Trichophytia (cutting deprive) – mycotic damage of smooth skin, a hair, nails sort Trichophyton fungi. It is characterized by formation of the inflammatory centers with a clear boundary, a peeling. The affected hair become fragile, break off over the level of skin and stick out in the form of penk. The disease is highly infectious. Deep damages of skin lead to deterioration in the general state, formation of abscesses. Treatment is carried out by protivomikotichesky means which are appointed locally and inside. In the started cases there can be persistent baldness on the place of hair.
The trichophytia is the mikotichesky disease of skin and its appendages caused by a fungus from the sort Trichophyton, can be antropofilny when a source of an infection is the person and zoofilny – this form of a trichophytia arises at contact with the infected animals. The trichophytia is a vysokontagiozny fungal disease, incidence in all age groups is approximately identical, but for children of younger and school age the trichophytia is diagnosed more often.
Sources of infection and pathogenesis of a trichophytia
Source of an infection are people, animals sick with a trichophytia and objects of use, obsemenenny mushroom disputes. Infection with a zoofilny trichophytia happens owing to contacts with sick animals, special danger is constituted by homeless animals. The risk to ache increases at continuous contact with animals – on livestock farms, in veterinary clinics and at a podkarmlivaniye of stray dogs and cats.
At chronic slow forms of a trichophytia that especially often occurs at women of middle age, the infection affects all family members through use of the general hairbrushes, pillows and objects of use. Such factors as density, neglect rules of personal hygiene and frequent contacts with the unprotected skin increase probability of intra family infection. After hit the mushroom dispute on skin or a hairy part of the head, begins their germination with formation of a mycelium that leads to further defeat both terms, and its appendages.
Clinical displays of a trichophytia
The symptomatology of a trichophytia depends on a form of a disease, type of the activator and features of an organism of the patient though superficial, infiltrative and infiltrative forms represent consecutive development of one pathological process. And in the absence of adequate treatment the superficial form of a trichophytia can pass into an infiltrative nagnoitelnuyu.
The superficial trichophytia meets on a hairy part of the head and on smooth skin, is externally shown by the roundish centers of defeat sharply limited from healthy skin. The incubatory period about a week then clinical manifestations – sites of skin of grayish-pink color of the small sizes with uneven outlines and an insignificant peeling begin. In the defeat centers the most part of hair is broken off at the level of skin or on 2-3 mm from it if head hair dark, then it is possible to see dark points – hemp of hair. Sometimes hair on the site affected with a trichophytia twist and bent, in certain cases hair are covered with a grayish-white raid which consists from a fungus dispute. The itch and any other subjective feelings are absent. On the periphery bubbles, purulent small knots and crusts in the form of a border are noted. The Otrubevidny peeling the most intensive in the center of the center, is closer to the periphery practically is not observed. If there is neither peeling, nor an intensive oblamyvaniye of hair, but are available characteristic of a hemp trichophytia, then it is necessary to conduct additional examination for an exception or confirmation of the diagnosis "Trichophytia".
Chronic forms of a superficial trichophytia begin in the childhood and its difference that it does not pass by the puberty period though is caused by the same activator. In pathogenesis of a chronic trichophytia the lack of vitamin A of an organism, endocrine violations of functions of gonads and other endocrine glands and vegetative nervous breakdowns (vegeto-vascular dystonia) which reduce protective reactions of an organism lies. The centers of defeat are localized in occipital and temporal zones of the head, there is a melkoochagovy or diffusion peeling. Sites with the broken-off hair are noted, at it is long the current trichophytia sites of an atrophy of skin with small gentle scars appear. Sometimes hardly noticeable scales on head skin which color gets a lilacky shade are practically not noticeable, black points from the broken-off hair are found only at attentive survey too.
The smooth skin affected with a chronic trichophytia cyanotic with existence of gray thin scales. Most often skin in buttocks, the internal surface of hips, forearms and elbows is surprised, on a face and on the top part of a trunk the trichophytia meets less often, universal spread of a trichophytia on a body is observed in isolated cases. The skin drawing is pronounced, the thickening of a horn layer of skin is possible because of what on palms and soles furrows in places of skin folds appear, furrows will be transformed to cracks over time. At defeats the trichophytia of palms and soles never forms bubbles. Bubbles, crusts and small knots are not characteristic of a chronic trichophytia too.
Sometimes the infection passes to nails though the trichophytia of nails can proceed also without damage of skin. Nails are thickened, become hilly, rough to the touch, at free edge of a nail it is possible to notice grayish-white spots and strips. The Nadnogtevy plate is not inflamed, the itch and unpleasant feelings are absent.
Infiltrative forms of a trichophytia are caused by zoofilny type of a fungus, such forms of a disease meet at the people living in rural areas more often. On a hairy part of the head the speaker over skin level infiltrate of cyanotic-red color in the diameter up to 8 cm appears if it is several infiltrates, then at merge they form an extensive purulent conglomerate of bizzare shapes. At the same time the inflammation has a clear boundary and does not extend to the neighboring sites of skin, the center of an inflammation of usually round or oval form.
The surface of infiltrate of a trichophytia izjyazvlyatsya often. Around it there is a roller consisting of plaques, small bubbles and the shrunk crusts. After a while around each hair the pustula after which final formation, hair in the center of defeat are loosened is formed and begin to drop out. From expanded hair follicles when pressing or casual pressing droplets, and at times and pus streams, the site affected with a trichophytia very painful are allocated at a touch. At an infiltrative nagnoitelnoy to a trichophytia form pushkovy hair also are involved in process, but they unlike long hair do not break off. The surface of head skin at a trichophytia is similar to honey honeycombs and if the nagnoitelno-infiltrative form of a trichophytia is observed in a beard and moustaches, then affected areas remind figs. In 7-10 days infiltrate begins to be softened.
Nagnoitelny forms of a trichophytia can be followed by intoxication symptoms: the general weakness, the increased body temperature, increase and morbidity of regionarny lymph nodes, appetite loss. In the absence of treatment nagnoitelny forms of trichophytias self-resolve as the developed suppuration is pernicious for a mycelium of mushrooms, but mikotichesky cages remain on the periphery and in scales on edge of the center of defeat. In certain cases nagnoitelny forms of a trichophytia are complicated by abscesses.
Diagnosis of a trichophytia
The dermatologist makes the diagnosis on the basis of clinical manifestations and features of activity of the patient (contact with animals, the outbreak of a trichophytia in kindergarten). If necessary the patient with a trichophytia can be directed to the mycologist. At a microscopic research of scrape on mushrooms mikotichesky cages and the expanded mycelium are found. If it is necessary to carry out the differential diagnosis, then conduct a cultural research with identification of the activator. At atypical cases of a trichophytia numerous holding diagnostic procedures is necessary.
Treatment and prevention of a trichophytia
Medical tactics depends on type of a trichophytia and if there is such opportunity, then it is necessary to be limited only to local medicines.
At treatment of a trichophytia of smooth skin without involvement in process of pushkovy hair it is expedient to apply alternation of antifungal ointments and iodinated solutions to processing of skin. So, in the morning affected areas grease with iodine solution, and do application with the ointments containing , , in the evening. If the inflammatory phenomena from skin are expressed more considerably, then at local treatment of trichophytias the combined gormonosoderzhashchy medicines are shown.
If the trichophytia of smooth skin has a large number of the centers and pushkovy hair are involved in process, then besides local therapy course treatment by reception of anti-fungal medicines in inside, for example, an itrakonazol, a flukonazol and other derivatives of triazole is shown. Hair in the centers of defeat are recommended to be shaved off or sheared. Infiltrative forms of trichophytias besides reception of system medicine and local antifungal therapy, demand also therapy of the suppurated infiltrate, crusts soften salicylic ointment or solution of permanganate of potassium then accurately remove, at a stage of permission of infiltrate rassasyvayushchy ointments, such as ikhtiolovy and a liniment according to Vishnevsky are shown.
Prevention of a trichophytia consists in timely identification of the centers of a disease with isolation of patients and a quarantine of contact persons. Systematic surveys in kindergartens allow to reveal children sick with a trichophytia and not to allow spread of an infection. Avoiding of contact with homeless animals, survey of pets including those which do not contact to wild reduce risk infiltrative trichophytia forms.