Based on the different strains of fungi that infect the hair, ringworm is divided into three categories: yellow ringworm, white ringworm, and black ringworm.
Yellow ringworm:
Yellow ringworm caused by fungi, mostly occurring in rural China, mostly childhood onset, at first for the hair root redness, small pustules, pustules dry after the formation of yellow scabs, single yellow scab-like lesions can be fused with each other and become thicker, the edge of the slightly higher, the middle of the concave like a butterfly, the center of the part of the hairs through. There are many fungi in the yellow scab, which can destroy the hair follicles and form atrophic scars, and the hairs can not grow back. Yellow scab thick place is also easy to secondary bacterial infection, so that the local with rat urine odor, self-conscious itch. The heavy type of patient skin lesions can spread to more than half of the scalp.
White ringworm:
Mostly caused by woolly microsporidia or rust-colored microsporidia. Mostly occur in child care institutions, small schools and other children's collective units, currently due to the increase in the number of urban cats and dogs, so the seeds of pellagra ÷ Room Can sexual milk coy Langjie 3 tarsal harriers? The body of the Body clip rhymes with superbus job smack? The title of the school? An evil-doer? A male and female? What is the name of the body? What's your name? The hair is not as thick as it used to be. There are hair breaks around B5 centimeters. This may be related to the development of sebaceous glands during puberty and the inhibitory effect of free fatty acids from the scalp on the fungus. Healing does not leave scars.
Black ringworm:
Caused by purple trichophyton and hair breakage trichophyton. It can develop in children and adults.
Black ringworm is the least prevalent of the three types of ringworm of the head. At the beginning of the scalp for small dotted scaly patches, like white ringworm, often scattered in the distribution and easy to be neglected, no obvious fungal sheaths, and close to the skin surface broken hair, black dots, so the name of black ringworm. The course of the disease is long, slow progress, can be up to the adult does not heal, easy to identify with tinea versicolor. Both tinea versicolor and tinea nigra can be accompanied by pus ringworm, manifested as localized pus, swelling, elevated in the skin, ulceration, and the formation of scars after healing.
Clinical ringworm should pay attention to the head with pustular dermatosis, psoriasis, seborrheic dermatitis and other differentiation. If the diseased hair with 10% potassium hydroxide solution treatment, observed under the microscope visible fungal hyphae or spores, yellow ringworm and white ringworm in the filtered ultraviolet lamp can occur green fluorescence.
Prevention and control:
(1) patient clothes, hats, pillow towels should be sunlight, ironing, boiling disinfection; contaminated hairdressing tools should be brushed, washed, soaked; with the bacterial hair, scales, scabs should be burned; do not wear each other's hats, each other towels, etc..
(2) ashwagandha, served for four weeks, while using 5% sulfur ointment, 2% tincture of iodine or other antifungal drugs, 4 weeks after the bacterial negative, and there is a normal newborn hair grows, then you can stop the drug. Because ashwagandha has certain side effects, such as nausea, headache, photosensitive rash, occasional temporary decline in white blood cells, positive urine protein, some patients with liver function abnormalities, so pay attention to the time and dose of the drug.
(3) Ketoconazole is taken orally, because of some side effects on the liver, need to check liver function regularly.
(4) Manual hair pulling treatment: this therapy can be considered for small areas, where the diseased hair is pulled out with tweezers, followed by 2% iodine tincture.
[Principles of treatment] 1. internal antifungal drugs (preferred ashwagandha toxin); 2. external antifungal preparations; 3. shampooing twice a day, *** 8 weeks; 4. shaving once a week, *** 8 weeks; 5. disinfection of the patient's living utensils or contact with the goods.
How can ringworm of the head be prevented and treated?
Like other infectious diseases, the preventive and curative measures for ringworm of the head should include three aspects, i.e., elimination of the source of infection, cutting off the means of transmission and protection of susceptible persons.
(1) Eliminate the source of infection, i.e., cure all patients with tinea capitis and sick domestic animals, which is the most important. Ringworm of the head not only invades the scalp, but also invades the root of the hair follicle, so the treatment is more complicated than other ringworm.
①Hair pulling treatment If the scope of tinea capitis is very small, manual hair pulling treatment can be used, i.e., using flat-tipped tweezers in the lesion area along the direction of hair growth against the root. It should also remove all normal hair within 3mm around the lesion area to avoid the spread of the lesion. The area is then cleaned and coated with 2% iodine once a day. The hair should be pulled out once a week for 3 to 4 times, and the hair should be washed frequently, and 5% sulfur ointment should be applied once a week. If the lesion area is large, you can first use X-ray irradiation to make the hair loose and easy to pull out. However, this method must have a certain technical equipment, and is not suitable for all patients, has been rarely used.
②Polysporin comprehensive treatment, that is, internal polysporin, with external 2% iodine or 5% sulfur ointment, shampooing every day, every 1 to 2 weeks to cut the hair. This method is suitable for all types of tinea capitis, but should pay attention to the contraindications and side effects of drugs, pay attention to review liver function during the service. Ashwagandha pimaricin is taken at 10-20mg per kilogram of body weight per day for 15-20 days, depending on the severity of the disease, the dose size should be adjusted. For lesions smaller yellow ringworm and white ringworm, should also try to combine manual hair pulling treatment, which can reduce the amount of oral medication to avoid possible side effects.
(2) cut off the transmission path If a person with tinea capitis is found, appropriate isolation measures should be taken. For example, children suffering from ringworm should not go to kindergarten or elementary school for the time being, and then resume collective life after being completely cured. At home, they should also avoid infecting their family members or other children. At the same time, hats, turbans, pillowcases, clothes and quilts used by patients should be sterilized by sunlight and boiling water. Contaminated barber tools should also be thoroughly disinfected, can be boiled to disinfect, can also be placed in a closed container with formaldehyde gas fumigation. Bacterial hair, scales and scabs should be burned by fire.
(3)Protecting the susceptible For ringworm, every child is susceptible, so ringworm is often spread in kindergartens or small schools. Prevention of ringworm of the head is not by taking medicine, but by strengthening publicity and education, so that children develop good hygiene habits, and often check children's heads, and if you find a suspicious situation, you should go to the hospital in time for treatment.
The ringworm of the head is a disease caused by fungal infection of the skin and hair, including yellow ringworm, black ringworm, white ringworm and pus ringworm.
I, yellow ringworm (Tinea favosa)
Aetiology and pathogenesis
This disease is caused by Trichophyton xylostroboides infections of the hair, scalp, smooth skin, nails and so on. This disease was many in the past, especially in rural areas, after vigorous prevention and treatment, it is now very rare.
Clinical manifestations
This disease is mostly onset in childhood, the first hair root skin redness, followed by the issuance of a small pustule, after drying into a yellow scab. With the expansion of the rash and the yellow scabs are fused with each other, thickening, central depression, there are hairs through, the edge of the slightly high as a saucer, forced to remove the yellow scabs, under which is a bright red moist vesicles or ulcers, there are many fungi in the scabs, such as untimely treatment can be hair follicle destruction, and finally the formation of atrophic scars, atrophic baldness. In the fungal infection at the same time, often secondary bacterial infection. The damage has a ratty odor and is self-conscious and itchy.
Treatment
1. Hair pulling treatment
For the damage area within the size of a nickel, not more than 3 pieces, can be used to pull out the hair with flat-tipped tweezers, and then localized application of 2% iodine tincture, once a day. In the past, the use of X-ray hair pulling is applicable to a wider range of people, is now less used or not used.
2. Griseofulvin (Griseofulvin)
10-15mg/kg a day, divided into oral, for 4-6 weeks, shampooing once a day, local with 5% sulfur ointment, 2% tincture of iodine, 1% ketoconazole or econazole cream, haircut once every 1-2 weeks.
3, Ketoconazole (Ketoconazole)
Weighing 40kg later, 200mg per day orally: weighing 20-40kg, 100mg per day orally; low days 20kg, 50-70mg per day; even served for 3 weeks, while the local topical 10% sulfur cream, nightly coated with 2.5% tincture of iodine, even with a haircut once a week for 1-2 weeks. The first is to use a hair cut once every 1-2 weeks.
Second, white ringworm
Aetiology and pathogenesis
This disease is mainly caused by iron colored microsporidium, canine (wool-like) microsporidium, Audu ounce of microsporidium, skewed oblique shaped microsporidium and chickens and birds of microsporidium.
Clinical manifestations
At first, it is a limited white scaly patch on which the hair turns gray, and if left untreated, it gradually enlarges, with satellite-like small scaly patches appearing around it. The root of the hair has a white condyloma-like sheath, and the hair often breaks off at about 0.5 cm from the scalp.
Treatment
Reference to tinea pedis
Three, black ringworm (Tninea nigra)
Etiology and pathogenesis
This disease is caused by a group of Trichophyton rubrum genus of fungi, accounted for the ringworm of the scalp patients of about 7%.
Clinical manifestations
Scaly plaques with very mild inflammation appear on the scalp in the form of small dots, sometimes with black dots, and sometimes with high breakage of hair with white condylomata. Chronic course.
Treatment
Poliofungin 10-20 mg/kg a day for 10-15 days. Wash hair daily and topically apply 2% tincture of iodine for 3-4 weeks.
Four, pustular ringworm (Kerion)
Aetiology and pathogenesis
Diseased parts of the scalp and hair follicles can often be pus in a piece or several pieces of red, swollen and bulging, cut and squeezed, a small amount of plasma or translucent pus can appear. Localized hair is very easy to pull out after the formation of scars, leaving permanent hair loss.
Treatment
Internal antibiotics and antifungal drugs, such as erythromycin, ashwagandha. Topically, 10% gentamycin ointment can be applied externally.
Chinese medicine method:
Internally: cypress 12g castor seed 15g chuanlian 9g bitter ginseng 12g honeysuckle 15g forsythia 12g violet dicotyledonin 15g wild chrysanthemum 18g dandelion 15g yungling 15g atractylodes 12g hemicrantha 10g
Externally: huang jing 15g lilac 15g hemicrantha 15g santolon 12g comfrey 15g
Topical: huang jing 15g lilac 15g hemicrantha 15g santolon 12g comfrey 15g