How to cure microsporia. Microsporia: a contagious disease that requires treatment. How does microsporia become infected?

Microsporia is a common infectious disease caused by a microscopic fungus of the genus Microsporum. The high frequency of this disease is explained by the fact that the microorganism that causes it is extremely contagious and is found in fairly high concentrations in the soil, on some types of plants and animals.

Microsporia refers to dermatophytosis, that is, skin diseases, which can affect both smooth skin and skin covered with hair. Damage to the scalp, which is accompanied by hair loss and some changes in the skin, is widely known as ringworm. However, this term cannot be applied to all types of microsporia. Mostly children get sick, which is associated with a less developed and more susceptible immune system, insufficient hygiene skills, as well as more frequent contact with animals ( street cats and dogs). However, it should be noted that lesions that occur in children often heal on their own by the time of puberty.

Depending on the type of fungus and the type of skin lesion, the following types of microsporia are distinguished:

• superficial;
• infiltrative-suppurative.

Infiltrative-suppurative microsporia is a severe form of the disease caused by zoophilic fungi, that is, fungi that mainly affect animals, and the natural source of which is dogs and cats. The damage caused by these microsporums affects the deeper layers of the skin, which is accompanied by a productive inflammatory reaction with the formation of purulent infiltrates. In severe cases, a large purulent focus forms, general malaise develops, and body temperature rises.

According to statistics, children under 10 years of age are most susceptible to infection. Some types of microsporia ( especially saprophytic, that is, living in the soil and environment) are found almost five times more often among boys than among girls, which is explained by their greater mobility and some features of social and everyday behavior. At the same time, after puberty the situation becomes the opposite. This is due, firstly, to hormonal changes, and secondly, to the fact that women have closer and closer contact with children, who are the main group of patients. Infection with zoonotic fungal species occurs equally frequently among boys and girls.

The severity of the disease depends on the type of infectious agent and, accordingly, its ability to penetrate tissue and cause local changes, as well as on the site of infection and the body’s response. In the vast majority of cases, ringworm and other types of microsporia do not pose any threat to the life of the infected person. However, the aesthetic defect created by the disease, as well as the itching present in some cases ( which can be either unexpressed or extremely intense) create significant discomfort for the patient. We should not forget that children with hair defects caused by ringworm often cannot adapt normally socially, as they are subject to ridicule from their peers. Such a situation can negatively affect their psycho-emotional development and cause significant psychological disorders in the future. Thus, it is extremely important to initiate adequate therapy as early as possible.

Interesting Facts

• The pathogen of microsporia is capable of surviving for long periods of time in environmental conditions ( some types of mushrooms can survive up to 10 years outside their natural host);
• For adults, damage to the smooth skin of the body is typical, while in children the scalp is more often affected;
• microsporia does not affect nails;
• damage to the deep skin layers, accompanied by the formation and secretion of pus, is called kerion ( translated from Greek - honeycomb), which is associated with the peculiar appearance of inflamed and swollen skin, from the enlarged pores of which pus oozes.

Skin structure

The skin acts as a protective barrier that prevents damage to internal organs and tissues. In addition, it protects the body from the effects of many adverse environmental factors.

The skin performs the following functions:

• UV protection. Melanin found in the skin ( dark pigment) is able to absorb ultraviolet radiation, due to which the skin protects the underlying soft tissues and organs from the harmful effects of sunlight.
• Protection against temperature changes. The skin and subcutaneous fatty tissue insulate the body, stabilizing its temperature. The ability of blood vessels to expand when the temperature rises and contract when it decreases allows the body to regulate temperature and also protect internal organs from overheating or hypothermia. Sweat glands located deep in the skin help cool the skin and, accordingly, the entire body due to the active evaporation of sweat during hot periods.
• Protection against toxins. The stratum corneum of the skin is impermeable to some organic and inorganic poisons and acids. However, thanks to a well-developed and branched network of blood vessels, the skin is able to actively absorb and absorb certain substances. For this reason, it is not recommended to expose the skin to potentially hazardous substances for a long time, as they can provoke not only a local, but also a systemic reaction. If toxic chemicals come into contact with your skin, you must immediately wash them off with plenty of water, and then seek qualified medical help from a doctor.
• Protection against bacteria. Intact skin is impermeable to most bacteria and pathogens. However, reduced local immunity, local irritation, microtraumas, cracks, wounds and other defects contribute to the penetration and development of infection.
• Sensitive perception. In the thickness of the skin there are sensitive nerve fibers, receptors, and free nerve endings that are capable of converting mechanical information into electrical impulses that are processed by the central nervous system and form sensation. The skin has tactile, vibration, pain and temperature sensitivity. The sensations formed allow not only to perceive information from the outside and interact with the outside world, but also protect the body from prolonged stay in unfavorable or dangerous conditions.
• Immune function. Immune cells found in the skin produce immunoglobulins ( antibodies), which perform non-specific ( directed against most pathogenic microorganisms) protective function.
• Retention of fluids and a number of substances in the body. The skin not only protects the body from the effects of adverse environmental factors, but also prevents excessive loss of fluids and a number of useful substances. This happens due to the fact that the skin isolates the internal environment of the body and does not allow plasma ( liquid component of blood) pass out. Thanks to this, the constancy of the internal environment is maintained. In case of massive burns or injuries, when the skin loses its anatomical and functional integrity, the body loses a large amount of plasma and electrolytes, which has an extremely negative impact on the patient’s condition.

• epidermis;
• dermis;
• subcutaneous fatty tissue.

Epidermis

The epidermis consists mainly of keratinocytes - special cells that during their development synthesize a number of proteins ( initially soft but then hardening), which create the stratum corneum of the skin.

There are several layers in the epidermis, each of which inherently reflects a certain stage of keratinocyte development.

The epidermis consists of the following layers:

• basal;
• spiny;
• grainy;
• brilliant;
• horny.

Layer spinosum It is represented by several rows of keratinocytes, which are connected to each other by peculiar spines - outgrowths formed by intercellular bridges. These spikes appear due to some reduction in the cell and condensation of its contents. The stratum spinosum, like the basal layer, is capable of dividing and replenishing skin defects, but this only happens when the basal layer is damaged.

Granular layer formed by 2 - 3 rows of flat cells, in which there are inclusions of waterproof proteins - keratin precursors.

Shiny layer present only in areas with rough, thick skin ( palms, soles). It is a thin layer of pinkish color, which is formed by flat keratinocytes without a nucleus.

Stratum corneum is the most superficial layer of the epidermis and is represented by several rows of flat keratinocytes, in which all intracellular organs are replaced by keratin, a hard, waterproof protein.

The epidermis is in a state of constant renewal, as under the influence of various factors ( both external and internal) cells of the stratum corneum are constantly exfoliated. In order to prevent the formation of skin defects, exfoliated cells are replaced with new ones. This happens through the constant division and development of keratinocytes, which, as they grow, move from deeper layers to the surface.

Dermis

The dermis consists of the following layers:

• papillary;
• reticulate.

Papillary layer The dermis is represented by loose connective tissue, which forms peculiar papillae. Thanks to this structure, this layer has significant elasticity and stretchability, which is extremely important for maintaining the skin structure.

Mesh layer It is represented by denser connective tissue that can withstand significant mechanical load.

In the dermis ( mainly in the papillary layer) skin appendages are located ( skin follicles and various glands), which perform a number of important physiological functions.

Skin appendages are represented by the following structures:

• sebaceous glands;
• sweat glands;
• hair follicles;
• nails.

Sweat glands They are exocrine glands with a simple structure, the main function of which is the production of a watery secretion - sweat. There are two types of sweat glands in the human body - eccrine and apocrine. The first, eccrine, are located on the entire surface of the body and are glands that synthesize simple sweat, which is 99% water, due to which it is involved in the regulation of body temperature. The second, apocrine, are located in the armpits, in the perineum and anus, and in some areas of the face. They synthesize a viscous secretion that has a distinct odor. These sweat glands do not participate in the regulation of body temperature, but their secretory activity increases in stressful situations. Apocrine glands develop during puberty.

Hair follicles are complex structures formed by the dermis and epidermis. They are located on the entire surface of the body, with the exception of the palmar surface of the hands, soles of the feet, glans penis, clitoris, and lips. The hair follicle, which is the basis of the follicle, is located deep in the skin, and on the face it can lie in the subcutaneous fatty tissue. The hair growing from the bulb is a structure formed by three shells. The outside of the hair is covered with horny scales ( cuticle), under which there is a cortex, represented by dead cells. In the center of the hair there is a medulla formed by keratin cells and air cavities. This concentric structure provides the necessary mechanical stability of the hair and realizes its protective potential.

Mammary gland are special modified sweat glands that, under the influence of a number of stimuli, are capable of synthesizing milk. Mammary glands are present in both women and men, however, against the background of hormonal differences during puberty, they fully develop only in women. The mammary glands are located in the breast area in such a way that their excretory ducts exit through the nipple.

Nails are also derivatives of leather. They are formed from keratin, which is synthesized by skin cells. Due to the presence of minerals, water and fat, nails are elastic and quite hard. The main function of the nail is to protect the fingertips and give them rigidity.

The dermis contains blood and lymphatic vessels, as well as nerve fibers that provide communication between the central nervous system and the peripheral parts of the body. Nutrients and oxygen entering the skin through blood vessels penetrate the epidermis through diffusion and provide its nutrition.

It should be noted that in addition to nutritional ( trophic) and respiratory function, blood vessels are involved in thermoregulation. This happens by changing the volume of blood flowing to the skin. Since the skin has a significant area and is in direct contact with the environment, an increase in blood supply with the dilation of blood vessels leads to cooling of the blood, and a decrease with narrowing leads to the preservation of heat, which, in turn, affects the entire body temperature. This mechanism of thermoregulation is of great importance in both warm and cold seasons. It should be noted that drinking alcohol causes the blood vessels located in the skin to dilate, which creates the illusion of warmth ( due to greater blood flow and heat to the skin, temperature receptors are activated), but which increases heat loss and increases the risk of serious frostbite.

Subcutaneous fat

Subcutaneous fatty tissue performs the following functions:

• Mechanical protection of internal tissues. The layer of fat located under the skin helps cushion shock, which provides some protection for internal organs.
• Skin mobility. The subcutaneous fat layer provides skin mobility, that is, it allows the skin to slide relative to the underlying soft tissue and bone structures. This may be due to both the loose structure of the fat and the rather loose connection between the dermis and the fat layer.
• Thermal insulation. Fat is a substance that conducts heat poorly. Thus, the fat layer allows you to maintain a constant body temperature for some time, regardless of environmental conditions. However, it should be noted that for long-term heat retention ( or cooling) other, more effective and controlled mechanisms of thermoregulation are needed.
• Supply of nutrients. Fat is an energy-rich chemical structure. In conditions of insufficient supply of nutrients, the body begins to break down its own adipose tissue, thereby replenishing the energy deficit.

Properties of fungi of the genus Microsporum

Under natural conditions, representatives of this family of fungi are able to grow only on structures rich in keratin ( protein produced by epidermal cells). For this reason, microsporum can only affect the skin directly ( or rather, the epidermis) and hair follicles. As noted above, microsporia does not affect nails.

For pathogenic fungi ( however, as with most other mushrooms) a characteristic structural feature is the presence of mycelium - a thin branched thread that grows from the base of the fungus and with the help of which it spreads. The mycelium is one giant multinucleate cell, which was formed as a result of the fusion of many fungal cells. Mycelium is capable of forming fungi and, under certain conditions, forming spores. Spores are cells with a dense shell, which, when placed in a favorable environment, can develop into a full-fledged mushroom; in other words, spores are one of the ways fungi reproduce.

The main pathogens of microsporia are the following fungi:

• Microsporum canis;
• Microsporum ferrugineum.

Microsporum ferrugineum (rusty microsporium) is a fungus that can infect humans and, under certain conditions, some animals. It is extremely contagious and can infect a person when exposed to even a small amount of fungus. Colonies of this fungus grown on artificial nutrient media have a brown or reddish color, which resembles rust on iron ( hence the corresponding name of the species). The mycelium is wide and flat.

It should be noted that the microsporum family is not limited to just these two representatives, but they are the ones that have the greatest clinical and practical importance. The remaining representatives of this family have a similar structure and similar properties.

Causes of microsporia

An important factor that contributes to the spread of infection is the high resistance of fungi in the external environment. Most members of the Microsporum family are able to maintain their infectious and pathogenic properties for many months and even years.

It should be noted that zoophilic forms of microsporia, the original source of which were any animals, are characterized by a limited number of transmissions. This is explained by the gradual weakening of the fungal strain on a substrate that is not natural for it ( in this case, human skin).

Adults are much less likely to suffer from microsporia. This is explained by a more stable immune system, developed nonspecific protection factors against bacterial and fungal infections, hormonal factors, as well as hygienic considerations. In addition, it should be noted that due to age-related changes in the scalp, microsporia almost never affects the scalp in adults, but is limited only to the smooth skin of the body.

It should be understood that just getting a fungus on the surface of the skin does not guarantee the development of ringworm ( or other clinical form of the disease). For a symptomatic disease to occur, a certain interaction between the infecting microorganism and the infecting macroorganism is necessary ( person). In other words, the development of a fungal infection depends on the infecting dose and the pathogenicity of the fungus on the one hand, and on the person’s immunity and defenses on the other.

The pathogenicity of the fungus depends on the following factors:

• type of fungus;
• amount of fungus.

Fungus quantity or, in other words, the infectious dose, is the factor that determines the rate of development and severity of the disease. The more fungal cells on the skin at the time of infection, the higher the risk of developing a clinically significant disease.

The body's defenses are represented by a number of nonspecific substances that are produced by the body's cells and are capable of destroying fungal cells ( have fungicidal activity). The second line of defense is formed by immune cells, which are located in the epidermis and are capable of actively absorbing foreign cellular elements. All these factors are directly dependent on the general condition of the body, the status of the immune system, as well as the health of the skin.

The following factors reduce the local protective potential and increase the risk of developing microsporia:

• Atopy ( genetic predisposition). Atopy is a genetically determined condition in which, under the influence of a number of stimuli, an excessive amount of class E immunoglobulins is synthesized, which activates a cascade of allergic reactions. As a result, an inadequate local reaction develops, which weakens local immunity.
• Local or systemic use of glucocorticosteroids. The use of drugs that reduce immunity, one way or another, reduces the protective potential of the skin and increases the risk of infection. Most often this occurs under the influence of glucocorticosteroid hormones, which are used in the form of various ointments or creams to treat other skin pathologies. To prevent infection, these drugs should be used only as prescribed by a doctor and strictly follow the recommendations and instructions.
• Ichthyosis. Ichthyosis is a hereditary skin disease in which excessive keratinization of the skin occurs due to a violation of a number of regulatory mechanisms. As a result, peculiar scales form on the skin ( similar to fish scales), the skin loses its elasticity and is injured at the slightest movement.
• Diseases of connective tissue and blood vessels . Changes that occur in the connective tissue framework of the skin and in the wall of blood vessels against the background of a number of autoimmune diseases impair local blood circulation and reduce the number of immune cells and protective factors on the surface of the skin.
• State of immunodeficiency. A state of immunodeficiency can occur while taking drugs that reduce immunity ( for cancer, after organ transplantation, against the background of severe systemic disorders), or after serious diseases of the immune system. In addition, immune function is impaired when infected with the human immunodeficiency virus ( HIV), as well as for some genetic abnormalities.

• Excessive sweating. Sweat changes the environment, increases acidity, and changes the electrolytic balance on the surface of the skin. In addition, moisture softens keratin, making the stratum corneum of the epidermis more susceptible to infectious agents.
• Professional risks. Frequent and prolonged contact with sick or stray animals significantly increases the risk of infection with zoophilic forms of microsporia.
• High humidity environment. High environmental humidity not only creates favorable conditions for fungal growth, but also, as noted above, softens the epidermis, reducing its protective potential.

After the pathogenic fungus enters the body, the incubation period begins, which can last from 2 weeks to 2 months. At this time, the fungus develops and multiplies, and the cellular components of the infectious agent begin to form. This period is not characterized by any external clinical manifestations. Symptoms of the disease occur after sufficient accumulation of the fungus and the development of a productive inflammatory reaction, which, in fact, forms the clinical picture.

Thus, despite a fairly developed immune system, under certain circumstances, fungi can easily infect a person and cause illness of varying severity.

Symptoms of microsporia

Depending on the clinical manifestations, it is customary to distinguish the following types of microsporia:

• microsporia of the scalp ( ringworm);
• microsporia of smooth skin;
• facial microsporia ( damage to facial hair in men);
• kerion

Common signs for all types of microsporia are the appearance of a red spot ( usually ring-shaped), within which the hair becomes brittle and baldness develops. Usually this causes enlargement of regional lymph nodes ( in case of damage to the head - lymph nodes of the neck). In most cases, itching is either absent or extremely mild and does not cause significant discomfort to the patient.

Damage to the scalp ( ringworm)

The disease gradually spreads, forming multiple foci. Due to the growth of these lesions from the center to the periphery, characteristic ring lesions are formed, which can merge with each other.

The inflammation is usually mild, but in some cases a severe inflammatory reaction may occur with the formation of a purulent infiltrate ( kerion).

Symptoms of ringworm

Symptom	Description of the symptom and the mechanism of its occurrence	Characteristic image
Red ring-shaped lesions	A fungus that has penetrated the skin provokes a local inflammatory response, which is accompanied by dilation of blood vessels, which gives the lesion a red tint. Due to the expansion of the focus from the center to the periphery, a peculiar ring-shaped shape is created.
Small pustules covered with crusts and broken hairs	Pus is a mixture of dead immune and fungal cells. In most cases, the disease proceeds without the formation of abscesses, however, in severe cases, small ulcers and pustules can form.
Baldness within the lesion	Fungi of the microsporum genus are not able to penetrate the cortex of the hair, so they attack it from the outside. At the same time, the fungus destroys keratin and a number of other protein substances of the hair, thereby weakening it. As a result, the hair breaks a few millimeters above the surface.
Black spots within the lesion	The blackheads are the remaining hair roots.
Gray scales and excessive keratinization of the skin within the lesion	Fungal infection disrupts the mechanism for regulating normal renewal and keratinization of the skin, thereby increasing the thickness of the stratum corneum of the epidermis.

Damage to smooth skin

Damage to facial hair in men

Kerion

Diagnosis of microsporia

Laboratory diagnostics

When collecting material for laboratory diagnostics, the following rules must be observed:

• before taking a sample, it is necessary to remove all remnants of ointment and other medications from the skin and hair using a cloth soaked in alcohol;
• hair from the fire is collected by cutting it with scissors or by pressing a damp cloth to which the broken hairs stick;
• fragments of skin and hair can be scraped off from the affected area using a blunt scalpel or a glass slide;
• Hair and skin fragments can be sent to the laboratory in special dark and light envelopes, which, thanks to the contrast created, make it possible to see the amount of material collected.

Laboratory diagnosis of microsporia is carried out in the following ways:

• Direct microscopy. Direct microscopy involves examining biological material obtained from a patient under a light microscope in order to identify signs characteristic of fungal infection. To increase the effectiveness of this method, hair samples are pre-soaked in a 10–20% solution of potassium alkali, which softens the hair and allows for better visualization of its internal structure. With microsporia, spores and mycelium are detected, which partially destroy the cortical layer of the hair ( cuticle), but which do not penetrate the medulla. It should be noted that a similar picture is observed not only with microsporia, but also with a number of other fungal infections.
• Growing fungus on special media. In order to accurately identify the fungus and determine its species, as well as, if necessary, to determine its sensitivity to antifungal drugs, a cultural method is used, which involves inoculating pathological material on special media with subsequent cultivation. A significant disadvantage of this method is its duration, since it takes one to two weeks to grow the fungus.

Wood's lamp

A Wood's lamp is a source of ultraviolet radiation equipped with a special glass that transmits light rays of a certain wavelength ( for maximum efficiency). Hair affected by microsporia glows under a Wood's lamp with a characteristic bright green or yellow-green color.

Histological examination

Treatment of microsporia

The course of treatment for microsporia can last quite a long time. This is due to the high resistance of the pathogen to various medications. In this regard, treatment is approached comprehensively, using various methods. This allows you to quickly eliminate the causative agent of the disease and prevent possible relapses ( repeated flare-ups of the disease). A cosmetic defect after an illness may persist for some time and sometimes requires additional consultation with a cosmetologist.

The following treatment methods for microsporia exist:

• general treatments;
• drugs for systemic treatment;
• drugs for local treatment;
• traditional methods of treatment.

General treatments

It is also necessary to monitor the normal intake of vitamins in the patient’s body ( varied diet, taking vitamin and mineral complexes). This will strengthen the immune system and speed up recovery.

The patient should use personal hygiene products - washcloths, towels ( changing them every few days), comb. Other family members and other people around the patient are recommended to undergo a preventive examination by a dermatologist.

Drugs for systemic treatment

The main antifungal drugs for systemic treatment are:

• Griseofulvin. For adults, the dose is 12.5 mg per 1 kg of body weight per day ( mg/kg/day). The maximum total daily dose is 1 g. Children are recommended 22 mg/kg/day. The drug is taken until negative microbiological test results appear. After this, at the discretion of the attending physician, the course can be extended with a dose reduction and more rare doses ( 2 – 3 times a week). It is advisable to use the drug with fatty foods ( for example, with milk, butter), as this contributes to its more complete absorption.
• Terbinafine. The standard dose is calculated depending on the patient's body weight. Small children up to 20 kg are recommended to take 62.5 mg/day, older children and adolescents weighing 20–40 kg are prescribed 125 mg/day. Adults over 40 kg receive 250 mg of the drug daily. The duration of admission is on average 8 – 12 weeks.

Preparations for local treatment

Preparations for topical use for microsporia

Traditional methods of treatment

The main folk remedies for fighting ringworm are:

• Garlic juice. Cut a clove of garlic lengthwise and rub its juice on the affected area of ​​the skin. This procedure is performed once a day ( preferably in the morning). After this, during the day the lichen can be lubricated with birch charcoal or plantain.
• Garlic vinegar. This remedy is widely used in the treatment of many dermatological diseases. To prepare it, chop a few cloves of garlic and pour in 0.5 liters of apple cider vinegar. The resulting mixture should be infused for 1 - 2 weeks, shaking occasionally. After preparation, rub the affected area of ​​skin with vinegar. To enhance the therapeutic effect, you can add a few drops of camphor oil to the infusion before use.
• Sophora japonica. To prepare this product you need 50 g of fruits or flowers of this plant. In the absence of contraindications, it is recommended to make an alcohol infusion. For 50 g of herb you need 0.5 liters of vodka ( strength not less than 35 degrees). Infusion lasts 3 – 4 weeks in a dark place. After preparation, the infusion is filtered and taken orally, 3 teaspoons per day. Regular brewing of tea with the addition of Japanese Sophora can also provide a certain therapeutic effect for microsporia.
• Ointment based on sea fish broth. To prepare the ointment, you will need about 400 ml of rich broth, 100 g of butter and a paste of several heads of grated garlic. This mixture is carefully applied to the affected area of ​​skin 2 - 3 times a day, wrapped with a clean bandage for 30 - 60 minutes.

All folk remedies against ringworm are used until signs of recovery appear. Since this process can take several months, it is recommended to consult a dermatologist. With its help, it will be possible to successfully combine traditional medicine with highly effective pharmaceuticals, which will lead to a speedy recovery.

The main criterion for stopping the course of treatment is not the disappearance of symptoms, but a special microbiological analysis. If the scalp is affected, 3 scrapings are made with a five-day break. In addition, the hair is illuminated with a fluorescent lamp ( wood lamp), which detects fungi. When lichen is localized on the skin, 3 scrapings are made with a three-day break. If all tests are negative, the patient is considered fully recovered and the course of treatment is stopped. This decision must be made by the attending physician.

Prevention of microsporia

Prevention of microsporia is based on the following measures:

• Study of persons in contact with patients. Due to the long incubation period, as well as frequent cases of asymptomatic carriage of the fungus, all persons who have come into contact with patients are subject to thorough examination.
• Using special antifungal shampoos. To prevent latent transmission of infection and reduce the risk of infection, persons who have come into close and prolonged contact with sick people are recommended to use an active treatment regimen using a number of antifungal shampoos. For this purpose, special mixtures based on selenium sulfide or povidone-iodine ( considered the most effective remedy). These shampoos should be used twice a week for 15 minutes for four weeks.

Microsporia (mycosis) of smooth skin is a fungal disease, popularly known as. With ordinary mycosis, they can affect hair, nails and skin. Microsporia of smooth skin, as the name implies, affects only smooth skin. Currently, it is the most common fungal skin disease.

Pathogen

The causative agent is a fungus Microsporum. It belongs to dermatophytes, that is, a group of harmful microorganisms that affect the external integument of humans and animals. Among Microsporum there are more than 20 subspecies, one of which is the most common causative agent of smooth skin microsporia - this is a fungus Microsporum Canis.

Microsporum Canis gets on human skin and finds the hair follicle. There the fungus lays spores, which after some time begin to germinate and have a detrimental effect on the skin.

The fungus spreads quickly, so within 5-7 days a person will see the first external manifestations of the disease.

Routes of infection

The most common way to “acquire” mycosis of smooth skin is skin-to-skin contact with an affected person or, what happens more often, animals. That is why ringworm is usually acquired by children who play with street animals(usually cats). For this reason, foci of the disease appear in those places that the animal could touch, or that, after contact, the person himself could touch with dirty hands: arms, neck, stomach and face.

Second way– contact through things touched by a person with mycosis. It can be clothing, towels and everyday items. Children often get this disease while playing in the sandbox. Microsporum spores could get on any object surrounding the patient, after which, when using the thing, the fungus can spread to a healthy person.

Symptoms

Main symptom of the disease– disruption of the normal condition of the skin. The patient develops a slight raised spot(in some cases just a halo) red. After a day or two, the skin on it begins to peel off and in some places becomes covered with dry crusts. Most patients experience itching in this area. With the exception of external signs, no other changes occur, including in human behavior: the fungus does not affect body temperature, mood and general condition of the body.

Diagnostics

After external signs appear, the disease is diagnosed using two methods: They are examined using a special lamp or a skin scraper is taken from the affected area. At the first appointment with a doctor, a fluorescent lamp is brought to the hearth in a dark room, which will show a green glow in case of infection with a fungus. In the first two days after the appearance of the red spot, there may be no glow, so at an early stage this method may be useless, but during treatment this procedure will quickly show whether the prescribed treatment is effective. The examination is recommended every 3 days.

Laboratory research are able to give a more accurate picture. When taking skin samples, the affected area will be treated with alcohol, and then a few dry scales will be carefully scraped off and sent for analysis under a microscope. An observer, if the patient truly has microsporia, will easily detect a large accumulation of spores.

Treatment of microsporia of smooth skin in humans

The disease is treated with local drugs, killing the fungal pathogen. Every morning the patient lubricates the affected area with iodine solution, and in the evenings applies healing ointments.

These include:

• Clotrimazole
• Isoconazole
• Ciclopirox
• Biphonazal
• 20% sulfur ointment
• Sulfur-salicylic ointment, etc.

After applying the drug, cover the area with a band-aid so that the product is completely absorbed overnight.

To relieve unpleasant itching, you can also use tar ointment.

Suprastin, for example, relieves discomfort after the first day of oral use. And the ointment helps in just a few hours, but has a strong tar smell, which not everyone likes.

In addition, tar ointment should be used when the area affected by microsporia is not lubricated with other drugs. Typically, patients apply iodine in the morning, two hours later tar ointment, and in the evening the healing drug.

As a preventive measure, a person should observe personal hygiene standards, avoid contact with street animals and people with smooth skin mycosis. If one person in the family becomes ill, he should be isolated from other family members and other household members should be examined. The patient's clothes are washed at high temperatures and then ironed with steam. This also applies to bed linen. If there are pets in the house, they also need to be carefully examined.

Microsporia is a fungal disease that attacks the skin and hair. Sometimes the disease affects the nail plates. The disease received its name due to the origin of the fungus, which belongs to the genus Microsporum. Another equally well-known name is “ringworm.” This is associated with the symptoms of microsporia.

When the fungus appears on the surface of the skin, it penetrates the integument and actively multiplies. When there is hair nearby, the fungus also attacks the hair. The fungus destroys the hair cuticles when it spreads spores on the scales.

This disease is considered one of the most common fungal ailments. Perhaps the only disease of a similar type that ranks ahead in the “popularity ranking” is foot fungus. Microsporia is very easily transmitted and it is not surprising that it is most often encountered in childhood. Adults get sick quite rarely.

This age division is due to the fact that from the moment they enter adolescence, all people develop organic acids in the hair area, which tend to slow down the development of the fungus and thus often allow the body to recover on its own without the use of therapeutic measures.

The main carriers of the fungus are cats, and occasionally dogs. The disease is contracted through tactile interaction with an infected animal, as well as through contact with things and fur on which the fungus remains. Once on the ground, the mushroom does not live long - from one to three months. Therefore, soil is not a natural environment for these organisms and can only be a transmission link for infection.

In our smaller brothers, the disease can be localized on the muzzle, on the outer part of the ears, on the front legs and occasionally on the hind legs. Often visually absolutely healthy felines are carriers of the fungus. Manifestations of the disease, which are seasonal, are associated with pregnancy in cats, as well as with more active interaction between children and the animal world in warmer months. The disease begins to gain momentum closer to August and reaches its peak in mid-autumn. The risk decreases only in mid-spring.

The incubation time of fungi that are transmitted to humans from animals ranges from five to seven days. Symptoms largely depend on the locations that the fungus occupies, as well as on how deeply it has been able to advance. There are two types of the disease: microsporia of smooth skin, and also a type of disease that attacks the scalp.

Microsporia localized on the smooth part of the skin

In the area attacked by the fungus, a convex spot is formed, the color scheme is closer to red, with clear contours and swelling. After a certain period, the spot grows. The edges are overgrown with a continuous ridge that rises above the formation. It consists of small nodes, crusts and blisters. The center gradually becomes pale pink, and peeling appears. The lesion takes on a ring shape.

Usually with this type there is one focus. In rare cases - two or three. Sizes range from five millimeters to thirty. The patient may not feel any discomfort, in some cases there is moderate itching.

For people suffering from allergies, it is a little more difficult to determine the presence of this fungus on the skin, since microsporia can be mistaken for an allergic reaction at first. In the case of topical use of hormonal drugs, the number of fungi can increase significantly.

Very rarely, the disease attacks the skin of the inside of the hands, soles and nail plates. A distinctive feature of this disease regarding nails is a targeted attack predominantly on the outer side of the nail plate. During the first stage, a dull stain is formed. Gradually it brightens and acquires a white color. The affected nail loses its rigidity, which manifests itself in its fragility. In the future, there is a possibility of nail destruction.

Microsporia of the scalp

This type mainly affects children between five and twelve years of age. Quite often, children recover without therapeutic interventions. It is curious that, according to statistics, children with red hair extremely rarely encounter this disease.

Microsporia of the scalp prefers mainly the crown area, crown, and also the temporal part. In most cases, there are only one or two lesions, and their sizes range from twenty to fifty millimeters. Their round or oval shape has clear contours. Near larger lesions, in some cases microfoci of five to fifteen millimeters appear. The disease begins with the appearance of peeling. The first few days the infection is limited to the hair follicle. If you look closely, you can discern a light-colored ring-shaped scaly formation encircling the hair.

By the sixth or seventh day, the disease begins to completely cover the hair, and it acquires a fragile structure, subsequently breaking approximately five millimeters from the skin. Outwardly it looks like a short haircut. What remains of the hair is covered with fungal spores. The affected skin is mostly reddish in color, with characteristic swelling and small light gray scales.

Microsporia with suppuration is characterized not only by a bright inflammatory process, but also by blue-red nodes that cover the ulcers. If you press the skin in this area, purulent fluid is released. The purulent form becomes the result of ill-chosen treatment tactics, the presence of other serious illnesses and ignoring the disease.

How to diagnose microsporia

Diseases of this type are studied and treated by dermatology. If the above symptoms occur, you should consult a dermatologist. To confirm the diagnosis, it is necessary to undergo several studies, including fluorescent (lamp examination), analysis using a microscope, as well as cultural study of pathological material.

The first type, thanks to the green glow, determines the presence of affected areas. For this, a special Wood's lamp is used. The examination is carried out in a dark room. The affected areas are prepared by removing crusts from them. If the disease has not had time to properly affect the hair, the glow may not be observed. In such cases, the hair is removed from the area that is supposedly infected, and by the root part it is determined exactly whether it is attacked by a fungus or not. If the mushroom dies, the glow still remains.

Luminescent testing helps:

• In search of the cause of the disease.
• Establish affected areas.
• When diagnosing after completed therapy.
• Check those who are in close proximity to the patient.
• In diagnosing a disease in an animal.

Skin microscopy examines the scales. If the patient has microsporia of the scalp, parts of broken hair are used. This research method helps in determining the class of fungi. The scales allow the detection of filamentous fungi. The presence of mycelium threads is confirmation of the presence of the fungus. Microscopic examination of the hair reveals the presence of spores.

During cultural analysis, the genus and variety of the fungus are determined, which later helps to determine the treatment strategy and preventive methods. The material for research is placed in a favorable environment. Usually on the third day Microsporum begins to grow.

How to treat microsporia

Before choosing treatment tactics, the doctor takes into account research, medical history and all the details that he can find out when communicating with the patient. When treating microsporia of smooth skin, external antifungal drugs are used. The affected areas are treated in the morning with iodine tincture from two to five percent. In the evening, an antifungal ointment is applied to the lesions. They take sulfur, salicylic, and sulfur-tar ointments. More modern ointments are used twice a day.

If the disease is accompanied by a severe inflammatory process, the doctor may prescribe medications that contain a hormonal component. Among them are ointments such as mycozolon and travocort.

If the disease is accompanied by a bacterial infection, Triderm cream can help in treatment. In cases where the disease takes a severe form, drugs based on dimexide are used. When the fungus attacks vellus hair and long hair, comprehensive treatment is necessary.

Therapy for microsporia of the scalp

When this type of disease occurs, preference is given to griseofulvin. This antibiotic, which is obtained from mold, is produced in tablet form. The medicine should be taken three to four times a day with meals. One teaspoon of vegetable oil is used along with the drug. It helps dissolve the medicine and prolong its activity in the body.

It is advisable for children under three years of age to take the drug in the form of a suspension. You should take an antibiotic until a test confirms the absence of fungus in the body. Then, for fourteen days, the drug should be taken every other day. The next two weeks - twice a week. The duration of the course is from six to eight weeks.

During therapy, you should shave your hair every week and wash your hair twice a week. It is advisable to apply antifungal ointment to the affected area. In tandem with it, it is possible to apply a five percent griseofulvin patch to the affected area.

When using griseofulvin, headaches, allergic rashes, and discomfort in the pancreas sometimes appear as a side effect. Due to the toxicity and negative effects of the drug on the liver, children should not take it. This also applies to people who have had hepatitis or suffer from liver-related ailments. It is also excluded from therapy in patients with kidney diseases, gastric and duodenal ulcers, neuritis, photodermatoses and diseases of the circulatory system.

A good option for replacing griseofulvin is terbinafine. During treatment of affected hairy areas, the drug is used in tablet form. The dosage is determined by a specialist. To select the appropriate dosage in childhood, the doctor focuses on the child’s weight category. The drug must be taken only once a day. The body tolerates it quite well. Side effects may include mild pain in the abdomen, as well as the effect of a full stomach. With some restriction of the diet, the patient can relieve himself of the state of discomfort by eliminating flatulence.

Preventive measures

The main principle of preventive measures is prompt diagnosis and isolation of patients. In schools and kindergartens, it is necessary to systematically examine children to detect microsporia. If the doctor finds signs of illness, the child should be isolated from others and surgical therapy should be started. Usually a special hospital is provided for such purposes. In addition to isolation measures, disinfection of the patient’s personal belongings is necessary.

It is imperative to see a doctor and undergo the necessary tests for people who have been in contact with the patient. It is recommended to be more careful with pets, as they are quite often the cause of infection transmission. If a fungus is detected, the animal should also be subjected to constructive therapy.

Microsporia is a highly contagious dermatophytosis caused by fungi of the genus Microsporum.

Etiology and epidemiology of microsporia

The most commonly isolated pathogens of microsporia are the fungi Microsporum canis, which are among the zoophilic fungi widespread in the world, causing dermatophytes in cats (especially kittens), dogs, rabbits, guinea pigs, hamsters, and in more rare cases - in monkeys, tigers, lions , wild and domestic pigs, horses, sheep, silver foxes, rabbits, rats, mice, hamsters, guinea pigs and other small rodents, as well as poultry. Infection occurs mainly through contact with sick animals or through objects contaminated with their fur. Infection between humans and humans is extremely rare, occurring on average in 2% of cases.

Microsporum audouinii is a common anthropophilic pathogen that can cause damage to the scalp and, less commonly, smooth skin in humans. Children get sick more often. The pathogen is transmitted only from a sick person to a healthy person directly through contact or indirectly through contaminated care and household items.

Microsporia is characterized by seasonality. Peaks in the detection of microsporia are observed in May-June and September-November. Various endogenous factors can contribute to the occurrence of the disease: sweat chemistry, the state of the endocrine and immune systems. In addition, children have insufficient density and compactness of the keratin of epidermal cells and hair, which also contributes to the introduction and development of fungi of the genus Microsporum.

Microsporia is a disease that is the most highly contagious of the entire group of dermatophytosis. Mostly children, often newborns, are affected. Adults get sick less often, while the disease is often registered in young women. The rarity of microsporia in adults is associated with the presence of fungistatic organic acids (in particular, uncylenic acid) in the skin and its appendages.

In recent years, there has been an increase in the number of patients with chronic mycosis against the background of severe systemic lesions - lupus erythematosus, chronic glomerulonephritis, immunodeficiency states, and intoxications.

Classification of microsporia

• microsporia caused by anthropophilic fungi Microsporum audouinii, M. ferrugineum;
• microsporia caused by zoophilic fungi canis, M. distortum;
• microsporia caused by geophilic fungi gypseum, M. nanum.

According to the depth of the lesion there are:

• superficial microsporia of the scalp;
• superficial microsporia of smooth skin (with damage to vellus hair, without damage to vellus hair);
• deep suppurative microsporia.

Symptoms of microsporia

Microsporum canis affects hair, smooth skin, and very rarely nails; foci of the disease can be located on both open and closed parts of the body. The incubation period of the disease is 5–7 days.
On smooth skin, the lesions look like swollen, raised erythematous spots with clear boundaries, round or oval outlines, covered with grayish scales. Gradually, the spots increase in diameter, and a raised ridge, covered with blisters and serous crusts, forms along their periphery. In 80-85% of patients, vellus hair is involved in the infectious process. The eyebrows, eyelids and eyelashes may be affected. With microsporia of smooth skin, there are no subjective sensations; sometimes patients may be bothered by moderate itching.

With microsporia of the scalp, the lesions are most often located in the occipital, parietal and temporal regions. In the initial period of the disease, a focus of peeling appears at the site of introduction of the pathogenic fungus. Subsequently, the formation of one or two large lesions of round or oval shape with clear boundaries, measuring from 3 to 5 cm in diameter, and several small lesions - screenings, ranging in size from 0.3-1.5 cm are characteristic. Hair in the lesions is broken off and protrudes above the level skin by 4-5 mm.

Along with the typical clinical symptoms of zooanthroponotic microsporia, atypical variants have often been observed in recent years. These include infiltrative, suppurative (deep), exudative, rosacea-like, psoriasiform and seboroid (proceeding like lichen asbestos), trichophytoid, exudative forms, as well as a “transformed” version of microsporia (with a modification of the clinical picture as a result of the use of topical corticosteroids) .

In the infiltrative form of microsporia, the lesion on the scalp rises somewhat above the surrounding skin, is hyperemic, and the hair is often broken off at a level of 3-4 mm. The sheath of fungal spores is weakly visible at the root of broken hair.

In the infiltrative-suppurative form of microsporia, the lesion usually rises significantly above the surface of the skin due to pronounced infiltration and the formation of pustules. When pressing on the affected area, pus is released through the follicular openings. Discharged hair is glued together with purulent and purulent-hemorrhagic crusts. Crusts and melted hair are easily removed, exposing the gaping mouths of the hair follicles, from which, like a honeycomb, light yellow pus is released. The infiltrative-suppurative form is more common than other atypical forms, sometimes occurring in the form of kerion of Celsus - inflammation of the hair follicles, suppuration and the formation of deep painful nodes.

Due to the absorption of fungal decay products and the associated secondary infection, intoxication of the patient’s body is observed, which is manifested by malaise, headaches, fever, enlargement and soreness of regional lymph nodes.

The formation of infiltrative and suppurative forms of microsporia is facilitated by irrational (usually local) therapy, serious concomitant diseases, as well as late seeking medical help.

The exudative form of microsporia is characterized by severe hyperemia and swelling, with small bubbles located against this background. Due to the constant impregnation of the scales with serous exudate and gluing them together, dense crusts are formed, which, when removed, exposes the moist, eroded surface of the lesion.

microsporia exudative form

With the trichophytoid form of microsporia, the lesion process can cover the entire surface of the scalp. The lesions are numerous, small, with weak pityriasis-like peeling. The boundaries of the lesions are unclear, there are no acute inflammatory phenomena. This form of mycosis can acquire a chronic, sluggish course, lasting from 4-6 months to 2 years. The hair is thin or there are areas of patchy baldness.

trichophytoid form

With the seborrheic form of microsporia of the scalp, sparse hair is mainly noted. The areas of discharge are abundantly covered with yellowish scales, upon removal of which a small amount of broken hair can be found. Inflammatory phenomena in the lesions are minimal, the boundaries of the lesion are unclear.

seborrheic form

Diagnosis of microsporia

The diagnosis of microsporia is based on the clinical picture and the results of laboratory and instrumental studies:

• microscopic examination for fungi (at least 5 times);
• inspection under a fluorescent filter (Wood's lamp) (at least 5 times);
• cultural research to identify the type of pathogen in order to properly carry out anti-epidemic measures;

When prescribing systemic antimycotic drugs, it is necessary to:

• general clinical blood test (once every 10 days);
• general clinical urine analysis (once every 10 days);
• biochemical examination of blood serum (before the start of treatment and after 3-4 weeks) (ALT, AST, total bilirubin).

Differential diagnosis of microsporia

Microsporia is differentiated from trichophytosis, pityriasis rosea, seborrhea, and psoriasis.

The superficial form of trichophytosis of the scalp is characterized by small scaly foci of round or irregular shape with very mild inflammatory phenomena and some hair thinning. The lesions are characterized by the presence of short gray hair broken off 1-3 mm above the skin level. Sometimes the hair breaks off above the skin level and looks like so-called “black dots”. In the differential diagnosis of microsporia, attention is paid to highly broken hair, with muff-like sheaths covering the hair fragments, and asbestos-like peeling. Of decisive importance in diagnosis is emerald fluorescence in the rays of a Wood's lamp of affected hair, detection of elements of a pathogenic fungus and isolation of the pathogen during cultural examination.

Zhiber's pityriasis rosea is characterized by more pronounced inflammation, a pink tint of the lesions, the absence of sharp boundaries, peeling in the form of “crumpled tissue paper”, the absence of the characteristic emerald glow and the absence of detection of elements of a pathogenic fungus during microscopic examination.

Psoriasis is more characterized by clear boundaries, dry lesions, silvery scales, and the absence of muff-like layers of scales on the affected hair.

Treatment of microsporia

Treatment Goals

• clinical cure;
• negative results of microscopic examination for fungi.

General notes on therapy

For microsporia of smooth skin (less than 3 lesions) without damage to vellus hair, external antimycotic agents are used.

Indications for the use of systemic antimycotic drugs are:

• multifocal microsporia of smooth skin (3 or more lesions);
• microsporia with damage to vellus hair.

Treatment of these forms is based on a combination of systemic and local antimycotic drugs.

Hair in the affected areas is shaved once every 5-7 days or epilated.

Indications for hospitalization

• lack of effect from outpatient treatment;
• infiltrative-suppurative form of microsporia;
• multiple lesions with damage to vellus hair;
• severe concomitant pathology;
• according to epidemiological indications: patients from organized groups in the absence of the possibility of isolating them from healthy individuals (for example, in the presence of microsporia in persons living in boarding schools, orphanages, dormitories, children from large and asocial families).

Treatment regimens for microsporia:

• Griseofulvin orally with a teaspoon of vegetable oil 12.5 mg per kg body weight per day

Additionally, therapy is carried out with locally active drugs:

• ciclopirox, cream
• ketoconazole cream, ointment
• isoconazole, cream
• bifonazole cream
• 3% salicylic acid and 10% sulfur ointment
• sulfur (5%)-tar (10%) ointment

When treating the infiltrative-suppurative form, antiseptics and anti-inflammatory drugs (in the form of lotions and ointments) are initially used:

• Ichthyol, ointment 10%
• potassium permanganate, solution 1:6000
• ethacridine, solution 1: 1000
• furatsilin, solution 1:5000

Then treatment is continued with the above antifungal drugs.

Alternative treatment regimens

• terbinafine 250 mg
• itraconazole 200 mg

Special situations

microsporia - Pregnancy and lactation.

The use of systemic antifungal drugs during pregnancy and lactation is contraindicated.

Treatment of all forms of microsporia during pregnancy is carried out only with locally active drugs.

Treatment of children with microsporia:

Griseofulvin orally with a teaspoon of vegetable oil 21-22 mg per kg body weight per day

Treatment is considered complete when three negative results of the study are carried out at intervals of 5-7 days.

Additionally, therapy is carried out with locally active drugs:

• ciclopirox, cream
• ketoconazole cream, ointment
• isoconazole, cream
• bifonazole cream
• 3% salicylic acid and 10% sulfur ointment, alcohol tincture of iodine
• sulfur (5%)-tar (10%) ointment

Alternative treatment regimens

• terbinafine: children weighing >40 kg - 250 mg 1 time per day orally after meals, children weighing from 20 to 40 kg - 125 mg 1 time per day orally after meals, children with body weight<20 кг — 62,5 мг 1 раз в сутки
• itraconazole: children over 12 years of age - 5 mg per 1 kg of body weight

Requirements for treatment results

• resolution of clinical manifestations;
• lack of hair glow under a fluorescent filter (Wood's lamp);
• three negative control results of a microscopic examination for fungi (microsporia of the scalp - 1 time in 5-7 days; microsporia of smooth skin with damage to vellus hair - 1 time in 5-7 days, microsporia of smooth skin - 1 time in 3-5 days).

Due to the possibility of relapses, after completion of treatment, the patient should be under clinical observation: for microsporia of the scalp and microsporia of smooth skin with damage to vellus hair - 3 months, for microsporia of smooth skin without damage to vellus hair - 1 month.

Control microscopic examinations during dispensary observation must be carried out: for microsporia of the scalp and microsporia of smooth skin involving vellus hair - once a month, for microsporia of smooth skin - once every 10 days.

A conclusion on recovery and admission to an organized team is given by a dermatovenerologist.

Prevention of microsporia

Preventive measures for microsporia include sanitary and hygienic measures, incl. compliance with personal hygiene measures and disinfection measures (preventive and focal disinfection).

Focal (current and final) disinfection is carried out in places where the patient is identified and treated: at home, in children's and medical organizations.

Preventive sanitary-hygienic and disinfection measures are carried out in hairdressing salons, baths, saunas, sanitary checkpoints, swimming pools, sports complexes, hotels, hostels, laundries, etc.

Anti-epidemic measures when microsporia is detected:

• For a patient diagnosed with microsporia for the first time, a notification is submitted within 3 days to the department of accounting and registration of infectious diseases of the Federal Budgetary Institution of Health "Center for Hygiene and Epidemiology" and its branches, to territorial dermatovenerological dispensaries.
• Each new disease should be considered as newly diagnosed.
• When registering a disease in medical organizations, organized groups and other institutions, information about the sick person is entered into the infectious diseases register.
• The journal is kept in all medical organizations, medical offices of schools, preschool institutions and other organized groups. Serves for personal registration of patients with infectious diseases and registration of information exchange between medical organizations and state sanitary and epidemiological surveillance organizations.
• The patient is isolated.

• When a disease is detected in children's institutions, a patient with microsporia is immediately isolated and routine disinfection is carried out before transfer to the hospital or home.
• Until a child with microsporia recovers, he is not allowed to enter a preschool educational institution or school; an adult patient is not allowed to work in children's and communal institutions. The patient is prohibited from visiting the bathhouse or swimming pool.
• For maximum isolation, the patient is allocated a separate room or part of it, personal items (linen, towel, washcloth, comb, etc.).
• In the first 3 days after identifying a patient in preschool educational institutions, schools, higher and secondary specialized educational institutions and other organized groups, medical personnel of these institutions conduct an examination of contact persons. An examination of contact persons in the family is carried out by a dermatovenerologist.

• The inspection is carried out before final disinfection.
• Further medical observation with mandatory examination of the skin and scalp using a fluorescent lamp is carried out 1-2 times a week for 21 days with a note in the documentation (an observation sheet is kept).
• Current disinfection of outbreaks is organized by the medical organization that identified the disease. Routine disinfection before hospitalization and recovery is carried out either by the patient himself or by the person caring for him.
• Responsibility for performing routine disinfection in organized teams and medical organizations rests with its medical personnel. Current disinfection is considered timely organized if the population begins to perform it no later than 3 hours from the moment the patient is identified.
• Final disinfection is carried out in microsporia foci after the patient leaves the foci for hospitalization or after the recovery of a patient who was treated at home, regardless of the length of hospitalization or recovery.

• In some cases, final disinfection is carried out twice (for example, in the case of isolation and treatment of a sick child in the isolation ward of a boarding school: after isolation - in the premises where the patient was and after recovery - in the isolation ward). If a child attending a preschool or school falls ill, final disinfection is carried out at the preschool (or school) and at home. In secondary schools, final disinfection is carried out according to epidemiological indications. The final disinfection in the outbreaks is carried out by a disinfection station. Bedding, outerwear, shoes, hats, carpets, soft toys, books, etc. are subject to chamber disinfection.
• An application for final disinfection in households and isolated cases in organized groups is submitted by a medical worker of a medical organization with a dermatovenerological profile.
• When 3 or more cases of microsporia are registered in organized groups, as well as for epidemiological indications, the exit of a medical worker from a medical organization with a dermatovenerological profile and an epidemiologist from state sanitary and epidemiological surveillance institutions is organized. As directed by the epidemiologist, final disinfection is prescribed and the scope of disinfection is determined.

• The medical worker who has identified the disease is working to identify the source of infection (contact with sick animals). Animals (cats, dogs) are sent to a veterinary hospital for examination and treatment, followed by the submission of a certificate from the place of treatment and observation of the patient with microsporia. If a stray animal is suspected, information is transmitted to the appropriate animal control services.

IF YOU HAVE ANY QUESTIONS ABOUT THIS DISEASE, CONTACT DOCTOR DERMATOVENEROLOGIST KH.M. ADAEV:

EMAIL: [email protected]

INSTAGRAM @DERMATOLOG_95

Thank you

Microsporia is a highly contagious (highly contagious) infectious disease of smooth skin, scalp and nails caused by pathogenic fungi genus Microsporum. It was on the basis of the Latin name of the infectious agent (Microsporum) that the name of the disease itself (microsporia) was adopted. Microsporia appears as round, red, flaky patches on the skin, bald spots on the scalp, or white and dull circles on the nails.

Microsporia and ringworm (microsporia and trichophytosis)

However, with the development of science and technological progress, doctors were able to identify not only signs of diseases, but also isolate their causative agents, which was literally a breakthrough. During this period, it was possible to establish that the disease, which has always been called ringworm, can be caused by two types of pathogenic fungi - Trichophyton and Microsporum. And then the type of ringworm caused by fungi of the genus Trichophyton began to be called trichophytosis, and Microsporum - accordingly, microsporia. But since the external signs and course of trichophytosis and microsporia are the same, these two infections retain the same common name - ringworm.

Thus, according to modern concepts, microsporia is a fungal infection ( mycosis), affecting the skin, hair and nails, and at the same time is considered one of the varieties of ringworm.

The causative agent of infection

• M. distorum;
• M. rivalieri;
• M. langeronii;
• M. canis;
• M. nanum;
• M. persicolor;
• M. gypseum;
• M. cookii;
• Keratynomyces ajelloii.

Methods of transmission of microsporia (how you can get infected)

So, depending on the main host, all types of Microsporum fungi are divided into three varieties:
1. Zoophilic fungi – the main hosts are animals (most often kittens, less often dogs);
2. Anthropophilic fungi – the main owners are people;
3. Geophilic fungi – the main habitat is soil.

Zoophilic, atropophilic and geophilic fungi, when they come into contact with human skin, cause the same infectious disease - microsporia, but the routes of their transmission and, accordingly, the methods of infection are different.

Yes, transfer zoophilic fungi genus Microsporum occurs through direct household contact with infected cats or dogs. And since kittens are most often carriers of microsporia, there are two seasonal peaks in the incidence of this infection - in mid-summer and autumn, when cats give birth. To become infected with microsporia, it is enough to pet a cat or dog that has the infection or is an asymptomatic carrier. People usually become infected from their pet cats or dogs, which are constantly in contact with their owners, sitting on laps, crawling under blankets, etc.

However, zoophilic fungi of the genus Microsporum can be transmitted to humans not only as a result of direct contact with a sick animal, but also indirectly through pieces of its fur. The fact is that cats and dogs that suffer from microsporia or are carriers of the fungus can leave small and unnoticeable pieces of hair on various household items (furniture, carpets, beds, sofas, armchairs, clothes, shoes, etc.), in which contains fungal spores. A person touching such pieces of wool containing fungal spores also becomes infected with microsporia.

Thus, transmission of zoophilic microsporia can occur both through direct contact with a sick animal, and through touching objects that have fur and skin flakes of an infected animal.

Anthropophilic fungi genus Microsporum are transmitted from a sick person to a healthy person through direct close contact (hugs, kisses, etc.) or through the use of various objects on which there are skin flakes of an infected person (for example, when using a comb, hat, hair scissors belonging to a person with microsporia). That is, anthropophilic fungi are transmitted in the same way as zoophilic fungi, but from person to person, and not from animals.

Infection geophilic fungi genus Microsporum occurs through direct contact with soil contaminated with these microbes.

When a person becomes infected with any type of Microsporum fungus (zoophilic, anthropophilic or geophilic), then in the future he becomes a source of infection for others who can be infected with microsporia from him. However, despite the hypothetical possibility of infecting other people, family members of patients with microsporia very rarely become infected.

The routes of transmission of microsporia described above do not fully reflect the picture of how a fungal infection occurs. Thus, if a fungus simply gets on the skin, a person will not get sick with microsporia, since the pathogenic microbe will be destroyed by normal microflora and the immune system or simply washed away during hygiene measures. This means that for the disease microsporia it is necessary not only for the fungus to get on the skin, but also for the presence of certain predisposing factors that will allow it to penetrate the skin and provoke an infection.

To such predisposing factors include the following:
1. Traumatic skin injuries;
2. Skin maceration;
3. Reduced immunity.

Thus, microsporia is transmitted from an animal or person to another person only if he has the specified predisposing factors.

Microsporia in children

The clinical manifestations, course and principles of treatment of microsporia in children do not differ from those for adults. Therefore, it is inappropriate to consider separately the characteristics of microsporia in childhood.

Types of microsporia (classification)

So, depending on the predominant area of ​​damage, microsporia is divided into three main types:
1. Microsporia of smooth skin;
2. Microsporia of the scalp;
3. Microsporia of nails.

In addition, medical specialists distinguish three forms of microsporia, depending on what type of pathogen caused the infection:
1. Zoonotic microsporia - caused by species of fungi Microsporum, which are zoophilic (the main hosts are animals);
2. Anthroponotic microsporia - caused by species of Microsporum fungi, which are classified as anthropophilic (the main host is humans);
3. Geophilic microsporia - caused by species of Microsporum fungi, which are classified as geophilic (the main habitat is soil).

The divisions into zoonotic, anthroponotic and geophilic microsporia have no clinical significance, since they all have the same symptoms, a similar course and are treated according to the same principles. This classification is important for epidemiologists because it allows them to identify the primary sources of infection and carry out appropriate anti-epidemic measures if necessary.

Clinically important is also the classification of microsporia according to the type of course, the depth of tissue damage and the response of the immune system to infection. According to these criteria, the following types of microsporia are distinguished:

• Surface form (the lesions are located on the surface of smooth skin or under the hair);
• Exudative form (foci are located on any part of the body and liquid discharge oozes from them);
• Infiltrative-suppurative form (the lesions penetrate deep into the tissues, at the site of the lesion there is severe swelling with the addition of a secondary bacterial infection, which causes suppuration);
• Nail shape(foci are located on the nails);
• Chronic form (a variant of a long-existing surface form).

Incubation period of the disease

Symptoms (signs) of microsporia

The very first symptoms of incipient microsporia are red spots that form on the scalp or body. If microsporia affects the scalp, then spots may appear not only under the hair, but also in the area of ​​the eyebrows and eyelashes. With microsporia of smooth skin, spots form on any part of the body.

A few days after their appearance, the spots become pink and rather pale, and their surface is covered with whitish scales. At the same time, the hair loses its color and breaks off at a height of several millimeters from the surface of the skin, creating the effect of a short haircut. Because of this, characteristic and clearly visible bald spots are formed on the scalp, on which skin with scales and short hair resembling stiff stubble are visible. In some cases, black spots form on bald spots.

Sometimes microsporia of the scalp does not cause the formation of bald spots due to hair breaking, but provokes the formation of a large number of scales, which people mistake for profuse dandruff, which appeared completely unexpectedly for them. Also, in rare cases, microsporia appears as a gray spot on the scalp, in the area of ​​which there is intense hair loss.

If lichen affects smooth skin, then the initial spots simply turn pale, acquire a grayish color and become covered with scales. Outside the spot, a clearly visible ridge is formed, raised above the surface of the skin, as if delimiting the affected area from healthy areas. Inside the spot, another spot may form, smaller in size, but exactly the same in structure, which is why the affected area takes on the appearance of a target.

Over time, foci of microsporia on smooth skin and scalp increase in size and take on the shape of a regular circle or oval. The size of the lesions can reach 10 cm in diameter. At the same time, their surface is covered with a dense layer of gray scales, which give them the appropriate color. As a result, the edge of the spot looks like a red rim, and the inside is painted a pale gray-pinkish color.

If two or more foci of microsporia are located nearby, they can merge into a spot. Scaly spots peel off with varying degrees of intensity. Sometimes peeling is accompanied by severe itching, and in other cases the spot does not cause any discomfort at all.

In children and adults, when foci of microsporia are localized on the scalp, face, neck or upper half of the body, body temperature may rise and the cervical lymph nodes may enlarge.

In severe cases of microsporia, severe inflammation of the skin develops in the affected area with swelling, exudation and suppuration, which is called scab.

In general, microsporia in children and adults occurs as described. Let's consider the features and more precise characteristics of spots characteristic of various forms of fungal infection.

Skin microsporia (smooth skin microsporia) in adults and children

However, the fungus can re-infect an area that is already inside the outer ring. In this case, another ring is formed inside the ring, as a result of which the lesion takes on the bizarre appearance of a target. Such affected areas of the “ring in a ring” type are characteristic mainly of anthroponotic microsporia.

The total number of microsporia foci on smooth skin is usually small and amounts to 1–3 spots. The diameter of the spots is most often 0.5 - 3 cm, but sometimes the lesions can increase up to 5 cm in radius. Closely located spots can merge into one. Lesions can be located on any part of the body, but most often they are located on the face, neck, forearms and shoulders.

Non-inflamed microsporia spots, as a rule, do not cause any unpleasant sensations. Sometimes they may be mildly itchy. If there is severe inflammation in the lesions, they are very itchy and painful.

In people who have reduced delayed sensitivity reactions, microsporia can occur in the so-called abortive form. In this case, the lesion looks like a pale pink spot without clear boundaries and bubbles forming a peripheral ridge.

In newborns and children under 3 years of age, microsporia occurs in an erythematous-edematous form, in which the lesion is red, inflamed and swollen with a minimal amount of scales and peeling.

In people prone to atopy (for example, those suffering from atopic dermatitis), microsporia occurs in a papular-squamous form. In this case, spots appear on areas of the skin characterized by the production of large amounts of sebum, such as the face, chest and back. The lesions are abundantly infiltrated (dense, swollen) and lichenified (the skin on them is dense and thickened, with a pronounced pattern and impaired pigmentation).

In young women (under 30 years of age) who suffer from increased hair growth on the legs, microsporia lesions usually appear in the form of red and inflamed nodules with a diameter of 2–3 cm. This is a deep form of microsporia.

Microsporia capitis (microsporia of the scalp)

A characteristic feature of childhood microsporia is that the infection almost never occurs in children with red hair.

Microsporia of the scalp is a round or oval lesion with a clear border, most often located on the crown, crown or temples. Usually there are 1 - 2 lesions on the head with a diameter of 2 - 5 cm. At the borders of the lesions, small secondary lesions with a diameter of 0.5 - 1.5 cm, which are screenings, may appear.

At the initial stages of the disease, a flaky patch of skin forms in the affected area. In this area at the roots of the hair, you can see ring-shaped scales surrounding the hairs along the entire perimeter. After a week, the hair itself is affected, losing color, becoming dull, brittle and fragile, and as a result breaks off at a distance of 5 mm from the surface of the skin. The short “brush” remaining in place of the broken hairs, dull and covered with a grayish coating, is an accumulation of fungal spores. If the roots of broken hair are smoothed in any direction, they will remain in the position they were given. The skin under the hair fragments is moderately reddish, dense and covered with a large number of grayish scales.

In the anthroponotic form of microsporia, a characteristic feature is the location of the lesions at the border of hair growth, when one half of the spot is on the scalp, and the second on the smooth skin.

The picture described above is a typical course of microsporia. However, in rare cases, the infection occurs in atypical forms, such as:

• Infiltrative form Microsporia of the head is characterized by an elevation of the lesion above the rest of the skin. The skin of the lesion is red and swollen, and the hair is broken off at a level of 4 mm.
• Suppurative form microsporia is characterized by a strong inflammatory process, as well as thickening and compaction of the skin in the affected area. In this case, bluish-red nodes with pustules on the surface are formed, through which pus comes out when pressing on the affected area.
• Exudative form microsporia is characterized by severe redness, swelling and small blisters in the affected area. Due to the secreted inflammatory fluid, the skin scales stick together and form a dense crust covering the lesion.
• Trichophytoid form microsporia is characterized by multiple small lesions with mild peeling. The lesions are vague, without clear boundaries and signs of inflammation, and the hair is broken off at a level of 1 - 2 mm.
• Seborrheic form microsporia is characterized by thinning of hair in some areas of the head. In the area of ​​such hair thinning, skin is visible, covered with a large number of yellowish scales. If the scales are removed, fragments of a small amount of hair become visible underneath them.

These rare forms of microsporia of the scalp are almost always associated with increased body temperature, inflammation of the lymph nodes of the neck and symptoms of intoxication (headache, weakness, lethargy, etc.).

Anthroponotic microsporia

On the scalp, lesions are located at the border of hair growth in the area of ​​the back of the head, crown and temples. As a rule, part of the lesion is located in the hair growth area, and part is on smooth skin. Such lesions are small, vague, with clear boundaries and peeling inside the spot. When located close to each other, the lesions can merge, forming one large, bizarrely shaped lesion area. In the area of ​​the lesions, the hair breaks off at a level of 4–6 mm and looks short-cut.

Zoonotic and geophilic microsporia

When the scalp is damaged, large lesions are formed, located strictly in the hair growth zone. The lesions are round or oval in shape, have clear boundaries and are covered with whitish scales. The hair in the lesion is broken off at a height of 6–8 mm, and the protruding fragments are covered with a white sheath of fungal spores.

Nail microsporia

Microsporia - photo

This photograph shows a microsporia lesion in a child.

This photograph shows a focus of microsporia on the scalp.

Diagnosis of microsporia

The method for diagnosing microsporia through a fluorescent lamp (Wood's lamp) is very simple - a doctor in a darkened room examines the affected area illuminated by such a device. Skin and hair affected by fungus in the light of a Wood's lamp flicker bright green. The reason for this phenomenon is not clear, but it allows you to quickly and accurately diagnose microsporia.

If necessary, the doctor can carefully scrape off a small amount of scales from the affected area with a blunt scalpel and examine them under a microscope, conducting a microscopic examination accordingly. Before scraping off the scales, the skin in the affected area is wiped with 96% alcohol. After this, only scales are scraped off from smooth skin, and hair fragments from the scalp. All collected material is placed on a glass slide, filled with a drop of 20% potassium hydroxide solution and examined under a microscope after 30 minutes.

With microsporia, twisted threads of mycelium are visible in the scales, and on the surface of the hair there are numerous spores attached to it like small balls along the entire outer perimeter. Due to the spores, the border of the hair is not clear, but blurred.

The cultural method for diagnosing microsporia is used when microscopic and luminescent results are positive in order to identify the type of fungus that causes it. Sometimes this is necessary to determine the optimal treatment strategy. For the cultural method, scales are removed from the affected area and placed on a nutrient medium. In the presence of microsporia, a colony grows on the medium in the form of a flat disk with a fluff on the surface.

In most cases, to diagnose microsporia, it is sufficient to examine the affected area through a Wood's lamp and subsequent microscopic examination.

Microsporia - treatment

General principles of therapy

If foci of microsporia are located on the scalp or vellus hairs of smooth skin are involved in the process, then treatment consists of taking antifungal drugs internally and applying them externally to the affected areas.

Most effective for oral administration for the treatment of microsporia, antifungal drugs containing the following active substances:

• Griseofulvin;
• Terbinafine (Terbizil, Lamisil, etc.);
• Itraconazole (Orungal, Irunin, etc.).

• Ointments with terbinafine (Lamisil, Terbizil, etc.), clotrimazole, isoconazole and bifonazole;
• Tincture of iodine 2 – 5%;
• Sulfuric ointment 10 – 20%;
• Sulfur-salicylic ointment;
• Sulfur-tar ointment.

During the entire period of therapy, the sick person should use separate towels, sponges, combs and other personal hygiene and household items, and not share them with other people. All things worn by a person suffering from microsporia should be washed with ordinary powder at a water temperature of 60 o C, which is sufficient to kill the fungal spores. Boil all the items he used for 15 minutes in water. Drawers, cartons and other containers where things of a person suffering from microsporia were stored should be treated with the antifungal disinfectant Terralin.

Microsporia of smooth skin and scalp - treatment

So, the following drugs should be taken orally to treat microsporia:

• Griseofulvin. The dosage is calculated individually from the ratio of 22 mg per 1 kg of body weight. The calculated amount is divided by 3 and taken 3 times a day with a spoonful of oil for 2 to 6 weeks. Once a week, a scraping from the affected area is submitted for analysis. After the scraping result for fungi is negative, Griseofulvin is taken for another 2 weeks at the same dose every other day. Then for another 2 weeks at the same dose the tablets are taken every 3 days.
• Terbinafine. Take 250–500 mg once a day for 4–6 weeks.
• Itraconazole. Take 100–200 mg 1 time per day for 4 weeks.

If there is severe inflammation on the skin, then in the first 3 to 5 days of therapy it is necessary to treat them once a day with Travocort ointment, which contains a hormone with a powerful anti-inflammatory effect. When the inflammation decreases, you should switch to using any other antifungal ointment (Travogen, Zalain, Lamisil, Terbizil, Terbinafine, etc.).

Hair from smooth skin should be shaved once a week or epilated with a special patch containing griseofulvin. For microsporia of the scalp, before starting treatment, you should shave the hair from the affected area, and do this 1-2 times a week until the end of the course of therapy. You should also wash your hair 1-2 times a week with tar soap or pharmaceutical shampoo containing selenium sulfide, ketoconazole or povidone-iodine.

Treatment of microsporia in children

• Children weighing 10 – 20 kg – take 3/4 tablets (94 mg) of Terbinafine 125 mg 1 time per day;
• Children weighing 20 – 40 kg – take 1.5 tablets (187 mg) of Terbinafine 125 mg once a day;
• Children weighing over 40 kg – take 2 tablets (250 mg) of Terbinafine once a day.

Itraconazole and Griseofulvin are not recommended for use in children due to their high toxicity.

External treatment of affected areas in the treatment of microsporia in children is carried out with the same drugs as in adults. The optimal ointment for children is Clotrimazole or Lamisil.

Disease prevention

Microsporia: pathogens, routes of infection, signs (symptoms), treatment and prevention - video