Azulay-Abulafia Luna, Giraldelli Gabriela, Alves Ana Luisa, Baka Jessica, Tavares Rodrigues Felipe
Dermatology Department, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Skin Appendage Disord. 2025 Apr;11(2):128-134. doi: 10.1159/000541672. Epub 2024 Oct 24.
Direct mycological examination and culture are the gold standard methods for diagnosing tinea capitis (Tc) despite 4-6 weeks of culture time. Meanwhile, specific trichoscopy patterns may be helpful in its diagnosis.
This retrospective, cross-sectional, observational study included 31 patients among 110 records from children with presumable clinical and trichoscopic Tc diagnosis, from two dermopediatrics centers, within 10 years. After trichoscopy, skin scraping from the patients was taken for direct mycological examination with 10% KOH and cultures in Sabouraud and Mycosel media; patients with positive cultures for and were selected. The association between the trichoscopic and etiological findings of Tc was statistically evaluated using Fisher's exact test.
Some trichoscopy findings, such as perifollicular desquamation and broken hair, were nonspecific to determine the Tc agent. The presence of Morse code (barcode-like) whitish sheath was more common in infection, even in the small number of patients of our sample. In contrast, comma hairs and black dots were more common in infection.
The trichoscopy findings suggest the pathophysiology of tinea infection according to the type of parasitism: ectothrix or endothrix and can be a useful tool where there are limited facilities.
尽管培养时间为4 - 6周，但直接真菌学检查和培养仍是诊断头癣（Tc）的金标准方法。同时，特定的皮肤镜检查模式可能有助于其诊断。
这项回顾性、横断面观察性研究纳入了来自两个儿童皮肤科中心10年内110份疑似临床和皮肤镜诊断为Tc的儿童记录中的31例患者。皮肤镜检查后，采集患者的皮肤刮屑，用10%氢氧化钾进行直接真菌学检查，并在沙氏培养基和含放线菌酮的培养基中培养；选择培养阳性的患者。使用Fisher精确检验对Tc的皮肤镜检查结果与病因学结果之间的关联进行统计学评估。
一些皮肤镜检查结果，如毛囊周围脱屑和断发，对于确定头癣病原体并无特异性。摩尔斯电码（条形码样）白色鞘在铁锈色小孢子菌感染中更为常见，即使在我们样本中的少数患者中也是如此。相比之下，逗号状发和黑点在紫色毛癣菌感染中更为常见。
皮肤镜检查结果根据寄生类型（外生性或内生性）提示头癣感染的病理生理学，并且在设施有限的情况下可能是一种有用的工具。
