Clinical Analysis Of 60 Cases Of Tinea Capitis In Children In Jilin Area

Objectives:1.To clarify the demographic characteristics,clinical types and pathogen spectrum of tinea capitis in children in Jilin Province.2.To study and analyze the characteristics and value of CFW fluorescence microscopy,Wood’s lamp and dermoscopy of tinea capitis in children in Jilin Province.3.To clarify the current status of treatment of tinea capitis in children in Jilin Province,including: systemic drug selection,efficacy observation,treatment course,and potential side effects.Methods:A prospective,single-center,descriptive study was conducted.Child patients with tinea capitis initially diagnosed at the Department of Dermatology,the Second Hospital of Jilin University from August 2020 to December 2021 were enrolled.Data concerning epidemiology,clinical photographs,CFW fluorescence microscopy,Wood’s lamp,dermoscopy,fungal culture and treatment were collected.The isolated strains were sent to the fungal laboratory of Peking University First Hospital for molecular sequencing identification.The above patients were regularly followed up until 1 month after clinical cure and discontinuation of medication.Results:1.60 child patients with tinea capitis were enrolled in this study,41 males and 19 females,with a male to female ratio of 2.16:1.There were 48 cases with a history of animal contact,accounting for 80% of the total number of cases,with cats and dogs being the predominant animals in contact.2.Clinical types: tinea alba in 46 cases,kerion in 13 cases,and black spot ringworm in 1 case.3.CFW fluorescence microscopy was positive in 59 cases,with a positivity rate of 98.3%.51 strains were isolated,with a culture positivity rate of 85.0%,with 46 strains of Microsporum canis accounting for90.2%.Wood’s lamp examination was performed in 52 cases,with a total positivity rate of 76.92% and a positivity rate of 92.68% for tinea alba.Dermatoscopy was performed in a total of 52 patients,with a positivity rate of 92.86% for the characteristic manifestations of tinea alba under dermoscopy.4.Effective treatment of tinea capitis could be manifested as clinical improvement,reduction or disappearance of bright green fluorescence intensity under Wood’s lamp（tinea alba）,reduction or disappearance of characteristic dermoscopic manifestations,reduction of mycelial/spore load in single hair by fungal microscopy or negative examination,and negative fungal culture.5.All systemic treatments for tinea alba were with itraconazole or terbinafine alone,and 97.8%were cured within 8 weeks,with no significant statistical difference in the time required for the two drugs to cure tinea alba in children.The systemic treatment of kerion was complicated by selective combination of antifungal agents with antibiotics,corticosteroids or immunomodulators.The maximum antifungal duration of kerion was16 weeks.Conclusion:1.The prevalent pathogen of tinea capitis in children in Jilin is predominantly Microsporum canis,and animal contact is considered the main risk factor.2.CFW fluorescence microscopy/Wood’s lamp/dermoscopy can be used to diagnose and evaluate the efficacy of treatment for ringworm,and fungal evidence is the gold standard for the diagnosis and cure of tinea capitis.3.Both terbinafine and itraconazole have good efficacy in the treatment of tinea alba in children,with no significant statistical difference in the time required to cure tinea alba in children.The treatment of kerion in children is complex and relatively long.