Trichophytosis
Trichophytia is a mycotic lesion of smooth skin, nails and hair by fungi from the genus Trichophyton. Usually, trichophytia is characterized by the appearance of inflammatory foci with very clearly defined boundaries and characteristic peeling. As a rule, the affected hair becomes more fragile, often breaks off at the level of the skin and sticks out like stumps. Trichophytosis is very contagious. Deeply affected skin leads to deterioration of the patient’s condition, as well as to the formation of abscesses. With neglect, there remains a characteristic baldness at the site of hair loss.
The content of the article:
Features of the course of trichophytia
Sources of infection and pathogenesis of trichophytia
Clinical manifestations of trichophytia
Diagnosis of trichophytia
Treatment and prevention of trichophytia
Trichophytosis
Trichophytia often occurs due to contact with an infected animal. Trichophytia is considered to be a purely fungal disease of a highly contagious form. Interestingly, the prevalence of this disease is the same in all age groups, but younger children and school-age children are diagnosed with trichophytia more often.
Features of the course of trichophytia
In the case of an infiltrative-suppurative form of trichophytia, downy hair is usually involved in the process, however, unlike long ones, they will not break off. The surface of the scalp when affected by trichophytia is very similar to honeycombs. Interestingly, the suppurative-infiltrative form of trichophytia is also visible in the area of the mustache and beard, while the affected skin looks like wine berries. After 10 days, the infiltrate will soften.
Suppurative forms of trichophytosis are usually accompanied by:
symptoms of intoxication with characteristic general weakness;
enlargement and tenderness of regional lymph nodes;
increased body temperature;
loss of appetite.
In the absence of treatment, such purulent forms of trichophytia can self-resolve, since developed suppuration is very detrimental to the mycelium of fungi, although mycotic cells will persist on the periphery and along the edge of the lesion, located in the scales. Sometimes suppurative forms of trichophytosis are complicated by abscesses.
Sources of infection and pathogenesis of trichophytia
The main source of infection is considered to be animals and people infected with trichophytia, as well as household items infected with them that have been seeded with fungus spores.
As is known, infection with zoophilic trichophytia occurs due to contact with a sick animal. Stray animals are a great danger. The risk of getting sick increases especially in the case of constant contact with an infected animal. This can happen on farms, in veterinary hospitals, and even if a person simply feeds a stray cat or dog.
In the case of a chronic sluggish form of trichophytia, which is often found among middle-aged women, the infection usually reaches all family members through a common comb, pillows and household items. Neglect of personal hygiene, regular contact with skin that is not protected — all this increases the likelihood of intra-family infection. After the penetration of the fungus spores on the skin or on the hair part of the head, the germination of these spores usually begins with the further formation of mycelium, which leads to further damage to the dermis and dermal appendages.
Clinical manifestations of trichophytia
Usually, the symptoms of trichophytia depend on the form of the disease, on the type of pathogen that caused it, and on the characteristics of the human body. It is known that infiltrative, superficial and infiltrative-suppurative forms, as a rule, represent the development of one pathological process that occurs sequentially. If adequate treatment is not available, the superficial form of trichophytia will turn into an infiltrative-suppurative form.
Superficial trichophytosis
If we talk about superficial trichophytosis, then it is observed on the hair surface of the head, as well as on smooth skin. Its external manifestations can be in the form of rounded lesions that are delimited from healthy skin. Usually the incubation period is a week, after that the first symptoms begin to appear, namely, the skin areas acquire a grayish-pink color, small spots have uneven outlines and peel off a little. In the lesions themselves, most of the hair is usually broken off. The latter can be both at the skin level and 3 mm from it. In the case of the disease of dark-haired people, dark dots, so-called hair stumps, are noticeable. It happens that on the surface affected by trichophytia, the hair is twisted or bent, and sometimes covered with a gray-white coating consisting of fungal spores. There are no symptoms such as itching or any other sensation of a subjective nature. Purulent nodules, blisters, crusts may be noted on the periphery. If we talk about such a characteristic symptom of trichophytia as bran-like peeling, then it most often manifests itself in the very center of the focus, and almost never occurs near the periphery. If there is no peeling or intense hair breaking, but characteristic hemp is inherent, it is necessary to immediately conduct an additional examination in order to exclude the diagnosis of trichophytia.
Chronic form
The chronic form of the superficial type of trichophytia can begin in childhood. Its distinguishing feature will be that it will not pass by puberty, despite the fact that it is caused by the same pathogen. The pathogenesis of the chronic form of trichophytia is based on a lack of vitamin A in the patient’s body, as well as endocrine disorders of the functions of the gonads and endocrine glands, and autonomic nervous disorders (for example, vegetative-vascular dystonia) — all this reduces the protective functions of the body. Usually, lesions are localized in the temporal or occipital part of the head, where small-focal (or diffuse) peeling occurs.
Manifestations on the hair
There are areas with broken hair, and with prolonged trichophytia, areas of skin atrophy with the presence of small scars appear. It is not so often that scales on the scalp can be noticeable, which are usually with a lilac tinge in color. They are almost unremarkable, as are the black dots from broken hair, which can only be detected by carefully examining them.
What does the skin look like
Smooth skin in its texture, which is affected by chronic trichophytia, is usually represented by a bluish color with the presence of gray and thin scales. Often the skin is affected in the buttocks, as well as on the inner surface of the thighs, elbows and forearms. There are affected areas on the upper part of the trunk, but much less often, and the spread of trichophytia over the entire surface of the body is very rare. The pattern on the skin is usually pronounced, there may be a thickening of the stratum corneum of the skin. The latter leads to the appearance of furrows on the feet and palms, namely in the place of skin folds. Such furrows will eventually become cracks. In the case of damage to the palms and feet, the formation of blisters has never been encountered. Nodules, blisters and crusts for the chronic type of trichophytia will also not be characteristic.
If the nails are affected
It very rarely happens that trichophytosis passes to the nails. In those cases of infection with nail trichophytia, the infection proceeds without damage to the nearby skin. With nail trichophytosis, thickening of the nails occurs, which also become bumpy, rough to the touch. On the side of the free edge of the nail, spots and streaks of grayish-white color are noticeable. The plate located above the nail is usually not inflamed, and there is no itching.
Infiltrative-suppurative form
If we talk about the infiltrative-suppurative form of trichophytia, then it is caused by a zoophilic type of fungus. This form is most common among residents and workers of rural areas. Its main symptom is a protruding infiltrate above the surface of the skin, which appears on the scalp. Such an infiltrate has a bluish-red color, and the diameter of the manifestation is no more than 7-8 cm. If there are several infiltrates, then at the time of fusion they form an extensive purulent conglomerate of various forms.
Inflammation is most often characterized by clear boundaries. It often does not spread to the adjacent surface of the skin. The focus of inflammation is characterized by an oval or round shape. The surface of such an infiltrate of trichophytia can often be covered with ulcers, around which a roller consisting of small bubbles, dried crusts and plaques is noticeable.
After a certain time, a pustule may form around each hair. After it is finally formed, the hair growing in the lesion begins to loosen and fall out. When pressing on the expanded hair follicles or with normal pressure, droplets, and sometimes pus, may be released. It should be noted that the area of the skin affected by trichophytia will be very sore when touched.
Diagnosis of trichophytia
Usually, a dermatologist is able to diagnose on the basis of the presented clinic and the characteristics of the patient’s vital activity (in contact with animals, with an outbreak of trichophytia in kindergarten or school). If necessary, a patient with trichophytia can be referred to a mycologist. During microscopic examination of the scraping, mycotic cells and mycelium can be detected, noticeably overgrown. Differential diagnosis is carried out if necessary to distinguish trichophytia from another similar disease. If an atypical case is observed, the doctor should send the patient for multiple diagnostic procedures.
Treatment and prevention of trichophytia
Treatment of trichophytia will depend on the type of disease. If possible, it is better to limit the use of local drugs. In the treatment of trichophytia with smooth skin (without downy hair involved in the process of inflammation), a number of antifungal ointments and solutions containing iodine should be used to treat the skin. For example, in the morning, it is recommended to lubricate the affected areas with an iodine solution, and in the evening — to make an application using Exoderyl, Lamisil and Microspore ointments. With a more pronounced severity of inflammatory processes in the framework of local treatment, the use of combined drugs containing hormones is indicated.
Trichophytia of smooth skin can also be characterized by the presence of a significant number of foci, in the development of which downy hair can be involved. In this case, in addition to local therapy, a course of treatment is prescribed, prescribing antifungal drugs used orally (for example, Itrazil and Irunin, as well as triazole derivatives). Dermatologists strongly recommend cutting hair in lesions.
If we talk about the treatment of infiltrative-suppurative forms of trichophytia, then in addition to the use of systemic drugs and local antifungal therapies, therapy of suppurated infiltrate is prescribed, in which the crusts soften after using salicylic ointment or potassium permanganate solution. After the crusts soften, they are carefully eliminated. At the stage of infiltration resolution, absorbable ointments are prescribed (Vishnevsky liniment or Ichthyol ointment).
Preventive measures
The best prevention of trichophytia will be the timely detection of the focus of the disease, while isolation of patients will be mandatory, as well as quarantine of contact persons. Conducting systematic examinations in kindergartens and primary schools will help identify patients with trichophytia, preventing the spread of infection.
It is important to avoid contact with stray cats and dogs, examine pets, especially those that come into contact with wild ones — all this will help reduce the risk of infiltrative-suppurative forms of this disease.