KMID : 0363220190570040182
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Korean Journal of Dermatology 2019 Volume.57 No. 4 p.182 ~ p.190
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A Descriptive Review of Kerion and Non-inflammatory Tinea Capitis
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Kim Soo-Min
Kim Young-Ah Cho Nam-Joon
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Abstract
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Background: Tinea capitis manifests either as a non-inflammatory or inflammatory type including kerion, which may cause permanent alopecia. In addition to antifungals, systemic corticosteroids (prednisolone at 1¡2 mg/kg/day) have been used to reduce inflammation in patients with kerion.
Objective: We studied the clinical and laboratory features, treatments, and prognosis of tinea capitis.
Methods: We performed a retrospective review of 12 cases of kerion and 12 cases of non-inflammatory tinea capitis (median age, 8 years; range, 3 months¡80 years) diagnosed using a potassium hydroxide mount at the National Health Insurance Service Ilsan Hospital between November 2011 and April 2018.
Results: Fungal cultures showed Microsporum species in 6 cases and Trichophyton species in 1 case. The duration of diseases and extent of lesions were greater in the kerion group than in the non-inflammatory tinea capitis group (p£¼0.05). Sixteen patients were treated with systemic antifungals. In the kerion group, 10 patients were treated with systemic antifungals (6 with itraconazole [median, 26 days; range, 21¡58 days] and 4 with terbinafine [median, 24.5 days; range, 13¡31 days]). The median intervals between the onset of treatment and scalp clearing (in 10 cases), the onset of new hair growth (in 9 cases), and complete regrowth of hair (in 7 cases) were 27 (range, 13¡ 77), 33 (range, 19¡63), and 89 (range, 42¡180) days, respectively, in the kerion group. The median dosage of prednisolone used in patients with kerion was 0.26 mg/kg/day (range, 0.15¡0.42) with good clinical response.
Conclusion: The patients with kerion responded well to antifungal treatments. A lower dose of prednisolone was adequate when systemic corticosteroids were required for the treatment of kerion.
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KEYWORD
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Kerion celsi, Microsporum, Prednisolone, Tinea capitis, Trichophyton
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