Yao Qi-Hao, Zhi Hui-Lin, Xia Xiu-Jiao, Liu Ze-Hu
Department of Dermatology, Hangzhou Third People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Zhejiang University School of Medicine, Hangzhou, China.
J Dermatol. 2025 Jan;52(1):35-42. doi: 10.1111/1346-8138.17523. Epub 2024 Nov 5.
Tinea capitis, a common public health problem in developing countries, has severe forms such as kerion. However, the underlying mechanisms and standard treatments for persistent cases of tinea capitis or kerion remain controversial. In this work, we investigate the ingrown hairs and corresponding treatment in persistent kerion of children. Children with persistent kerion were enrolled among 312 cases of tinea capitis at the Department of Dermatology, Hangzhou Third People's Hospital from January 2020 to June 2024. The presence of fungal infection was ascertained by direct microscopic examination under calcofluor white staining and routine culture. The structure of the ingrown hairs was observed directly by a dermatoscope, which was subsequently extracted using sterile tools. A total of six cases of persistent kerion among 312 cases of tinea capitis were enrolled. Ingrown hairs were ascertained under dermatoscopy and extracted by minor operation. Except for one patient who continued oral terbinafine, the other five cases were cured by removal alone. Ingrown hairs, induced by fungal infection, may be an aggravating factor of persistent course of tinea capitis. Our study demonstrated that the presence of ingrown hairs could be confirmed through direct dermatoscopy, and patients experienced significant improvement following removal treatment under dermatoscopy.
头癣是发展中国家常见的公共卫生问题，有诸如脓癣等严重形式。然而，头癣或脓癣持续病例的潜在机制和标准治疗方法仍存在争议。在这项研究中，我们调查了儿童持续性脓癣中的内生毛发及相应治疗方法。2020年1月至2024年6月期间，在杭州市第三人民医院皮肤科的312例头癣病例中纳入了患有持续性脓癣的儿童。通过荧光增白染色直接显微镜检查和常规培养确定真菌感染的存在。用皮肤镜直接观察内生毛发的结构，随后用无菌工具将其取出。在312例头癣病例中共纳入6例持续性脓癣。通过皮肤镜检查确定内生毛发并通过小手术取出。除1例患者继续口服特比萘芬外，其他5例仅通过切除治愈。真菌感染引起的内生毛发可能是头癣病程持续的一个加重因素。我们的研究表明，通过直接皮肤镜检查可以确认内生毛发的存在，并且患者在皮肤镜下切除治疗后有显著改善。
