A. V. Zhuchkina

Kerion Celsi is an acute inflammatory reaction that develops in response to the penetration of dermatophytes into hair follicles and is accompanied by a secondary bacterial infection and a reaction of the lymph nodes. The incidence of kerion in mycosis of this localization can vary from 15% to 57%. Despite the widespread distribution of dermatophytes in the pediatric population, studies in the field of etiology and diagnostics of kerion Celsi are limited and contradictory. The aim of this study is to analyze to analyze the clinical and laboratory features of kerion Celsi caused by Trichophyton tonsurans. The article describes a case of kerion Celsi caused by the anthropophilic fungus T. tonsurans . The patient received complex treatment in the conditions of the daily dermatovenereology hospital of the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology of Moscow Health Department. The development of kerion Celsi was caused by incorrect long-term use of topical glucocorticosteroids, and was also delayed due to incorrect diagnostic tactics in the outpatient setting. During the laboratory examination of the pathological material obtained from the patient, the growth of the T. tonsurans culture was not obtained. The etiological diagnosis was made based on the results of direct microscopy and PCR. Direct microscopy of the hair revealed the location of the spores as endothrix . After hospitalization in the pediatric dermatovenereology department, the patient quickly responded to treatment with oral antimycotics and antibiotics. Kerion Celsi is a difficult-to-treat form of scalp mycosis that negatively affects the quality of life of the child and family. The international and domestic experience in diagnosing kerion Celsi demonstrated in the article indicates the need to refer children with rashes on the scalp to a dermatovenereologist for timely diagnosis of mycosis and prevention of serious complications.

Introduction. Microsporum canis (M. canis) is a zoophilic dermatophyte, causative agent of human and animal dermatophytosis. Scalp mycosis caused by M. canis, accompanied by involvement of a large area of the skin, rarely develops in adults due to physiological peculiarities caused by low pH and high concentration of polyunsaturated fatty acids in sebum. Epidemiological data on the incidence of mycosis in adults vary from 1.5 to 44% in different countries. Late treatment, diagnostic errors and the use of topical corticosteroids contribute to the dissemination of the process. Due to the widespread increase in the number of adult cases of microsporidia infection, the situation necessitates the need to increase awareness of the medical community.Aim. To analyse the clinical and laboratory features of M. canis infection in an adult patient.Results. This article describes a case of scalp mycosis with diffuse skin lesions caused by M. canis in an adult patient. Effective treatment was delayed for a year due to incorrect clinical and laboratory diagnosis. In Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology» during the laboratory examination ial the growth of M. canis culture was obtained. Direct microscopy revealed the location of spores as an ectothrix. Treatment with systemic itraconazole according to a continuous scheme gave a positive result within six weeks.Conclusion. Scalp mycosis with extensive involvement of the trunk and extremities caused by M. canis is clinically uncommon in adults in most regions, emphasising the difficulty in diagnosing widespread dermatophyte infection in this clinical example. In cases presenting with extensive erythema with scaling on the scalp and trunk, fungal infection should be excluded. Careful collection of epidemiological history including migration, animal contact and physical examination for broken hairs, luminescent diagnosis and mycological investigations are required.

Introduction. Mycosis of the scalp (Tinea capitis) is one of the most common infections localized on the scalp and occurs mainly in children. The frequency of purulent inflammatory type (Kerion celsii) is about 15% of all cases of of scalp mycosis. The causative agents are zoophilic dermatophyte fungi that cause skin mycoses in cattle, donkeys, dogs, goats, sheep and horses. Zoonotic infection Trichophyton verrucosum is reported ubiquitously, more frequently in Asia and the Middle East. Human infection occurs in rural areas where close contact with animals is more likely. The urgency of the problem is associated with the increasing number of cases of severe scalp mycosis caused by T. verrucosum.Aim. Analyse clinical and laboratory features of T. verrucosum infection.Results. The article describes two cases of mycosis of the scalp caused by T. verrucosum. Both patients received complex treatment in the inpatient department of the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology. Effective treatment was delayed due to incorrect clinical and laboratory diagnosis of the disease. After hospitalization in the pediatric dermatovenereology department, both patients quickly responded to treatment with oral antifungals. No growth of T. verrucosum culture was obtained during laboratory diagnostics of pathological material. Direct microscopy revealed an ectothrix-like arrangement of spores.Conclusions. Due to active migration and the popularity of tourism, dermatovenerologists in their daily practice must be prepared for an increase in infectious diseases. A properly collected anamnesis allowed specialists to establish the correct diagnosis of scalp mycosis caused by a zoophilic dermatophyte. In the given clinical examples, when the bacteriological method did not give a result, direct microscopy allowed to confirm the clinical diagnosis, identify the etiologic agent (T. verrucosum) and optimize the tactics of systemic and topical therapy.