查，正在增加，并据报道有助于识别细微的迹象。须癣毛癣菌在英国占大多数病例，特比萘芬越来越被提倡作为一种安全有效的治疗方法。只要儿童正在接受适当的全身和局部治疗，就无需将其从学校中排除，但应筛查家庭成员，并且应治疗携带者。应避免使用类固醇和手术治疗。治疗失败很常见，可能是多因素的。应寻求完成治疗后的真菌学治愈，因此对头癣病例需要进行随访。开发分子诊断方法可能会提高我们未来准确快速诊断头癣的能力。讨论了影响其他解剖部位的新兴新发皮肤真菌病，虽然在英国不常见，但由于全球旅行的增加，可能会看到。
