Jahič Andraž, Stanič Jan, Tomazin Rok, Dolenc Voljč Mateja
Department of Dermatovenereology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Case Rep Dermatol. 2025 Jul 4;17(1):304-310. doi: 10.1159/000547156. eCollection 2025 Jan-Dec.
Kerion celsi is a form of deep inflammatory tinea capitis, presenting with suppurative, tender plaque, often with pustules and purulent drainage. Tinea capitis is believed to be increasing in incidence worldwide. It mostly affects children and is most commonly caused by zoophilic dermatophytes. Globally, the most common transmission route is anthropophilic.
Here, we present a case of a 92-year-old female without associated chronic diseases, who lived alone in urban apartment and developed kerion in addition to having chronic untreated toenail onychomycosis and tinea pedis. Using PCR, we confirmed as the causative pathogen of toenail onychomycosis and kerion, suspecting autoinoculation pattern of transmission of dermatophytes from feet to the scalp. With the literature review, we discovered sporadic case reports, linking toenail onychomycosis caused by to development of kerion and kerion-like lesions in adult patients.
Our case report: (1) adds another interesting case to series of rare cases of causing kerion in elderly, suspecting it is in fact more common than thought, (2) highlights PCR as a useful diagnostic tool for fast diagnosis and implementation of appropriate antifungal therapy, (3) recognizes a pattern of autoinoculation transmission of from toenail onychomycosis to the scalp, causing kerion celsi in elderly.
凯尔西脓癣是一种深部炎性头癣,表现为化脓性、压痛性斑块,常伴有脓疱和脓性分泌物。头癣在全球的发病率据信正在上升。它主要影响儿童,最常见的病因是亲动物性皮肤癣菌。在全球范围内,最常见的传播途径是亲人性的。
在此,我们报告一例92岁女性病例,该患者无相关慢性疾病,独居在城市公寓,除患有慢性未治疗的趾甲甲癣和足癣外,还患上了脓癣。通过聚合酶链反应(PCR),我们确认 为趾甲甲癣和脓癣的致病病原体,怀疑存在皮肤癣菌从足部至头皮的自体接种传播模式。通过文献回顾,我们发现了零星的病例报告,将由 引起的趾甲甲癣与成年患者的脓癣及脓癣样病变的发生联系起来。
我们的病例报告:(1)为一系列由 引起老年人脓癣的罕见病例增添了又一有趣病例,怀疑其实际比想象中更为常见;(2)强调了PCR作为一种有用的诊断工具,可用于快速诊断并实施适当的抗真菌治疗;(3)识别出了 从趾甲甲癣至头皮的自体接种传播模式,可在老年人中引起凯尔西脓癣。