We report the case of a 3yearold girl with a kerion celsi caused by m. A formerly health 11yearold boy was presented at the dermatology department with a 2month history of an inflammatory mass on the scalp after an injury. Are dermatophytid reactions in patients with kerion celsi. Both groups were treated with oral griseofulvin for 8 weeks. Kerion celsi is the result of a severe inflammatory reaction to tinea capitis infections. It produces a painful, inflammatory, crusted mass that can be associated with purulent discharge and regional lymphadenopathy. All inflammatory tc cases were caused by kerion celsi and there were no favus forms, a rare clinical presentation in the region studied. Significant changes in epidemiology, etiology, and the clinical pattern of mycotic infections caused by microsporum spp have been observed in recent years.
A case report article pdf available in cocuk sagligi ve hastaliklari dergisi 574. For language access assistance, contact the ncats public information officer. A retrospective study of the management of pediatric. Incision of kerion nodulesnot recommended tinea corporis tinea circinata affects the glabrous skin. Tinea capitis can range from noninflammatory scaling resembling seborrheic dermatitis to a severe pustular eruption with alopecia, known as a kerion celsi. The lesions occurred on the distal part of the forearm of four patients and in the breast area of one patient, most occurring during the spring months. Kerion celsi genetic and rare diseases information.
A case of kerion due to trichophyton mentagrophytes. Kerion is a severe hypersensitivity reaction to fungal infection that is rarely seen in the groin. The disease frequently occurs in children and is rare in adults. The disease is considered to be a form of superficial mycosis or dermatophytosis.
Kerion celsi produces a painful, inflammatory, crusty matted mass, often associated with purulent discharge and regional. Inflammatory tinea capitis is the result of a hypersensitivity reaction to a dermatophytic infection. Four of these were farmers, and one was a veterinarian. This case highlights the clinical course of a 20yearold bedouin woman who presented with severe kerion celsi. Kerion celsi is a severe inflammatory type of tinea capitis which is the result of a hypersensitivity reaction to the infection.
Tinea capitis is a common dermatophyte infection of the scalp in children. Besides the scalp, it may involve glabrous skin, hairy regions and nails. Erythema nodosum induced by kerion celsi of the scalp in a child. The usual forms are favus, kerion celsi, dermatophytic majocchi granuloma, and mycetoma. Kerion celsi caused by trichophyton verrucosum probably. Erythema nodosum en in association with kerion celsi is a rare condition in children, with only 11 cases having been reported in the english literature. Kerion celsi is a severe inflammatory form of tinea capitis that is characterised by a tcellmediated hypersensitivity reaction against. We describe three neonates with the diagnosis of kerion celsi. Avian and human influenza a viruses alike have shown a capacity to use the eye as a portal of entry and cause ocular disease in human beings. We present a case of highly inflammatory tinea capitis, also known as kerion celsi, caused by m. Kerion celsi is the inflammatory extreme of tinea capitis, representing a delayed hypersensitivity reaction to the causative dermatophyte. Childhood erythema nodosum associated with kerion celsi.
Epidemiologi tinea capitis primarily occurs in children, prepubertal. Kerion celsi is a hypersensitivity tlymphocyte mediated reaction to dermatophytes, especially microsporum canis, but also trichophyton verrucosum, trichophyton mentagrophyte and microsporum gypseum. The lesions had started as papulonodules, developed a boggy swelling studded with pustules and. Fungal infections caused by m canis, followed by m gypseum and m hominis, involving skin and its appendages, represent one of the most common diseases worldwide and a recalcitrant problem in dermatology that. Patients admitted to the dermatology clinic of van regional training and research hospital between november 22, 2012, and july 1, 20, diagnosed with kerion celsi were evaluated for dermatophytid reactions.
A 5yearold boy with a large kerion celsi before treatment. Shreberkhassidim r, ramot y, maly a, horev l, zlotogorski a. Kerion celsi produces a painful, inflammatory, crusty matted mass, often associated with purulent discharge and regional lymphadenopathy. Kerion celsi is rarely associated with microsporum audouinii infection. Report of three cases tinea capitis is a fungal infection caused by dermatophytes, frequent in children but uncommon in the neonatal period. Fungi identification was made by macro and microscopical colony morphology analyses and molecular genotypic studies. Favus or tinea favosa is the most severe form of tinea capitis. Canis common in children and immunocompromised adults clinical polymorphism tropics and. Kerion celsi due to microsporum canis with a dermatophytid reaction. In the treatment of kerion celsi, antifungal medicine can be used, but incision and drainage should be avoided. Pdf on jun 30, 2018, ismiralda oke putranti and others published severe. He had many inflamed, boggy, suppurative nodules over the left occipitoparietal area of the scalp and, 2 weeks later, developed multiple. He had many inflamed, boggy, suppurative nodules over the left occipitoparietal area of the scalp and, 2 weeks later. In europe, microsporum canis is the most common cause 80% of cases, although an increased number of cases caused by trichophyton spp particularly t tonsurans have been described since.
Kerion celsi caused by trichophyton tonsurans in a child. Pdf on jun 1, 2018, hidenori nakagawa and others published kerion and tinea capitis find, read and cite all the research you need on researchgate. It is characterized by tender, boggy nodular swelling with regional lymphadenopathy. If you have problems viewing pdf files, download the latest version of adobe reader for language access assistance, contact the ncats public information officer genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. Alopecia in a boy with nephrotic syndrome dermatology. Browse az genetic and rare diseases information center. Skin scrapings for mycological culture and swabs for bacteriological culture. The changing face of microsporum spp infections clinics. Tinea capitis is a disease caused by superficial fungal infection of the skin of the scalp, eyebrows, and eyelashes, with a propensity for attacking hair shafts and follicles see the image below. This clinical condition is often caused by gram positive bacteria e. Six girls 32% and boys 68% were included in this study.
Bougrinea,villeneuvetangc,bouffardd, rouleau d, chartier s 2014 kerion of the vulva caused by trichophyton mentagrophytes. Kerion celsi is the inflammatory manifestation of tinea capitis secondary to host immunologic responses and its occurrence in newborns is extremely infrequent. A healthy 3yearold boy presented to our emergency department with a 2week history of inflammatory scalp lesions. In reporting a case of kerion celsi in the scalp of an adult arch. A presumptive diagnosis of kerion celsi was made in our patient. Five patients had kerion celsi on the glabrous skin. Dermatophytid reactions were evaluated in patients diagnosed with kerion celsi. Pdf on jun 30, 2018, ismiralda oke putranti and others published severe kerion celsi effectively treated with skin debridement and antifungals find, read and cite all the research you need on. This is the fourth case to be reported in the american literature of kerion of the adult scalp and the sixteenth of either the kerionic or the superficial type of ringworm in which the diagnosis was proved by culture or. If you have problems viewing pdf files, download the latest version of adobe reader. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext.
The disorder presents as inflammatory erythematous plaques covered with crusts7. Fluctuating lesions or furuncles of the scalp occur frequently in dermatological practice. Severe kerion celsi effectively treated with skin debridement and. Fluctuating lesion of the scalp after a journey to the. Keratinophilic fungus an overview sciencedirect topics. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126. Pdf severe kerion celsi effectively treated with skin. Erythema nodosum regressed two weeks later and the kerion of the scalp regressed six weeks after starting the treatment, leaving residual scarring alopecia. Canis common in children and immunocompromised adults clinical polymorphism tropics and atypical forms. In addition to the traditional presentation of scaly, annular patches with hair loss, there are several inflammatory forms of tinea capitis, such as kerion celsi, which is an intense, localized hypersensitivity reaction to the presence of a dermatophyte. Pdf severe kerion celsi effectively treated with skin debridement. It is often seen with zoophilic ectothrix dermatophytes such as microsporum canis, but it is increasingly caused by endothrix infections such as t. Kerion celsi is the inflammatory, suppurative type of tinea capitis often seen in young african american individuals. Unlimited viewing of the articlechapter pdf and any associated supplements and figures.
However, whereas influenza viruses generally represent a respiratory pathogen and only occasionally cause ocular complications, the h7 virus subtype stands alone in possessing an ocular tropism. Physical examination revealed diffuse erythematous lesions, with focal areas of alopecia and several pustular patches with extensive suppurative discharge figures 1 and 2. Concerning clinical form, there were 19 83% cases of tonsurant tc and 4 17% cases of inflammatory tc. The patient was diagnosed as erythema nodosum probably induced by kerion celsi, that has not been reported in. Glucocorticoids are often recommended along with oral antifungals in the treatment of kerion celsi. Kerion celsi due to arthroderma incurvatum infection in a. Iwasawa, yaei togawa, fumi akita, naotomo kambe, hiroyuki matsue, takashi yaguchi, kazuko nishimura, kerion celsi due to arthroderma incurvatum infection in a sri lankan child.
Most cases of kerion celsi develop in schoolage children and delayed treatment usually results. Kerion celsi is a severe inflamed deep abscesses form of tinea capitis which mostly occurs in children population. Histopathologic findings include a spectrum from mild. In this randomized study, the efficacy of combination therapy with oral griseofulvin and oral prednisolone n 17 was compared to oral griseofulvin alone n in the treatment of kerion celsi. There might be pus discharge and sinus formation that mimics bacterial folliculitis or an abscess of the scalp. Kerion celsi caused by trichophyton tonsurans in a child the lancet. A kerion is a boggy violaceous inflammatory area of dermal suppuration and folliculitis. It usually appears as raised, spongy lesions, and typically occurs in children. Erythema nodosum induced by kerion celsi of the scalp in a. Kerion is the result of the hosts response to a fungal ringworm infection of the hair follicles of the scalp occasionally the beard that can be accompanied by secondary bacterial infections.
Inflammatory tinea capitis can be caused by microsporum canis, trichophyton mentagrophytes, t tonsurans, t rubrum, and m gypseum. Kerion celsi is a severe inflammatory form of tinea capitis that is characterised by a tcellmediated hypersensitivity reaction against dermatophyte fungi. Of the tonsurant forms, 14 74% were trichophytic 60% of total and 5 26% microsporic 23% of total. This honeycomb is a painful inflammatory reaction with deep suppurative lesions on the scalp. The clinical presentation ranges from a noninflammatory lesion to an inflammatory disease with erythematous scaly lesions with alopecia, that may progress to kerion celsi. View enhanced pdf access article on wiley online library html view download pdf for offline viewing. Frequent shaving of pubic hair and religious conservatism surrounding genital hygiene are common among bedouin women in the negev desert, and may predispose to kerion. Clinically, kerion celsi presents boggy inflammatory mass studded with broken hairs and follicular orifices oozing with pus. Pdf infections, infestations and neoplasms of the scalp. Some authors have advocated the use of oral corticosteroids in patients with kerion formation to inhibit the host inflammatory response and minimize the risk of scarring.
Cervical lymphadenopathy and fever were also noted. Kerion is characterized by an inflammatory welldelimited and painful plaque, with pustules and suppurative abscesses. Several synonyms are used, including ringworm of the scalp and. Kerion celsi is a type of tinea capitis often caused by the zoophilic dermatophyte microsporum canis 1,2.
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