백선종창 및 비염증성 두부백선의 임상적 연구 = A Descriptive Review of Kerion and Non-inflammatory Tinea Capitis

다국어 초록 (Multilingual Abstract)

Background: Tinea capitis manifests either as a non-inflammatory or inflammatory type including kerion, which may cause permanent alopecia. In addition to antifungals, systemic corticosteroids (prednisolone at 1∼2 mg/kg/day) have been used to reduce inflammation in patients with kerion.
Objective: We studied the clinical and laboratory features, treatments, and prognosis of tinea capitis.
Methods: We performed a retrospective review of 12 cases of kerion and 12 cases of non-inflammatory tinea capitis (median age, 8 years; range, 3 months∼80 years) diagnosed using a potassium hydroxide mount at the National Health Insurance Service Ilsan Hospital between November 2011 and April 2018.
Results: Fungal cultures showed Microsporum species in 6 cases and Trichophyton species in 1 case. The duration of diseases and extent of lesions were greater in the kerion group than in the non-inflammatory tinea capitis group (p＜0.05). Sixteen patients were treated with systemic antifungals. In the kerion group, 10 patients were treated with systemic antifungals (6 with itraconazole [median, 26 days; range, 21∼58 days] and 4 with terbinafine [median, 24.5 days; range, 13∼31 days]). The median intervals between the onset of treatment and scalp clearing (in 10 cases), the onset of new hair growth (in 9 cases), and complete regrowth of hair (in 7 cases) were 27 (range, 13∼ 77), 33 (range, 19∼63), and 89 (range, 42∼180) days, respectively, in the kerion group. The median dosage of prednisolone used in patients with kerion was 0.26 mg/kg/day (range, 0.15∼0.42) with good clinical response.
Conclusion: The patients with kerion responded well to antifungal treatments. A lower dose of prednisolone was adequate when systemic corticosteroids were required for the treatment of kerion. (Korean J Dermatol 2019;57(4): 182∼190)

참고문헌 (Reference)

1 김기홍, "우리나라에서 시대적 및 사회적 변화에 따른 백선환자의 임상양상의 변화와 원인균의 변천" 대한의진균학회 11 (11): 1-12, 2006

2 김상민, "두부백선의 임상 및 진균학적 고찰" 대한의진균학회 11 (11): 184-190, 2006

3 Asawanonda P, "Wood’s light in dermatology" 38 : 801-807, 1999

4 Zampella JG, "Tinea in tots : cases and literature review of oral antifungal treatment of tinea capitis in children under 2 years of age" 183 : 12-18, 2017

5 Oh SH, "Tinea capitis of adults in Taegu city for 11 years(1978-1988)" 27 : 666-679, 1989

6 Miletta NR, "Tinea capitis mimicking dissecting cellulitis of the scalp : a histopathologic pitfall when evaluating alopecia in the post-pubertal patient" 41 : 2-4, 2014

7 Shastry J, "Tinea capitis mimicking dissecting cellulitis in three children" 35 : e79-83, 2018

8 Gilaberte Y, "Tinea capitis in infants in their first year of life" 151 : 886-890, 2004

9 Gupta AK, "Tinea capitis in children : a systematic review of management" 32 : 2264-2274, 2018

10 Fremerey C, "Tinea capitis in a newborn" 378 : 2022-, 2018

11 Lee KH, "The use of antifungal agents in the treatment of dermatophytoses in childhood" 6 : 135-139, 2001

12 John AM, "The kerion : an angry tinea capitis" 57 : 3-9, 2018

13 Chen X, "Systemic antifungal therapy for tinea capitis in children : an abridged Cochrane review" 76 : 368-374, 2017

14 Liu ZH, "Successful treatment of severe kerion celsi in an immunocompromised girl with evacuation of pus, terbinafine and short course glucocorticosteroids" 26 : 42-45, 2016

15 Ginsburg CM, "Randomized controlled trial of intralesional corticosteroid and griseofulvin vs. griseofulvin alone for treatment of kerion" 6 : 1084-1087, 1987

16 Boven TF, "Permanent hair loss after kerion celsi" 153 : 3151-3152, 1991

17 장석환, "Microsporum canis 에 의한 피부진균증의 임상적 연구" 대한의진균학회 19 (19): 39-44, 2014

18 Caplan RM, "Medical uses of the Wood’s lamp" 202 : 1035-1038, 1967

19 Lapergola G, "Kerion celsi caused by Trichophyton tonsurans in a child" 18 : 812-, 2018

20 Aste N, "Kerion celsi : a clinical epidemiological study" 41 : 169-173, 1998

21 Gupta AK, "Itraconazole is effective in the treatment of tinea capitis caused by Microsporum canis" 18 : 519-522, 2001

22 Isa-Isa R, "Inflammatory tinea capitis : kerion, dermatophytic granuloma, and mycetoma" 28 : 133-136, 2010

23 Zaraa I, "Inflammatory tinea capitis : a 12-year study and a review of the literature" 56 : 110-116, 2013

24 천상진, "Epidemiology and Identification of Organisms Causing Superficial Dermatomycoses at Tertiary Hospitals in Korea: A Prospective Multicenter Study" 대한의진균학회 23 (23): 45-53, 2018

25 Admani S, "Cutaneous infectious diseases : kids are not just little people" 33 : 657-671, 2015

26 Chun IK, "Clinical and mycological studies of tinea capitis in Chonnam area(1986-1995)" 1 : 83-89, 1996

27 Shin DH, "Clinical and mycologic studies of tinea capitis in Taegu" 3 : 132-138, 1998

28 권오성, "Clinical Burden of Primarily Misdiagnosed Tinea capitis: A Comparative Statistical Analysis" 대한의진균학회 22 (22): 149-158, 2017

29 Fuller LC, "British association of dermatologists’guidelines for the management of tinea capitis 2014" 171 : 454-463, 2014

30 Keipert JA, "Beneficial effect of corticosteroid therapy in Microsporum canis kerion" 25 : 127-130, 1984

31 Tan CW, "A review of tinea capitis in a cohort of Asian children" 47 : 156-158, 2018

32 Proudfoot LE, "A retrospective study of the management of pediatric kerion in Trichophyton tonsurans infection" 28 : 655-657, 2011

33 Hussain I, "A randomized, comparative trial of treatment of kerion celsi with griseofulvin plus oral prednisolone vs. griseofulvin alone" 37 : 97-99, 1999

34 Cho YS, "A case of kerion celsi due to Microsporum canis in an aged women" 24 : 844-847, 1986

35 Klatte JL, "100 years of Wood’s lamp revised" 29 : 842-847, 2015