tinea capitis
Introduction
Head introduction Head lice are shallow fungal infections of the scalp and hair. According to the pathogens and clinical manifestations, they can be divided into three types: jaundice, white peony and black spot. Occurs in children, is highly contagious, and is easily transmitted to each other in nurseries, kindergartens, primary schools and families. It is mainly transmitted through contaminated hairdressing tools, and can also be infected by contact with cats, dogs and other livestock. basic knowledge The proportion of illness: 1.5% Susceptible people: no special people Mode of infection: contact spread Complications: Hyperthyroidism
Cause
Head lice cause
Fungal infection (35%):
Head lice are diseases caused by fungal infections of the scalp and hair. They suffer from head lice, and many gray scales or large pieces of jaundice appear on the scalp. They can also cause hair to break or fall off. In severe cases, the hair is uneven or even left. That is what people call "steamed bread".
Contact infection (25%):
The occurrence of head lice is mainly caused by contact with head lice patients or sick animals. It is extremely rare to be infected from nature. Normal people are often in close contact with head lice, especially children playing together and heads touching each other. Contact, it is easy to be infected, and sickness after contact with sick animals, this is a direct infection, if you use a hat, headscarf, pillow, comb or hair clipper, scissors, etc. used by head lice patients Being infected, this is called indirect infection. It can be seen that head lice are easily contagious. In the past, head lice were very popular in China, and head lice patients were often seen in hospitals.
Resistance (25%):
However, fungal infections do not necessarily cause head lice, which is closely related to the body's resistance to fungi. Most adults are more resistant to fungi, while children are weaker, so head lice are more common in children.
Pathogenesis
The proper environment of the host skin is very important for the development of dermatophytosis. Except for the injury, the increased moisture of the impregnated skin is also suitable for the growth of dermatophytes. The airtight clothing can increase the temperature and humidity of the skin and interfere with the stratum corneum. The barrier function, after the skin sputum invades the skin, has to go through several stages of development, including the incubation period, during the anti-infection process to increase and degenerate.
Prevention
Head lice prevention
If a head lice patient is found, appropriate isolation measures should be taken. For example, children with head lice should not go to kindergarten or primary school for the time being, and then resume their collective life after they are completely cured. Avoid transmission to family members or other children at home. At the same time, the hats, headscarves, pillow covers, clothes, etc. used by the patients should be disinfected by means of sun exposure, boiled water and other methods. Contaminated barber tools should also be thoroughly disinfected, boiled or sterilized, or placed in a closed container with formaldehyde gas. The infected hair, scales and suede are burned by application.
Complication
Head lice complications Complications
Astragalus can be spread by itself because of scratching. Some patients with white sputum can have purulent sputum, body sputum, hyperthyroidism and granuloma.
Symptom
Head lice symptoms common symptoms scaly pustules, herpes, herpes, bacterial infection, scalp, scalp, dandruff, multiple lymph nodes, permanent alopecia,
Astragalus is more common in childhood, can continue to adult and not self-healing, this is because unsaturated fatty acids have no inhibitory effect on the growth and reproduction of Trichophyton rubrum, white peony, mainly in preschool children, due to increased sebum secretion during adolescence The unsaturated fatty acids in sebum inhibit the pathogen of white sputum, so they can heal themselves until puberty, and children and adults can develop morbidity.
1. Astragalus Chinese medicine is called bald sore, "squeeze sore", "fat sore", etc., commonly known as "steamed head". After invading the scalp stratum corneum, Rhododendron chinense grows and multiplies, and quickly forms needles or mung beans at the roots. Large and small herpes, then become pustules, pustules form a sulphur-colored cognac after drying, the skin lesions expand, the skin becomes thicker, the edges are lifted, the center sticks to the scalp and is slightly sunken, and the center has hair shafts through, the appearance It is a dish-like shape called disc-shaped jaundice. It is composed of Phyllostachys pubescens and exfoliated epithelial cells. It is fragile and highly contagious. It removes the suede hard, and it is bright red moist erosion surface or shallow. Ulcers, easily secondary to bacterial infections, emit a uriney smell of rats, accompanied by swelling of nearby lymph nodes, hair invaded by pathogenic bacteria, become dull or curved, easy to remove, but no hair loss, and finally hair follicle destruction, Left atrophic scars and permanent alopecia, dish-shaped jaundice, atrophic scars, permanent alopecia are the three clinical features of jaundice. If jaundice is not treated in time, the continuous development of skin lesions can affect the entire scalp and form a wide range. Sexual alopecia Scars, but in the hairline can leave 1 ~ 2cm normal hair band, scars can be scattered in a few normal hair, itching is severe, can be spread by scratching itself, the hairy fungus can invade the trunk and smooth skin and deck of the limbs, There may be jaundice and skin atrophy, and nail damage is difficult to distinguish from other hyperthyroidism.
2. White peony Chinese medicine is called white baldness, and sputum hair sputum, such as "Surgical Treatment of the Whole Book" records that "the hair is a gradual bald spot on the head, long time is far away, dry and itchy, by the yin deficiency hot, shaved When the wind sorrows into the hole, it does not scatter, and the blood does not swell." The initial manifestation is a follicular papule with white scales on it, and the skin lesions gradually expand to form white scaly patches, which are round or oval. Clear boundaries, no obvious inflammation, slight itching or no symptoms. If left untreated, small satellite lesions may appear around the patchy lesions. Due to parasitic fungal spores, the hair roots around the lesion area are surrounded by a characteristic scaly sheath. It is not easy to remove, it is called fungus sheath, the disease is dry and dull, and the scalp grows about 4~5mm, which is easy to remove, grayish white scale spots, bacterial sheath and hair loss are the three clinical features of white peony. Some patients can With purulent sputum, body sputum, hyperthyroidism and granuloma.
3. Black spot initial damage is small white scaly plaque, scattered distribution, mild or no inflammation, sometimes white, due to spores in the hair to make the hair become brittle, the hair at the lesion scalp is broken, broken The residual root remains black in the mouth of the hair follicle, so the name is black spot, the disease course is longer, the disease progresses slowly, and it can not heal itself until adulthood. Over time, due to the destruction of hair follicles, there is a little flaky scar and Baldness, a small number of patients with insignificant hair loss, and mainly for desquamation, easy to be confused with seborrheic dermatitis, in addition, pathogens can also invade smooth skin and deck.
4. Purulent sputum is a strong inflammatory reaction of human skin to pro-animal or intimate fungal infections. Pus sputum also occurs in children, especially preschool children, initially manifested as purulent folliculitis, clustered small pustules. Fusion forms a inflammatory nodule or mass with clear boundaries, soft touch, small pus on the surface consistent with the hair follicle mouth, like honeycomb, porous pus during extrusion, loose hair and easy to remove, self-conscious pain Or asymptomatic, if secondary bacterial infection, there are obvious pain and tenderness, nearby lymph nodes often swollen, damage often single, there are a few multiple, often followed by scars and alopecia.
Examine
Head lice inspection
(1) Direct microscopic examination of fungi: intravital hyphae or joint spores can be seen in the jaundice, and staghorn hyphae and spores can be seen in the scutellaria; the round stalks of the scutellaria are arranged around the dense mosaic; For the chain spores arranged in a string, the spores are larger.
(2) Fungal culture: can help determine the pathogenic bacteria.
(3) Wood's lamp inspection: Astragalus membranaceus is dark green fluorescent; white peony is bright green fluorescent; black sputum is non-fluorescent.
Diagnosis
Head lice diagnosis
According to the clinical manifestations, the shape and location of the lesions and microscopic examination can confirm the diagnosis, but should be differentiated from neurodermatitis and chronic eczema:
First, neurodermatitis: there is obvious mossy, no blister, mold microscopy negative.
Second, chronic eczema: no edge of the embankment, the boundary is not clear, the mold is negative.
1. Psoriasis scalp psoriasis damage is marked by inflammatory erythema, clear silvery white thick, hair bundled, but no hair loss, sterile sheath, fungal examination negative.
2. Seborrheic dermatitis The scalp has diffuse scaly plaques, unclear borders, or oily suede, with hair loss, but no hair loss and fungal sheath, negative fungal examination.
In addition, it is necessary to identify the head eczema, scalp pityriasis, etc., if necessary, mycological examination, purulent sputum should also be associated with suppurative skin abscess such as head piercing folliculitis and inflammation around the hair follicle, the latter no honeycomb Follicular pores, obvious pain, often accompanied by fever, if necessary, fungal microscopic examination can be identified.
