Alameen Albraa Babiker Mohammed, Elamin Anas Babiker Mohammed, Imamaldin Mohammedalmujtaba Gamar Abdallah, Elhassan Mohammed
Faculty of Medicine, Omdurman Islamic University, Khartoum, Sudan.
Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
Ann Med Surg (Lond). 2025 Aug 5;87(9):6181-6185. doi: 10.1097/MS9.0000000000003660. eCollection 2025 Sep.
Systemic juvenile idiopathic arthritis (SJIA) is a unique subtype of juvenile idiopathic arthritis (JIA) with very special clinical manifestations, complications, and management options. The simultaneous presentation of tinea capitis and eosinophilia has not been reported in the context of Systemic Juvenile Idiopathic Arthritis before.
A 5-year-old Sudanese boy presented with fever and bilateral ankle arthritis in a background of extensive scalp lesions, which were scaly, itchy, and associated with hair loss. On examination: his weight was on the fifth percentile. There was cervical lymphadenopathy, hepatomegaly, and signs of bilateral ankle arthritis. Complete blood counts revealed leucocytosis, thrombocytosis, mild eosinophilia, and microcytic hypochromic anemia. Anti-dsDNA was positive with equivocal ANA profile, CRP was 34.4 mg/l, and LDH was very high. The patient received antibiotics, systemic antifungal, corticosteroids, hydroxychloroquine for which he achieved good results.
These results support the diagnosis of SJIA in a background of a tinea capitis with mild eosinophilia. Several case reports described extensive dermatophytosis in the background of other autoimmune diseases. The etiology of the eosinophilia was mysterious.
Physicians should be alert to the presentation of systemic JIA. The association between SJIA, tinea capitis, and eosinophilia remained largely mysterious, and multicenter studies are needed to explore this further.
全身型幼年特发性关节炎（SJIA）是幼年特发性关节炎（JIA）的一种独特亚型，具有非常特殊的临床表现、并发症及治疗选择。此前，在全身型幼年特发性关节炎的背景下，头癣和嗜酸性粒细胞增多同时出现的情况尚未见报道。
一名5岁苏丹男孩，在广泛头皮病变的背景下出现发热及双侧踝关节关节炎，头皮病变表现为鳞屑状、瘙痒且伴有脱发。检查发现：其体重处于第五百分位。存在颈部淋巴结肿大、肝肿大及双侧踝关节关节炎体征。全血细胞计数显示白细胞增多、血小板增多、轻度嗜酸性粒细胞增多及小细胞低色素性贫血。抗双链DNA阳性，抗核抗体谱不明确，C反应蛋白为34.4mg/L，乳酸脱氢酶非常高。该患者接受了抗生素、全身性抗真菌药、糖皮质激素及羟氯喹治疗，取得了良好效果。
这些结果支持在伴有轻度嗜酸性粒细胞增多的头癣背景下诊断为SJIA。几例病例报告描述了在其他自身免疫性疾病背景下的广泛皮肤癣菌病。嗜酸性粒细胞增多的病因不明。
医生应警惕全身型JIA的表现。SJIA、头癣和嗜酸性粒细胞增多之间的关联在很大程度上仍不明确，需要多中心研究进一步探索。
