Microsporia is a fungal disease of the skin and hair.
Mostly children are ill. There are anthroponotic and zooanthroponotic microsporia. Anthroponotic microsporia in our country is very rare.
Pathogens – anthropophilic microsporums (Microsporon fen-ugineum) – affect the horny epidermis and hair; are highly contagious. The source is a sick person. Ways of transmission – direct and indirect (through hats, brushes, combs, clothes, toys and other items).
Zooanthroponotic microsporia is a common mycosis. Pathogens – zoophilic microsporums (in our country M. canis) – affect the stratum corneum and hair; in terms of contagiousness they are inferior to anthropophilic ones. Sources – cats (especially kittens), less often dogs. Ways of transmission – direct (main) and indirect (through objects contaminated with hair or scales containing M. canis). Relatively infrequently, infection occurs from a sick person.
The clinical picture of microsporia
Manifestations of anthroponotic and zooanthroponotic microsporia are of the same type and similar to superficial trichophytosis, in contrast to which it is characterized by: clearer boundaries, rounded outlines, large lesions on the scalp; breaking off (traditionally continuous) hair at the level of 6-8 mm; the presence of whitish sheaths within the “stumps”; lack of black dots; on smooth skin – multiple foci; almost constant involvement of vellus hair, infrequent enlargement of behind-the-ear, occipital and cervical lymph nodes. Changes in the type of infiltrative-suppurative trichophytosis are possible.
The diagnosis of microsporia must always be confirmed by laboratory tests (microscopy, culture of affected hair or skin scales). Fluorescent diagnostics (examination under a Wood’s lamp) is important.
Prevention of microsporia
Isolation of sick babies; examination of all those in contact with the patient (including pets) using a Wood’s lamp; capture of homeless cats and dogs.
Treatment of microsporia
Treatment is similar to superficial trichophytosis.
It is carried out in the hospital and on an outpatient basis. If only smooth skin is affected, the lesions are lubricated in the morning with 2-20% iodine tincture and in the evening with 5-10% sulfur-salicylic ointment for several weeks, i.e. until the complete disappearance of lesions. If the scalp is affected, the hair in the foci is shaved once a week and the foci are lubricated in the morning with 2-5% alcohol solution of iodine, at night – 5% sulfur-salicylic or 5-10% sulfur-tar ointment. It is also recommended to wash your hair every other day with hot water and soap. At the same time, griseofulvin is administered orally in tablets at the rate of 22 mg per 1 kg of body every day (for 20-25 days). After receiving the first negative test for fungi, griseofulvin is prescribed every other day for 2 weeks, and then after 3 days for another 2 weeks until complete recovery. In babies with contraindications to griseofulvinotherapy, it is recommended to remove hair with a 4% aniline patch. Previously, the hair is shaved off, the plaster is applied in a thin layer on the foci. For children under 6 years of age, the patch is applied once for 15-18 days, and for older children – twice, changing the bandage after 8-10 days. Hair usually falls out after 21-24 days. Then fungicidal agents are prescribed. With infiltrative-suppurative trichophytosis, treatment begins with the removal of crusts present in the lesions, using dressings with 2% salicylic vaseline. Then the hair is manually epilated (removed) with tweezers both in the foci and 1 cm in their circumference. In the future, wet-drying dressings are prescribed from an OD% solution of ethacridine lactate, a 10% aqueous solution of ichthyol, or drilling fluid. After the elimination of acute inflammation, 10-15% sulfur-tar, 10% sulfur-salicylic ointment, Wilkinson’s ointment are used. This treatment can be combined with giving griseofulvin orally.