Croatia (en)
Fungal skin disease in children is a heterogeneous group of lesions of the skin, substances that are pathogenic microscopic fungi. Fungal skin diseases in children can lead to peeling, itching, cracks in the skin, hair loss, nail loss. Diagnosis of fungal skin diseases in children includes inspection, fluorescent testing, microscopy and culture of scrapings microflora. Comprehensive treatment of fungal skin diseases in children is carried out by using external and systemic antifungal agents, desensitizing, and corticosteroid medicines, Immunostimulants, physiotherapy.
Fungal skin diseases in children develop a loss of smooth skin and its appendages (hair and nails) of parasitic fungi. Dermatology accounted for fungal infections share it is 37-40% of all skin diseases. There is a tendency to increase the number of children with fungal skin disease developed simultaneously with other skin diseases atopic dermatitis, eczema, psoriasis, pyoderma. The danger of fungal diseases of the skin is a toxic and sensitising action of the fungus of the child's body, which triggers the development of allergic reactions, weakened immunity, the burden of chronic disease.
The depth of the loss of fungal skin diseases in children is divided into keratomycosis (pityriasis versicolor), dermatofitia (microsporia, trichophytosis, favus, epidermophyton, rubromycosis); yeast infection; deep mycoses.
Keratomycosis is characterized by damage to the Horny layer of the epidermis without the development of inflammatory reactions, damage to hair and nails. Dermatofitia are involved in weak or strong inflammatory changes in the skin inside the epidermis, damage the hair and nails. Dermatophytes (fungi of the genera Trichophyton, Microsporum, Epidermophyton) are the main causative agents of fungal skin diseases in children. Superficial candidiasis – the second most common detection among the fungal skin diseases in children are caused by pathogenic fungi of the genus Candida (usually C. albicans) affecting skin and mucous membranes.
The incidence of dermatomycosis among all the fungal diseases, because of the constant close contact of the skin with the environment. The causative agents of fungal skin diseases in children widely distributed in nature, are very diverse and have a high resistance to external factors. Fungal skin diseases in children are usually detected in the form of sporadic cases, the disease cases is more typical of dermatophyte scalp.
The source of anthropophilic dermatomycosis is a sick man, zoophilic (microsporia) - sick animals (stray cats and dogs, cows, horses), a rare geophysical soil. Infection occurs through direct contact of the child with skin and hair of the patient or through everyday objects, fungi and their spores (towels, washcloths, combs, toys, caps, shoes). Often fungal skin diseases in children infected in swimming pools, showers and baths, on the beach, in hairdressing salons, organised children's groups.
Characteristics of children's skin (hydrophilicity, increased vascularization, reduce the bactericidal activity of sweat and sebaceous glands, easy vulnerability), the immaturity of the immune system to facilitate the penetration of the pathogen into the epidermis, promote the rapid development of fungal diseases in children.
Fall of protective forces of an organism of the child can be triggered by bad ecology, stress, prolonged use of antibiotics and chronic infections. With a weak immune system opportunistic fungi that live in norm of the baby's skin, can transform into a pathogenic form and cause disease fungal (e.g. Malassezia furfur is the causative agent of multi-colored lichen).
The nature and severity of the symptoms of fungal skin diseases in children depend on the type and virulence of the pathogen, localization, and lesion size, the reactivity of the organism. Fungal infections of the skin in children the most common and contagious are microsporia and trichophytosis (ringworm), occurs in the primary lesion of smooth skin and scalp.
microsporia in most cases (99%) is called zooantropophilic the fungus Microsporum canis, rarely anthropophilic M. ferrugeneum. It generally occurs in children of preschool and younger school age; progresses to the formation of small, rounded, well defined lesions. Within damage to the skin is covered with small, grayish-white spots. Smooth skin microsporia occurs in concentric erythematous-squamous plaques, surrounded by a pillow of small blisters and scabs.
Children at an early age often marked by a superficial trichophytosis of the scalp caused by trichophyton an anthropophilic (Trichophyton tonsurans and T. violaceum), accompanied by loss of color, elasticity and Shine to the hair, the formation of clear, full of small elements. Clinical symptoms of trichophytosis smooth skin resemble symptoms microsporia. For the infiltrative-suppurating forms characteristic of perifolliculitis and deep follicular abscess.
Pityriasis versicolor is seen in children; characterized by the appearance on the skin of the back and chest cream, light brown or yellowish-pink spots of irregular shape, prone to peripheral growth. The disease is slightly contagious, it is a chronic, relapsing course; the skin does not tan (secondary leukoderma).
With the defeat of the fungus achorin of schonleini developed a rare fungal skin disease in children - favus (ringworm) usually occurs on the scalp the formation of sculling - dry thick crusts of a yellowish or light brown on the edges and the center, publishes a stagnant smell. Affected by fungus in the hair, become like tow. Favus can result in fixed scar skin atrophy and loss of hair follicles.
Rubromycosis caused by the anthropophilic pathogen, T. rubrum, occurs in children aged 7-15 years; looks like dry skin on the feet and hands, clear pink-red, small pockets scalloped-edge; damage to the nails.
When epidermophyton folds and soles of the feet, is a little redness, peeling, cracks, and bubbles, hyperkeratosis accompanied with itching.
Various types of onychomycosis is characterized by thickening, by changing the shape and color of the nail plate to its gradual destruction, onycholysis, damage to the nail axis.
Candidiasis in children is most often manifested thrush - white coating on the tongue, gums, cheeks. Vesicular rash and extensive superficial ulceration, accompanied by itching and burning may also occur in the natural skin folds.
After suffering a fungal skin diseases in children was born, is not immune, and it can be re-infected by the same species of fungus.
To identify the fungal diseases of the skin requires a holistic examination of the child, children's dermatologist.
Microscopy of clinical material (hair, flakes of skin, the Horny mass of the nail bed) allows to detect the mycelium, mycelium or spores, to confirm fungal infection of the skin in children and to determine its tissue form. Sowing curettage is the most common and selective media help to distinguish the pure culture of fungi and determine their drug sensitivity; bacterioscopy smears cultures and biochemical analysis – perform phenotypic identification of the causative agent.
Research baby's skin under a wood's lamp will reveal Golden-yellow glow of horizontal multi-colored lichen, bright green - when microsporia, weak – loss of trichophyton.
Fungal skin diseases in children should be distinguished from a rash of similar manifestations: psoriasis, neurodermatitis, eczema, erythrasms, vitiligo, seborrhea, syphilitic leukoderma etc.
In the treatment of fungal skin diseases in children in the outpatient and without the effect, the presence of comorbidity and serious - specialized hospital. In the treatment of fungal skin diseases in children using monotherapy or a combination of external and systemic antimycotic means, antihistamine and glucocorticoid drugs, immunostimulants, multivitamins, physiotherapy.
Perform daily processing of skin lesions with antiseptic solutions (furatsilina, potassium permanganate, boric acid); treatment is carried out and the stop plate are nails; hair in the lesion has been removed, remove the cover.
Fungal infections of the skin folds, hands and feet in children using antifungal pastes, creams, lotions, emulsions terbinafine, naftifin, clotrimazole, miconazole, ketoconazole; sulphur-tar -, salicylic -, naphtha lane ointments. When you join a bacterial infection, the amount of antimycotic ointments containing antibiotics and corticosteroids. Serious and widespread dermatophytic old, losing hair and nails in addition to showing receiving systemic antifungal agents (griseofulvin, Itraconazole, fluconazole). If necessary, the treatment of fungal infections of the skin and nails, surgical removal of the nail plate.
Physical treatment of fungal skin diseases in children include medicinal electrophoresis, pulse magneto therapy, therapy pulse and high frequency currents, UHF-therapy.
In the treatment of fungal skin diseases in children is long and continued until resolution of clinical symptoms and a negative control test fungi.
Fungal skin disease in children is a constant rate and requires a long-term systematic treatment, but a strict adherence to the recommendations have a favorable prognosis. Fungal diseases of the skin in children become chronic, recurrent form and can continue into adulthood.
Preventing the spread of fungal skin diseases in children includes quarantine measures in institutions; disinfection of premises, household goods, clothing, shoes, manicure and hairdressing supplies; the removal of contact with the child animals, to compliance with the rules of personal hygiene, the proper care of the skin, normalizes immunity.
