Successful treatment of severe kerion Celsi in an immunocompromised girl with evacuation of pus, terbinafine and short course glucocorticosteroids

Liu, Zhenran; Zhang, Y.; Zhu, Jingyu; Dai, Yeqin; Shen, Hong

doi:10.1016/j.mycmed.2015.12.005

Cited by 7 publications

(7 citation statements)

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“…Reactive lymphadenopathy, especially cervical or suboccipital, is a very common associated feature. KC often occurs in children but it has been described in elderly patients [49][50][51]. The higher Figure 5.…”

Section: Kerion Celsi [Kc] [So-called Deep Tinea Capitis] Is An Uncommentioning

confidence: 99%

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Infections, Infestations and Neoplasms of the Scalp

Canpolat¹

2017

Hair and Scalp Disorders

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This chapter reviews common cutaneous infections, infestations, and neoplasms of the scalp. Infections of the scalp are subdivided into three major groups. The most seen are: (1) Bacterial: Folliculitis, folliculitis decalvans, tufted hair folliculitis and acne keloidalis nuchae. (2) Fungal: Tinea capitis, favus and kerion celsi. (3) Protozoal: Syphilitic alopecia. Pediculosis capitis is the most common worldwide infestation of the scalp. The neoplasms of the scalp are large group of different diseases due to arising different origin. In the following section, trichilemmal cyst, proliferating trichilemmal cyst, nevus sebaceous and cylindroma are discussed in detail.

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Section: Kerion Celsi [Kc] [So-called Deep Tinea Capitis] Is An Uncommentioning

confidence: 99%

“…Diagnostic errors causes patients to undergo unnecessary surgery or antibiotic treatment. However, there is little evidence to support the use of antibiotics for severe KC [49]. Kerion celsi requires treatment with systemic antifungals to penetrate the affected hair shafts.…”

Section: Kerion Celsi [Kc] [So-called Deep Tinea Capitis] Is An Uncommentioning

confidence: 99%

Infections, Infestations and Neoplasms of the Scalp

Canpolat¹

2017

Hair and Scalp Disorders

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“…1 Kortikosteroid oral, yaitu prednison diberikan sebagai pengobatan tambahan pada kerion celsi dengan tujuan untuk mengurangi nyeri, bengkak, dan peradangan. [8][9][10][11] Liu dkk. menyajikan sebuah laporan kasus yang mengemukakan keberhasilan terapi kerion celsi pada pasien imunokompromais dengan kombinasi antifungi, evakuasi pus dan prednison oral jangka pendek yang diturunkan perlahan dosisnya hingga dihentikan pada hari ke-10.…”

Section: Pendahuluanunclassified

“…menyajikan sebuah laporan kasus yang mengemukakan keberhasilan terapi kerion celsi pada pasien imunokompromais dengan kombinasi antifungi, evakuasi pus dan prednison oral jangka pendek yang diturunkan perlahan dosisnya hingga dihentikan pada hari ke-10. 11 Imunokompromais adalah kondisi defisiensi imun oleh penyebab apapun, sehingga kemampuan sistem imun untuk melawan infeksi berkurang atau sepenuhnya hilang. Dalam keadaan tersebut imunitas seluler pasien terganggu sehingga rentan terhadap infeksi, termasuk dermatofita.…”

Section: Pendahuluanunclassified

“…Organisme patogen biasanya didapatkan dari kontak dengan hewan, yang merupakan sumber yang umum ditemukan. 2,4,11,20 Pada infeksi endotriks, artrokonidia dan hifa berada di dalam batang rambut dan korteks serta kutikula tetap utuh. Pola tinea kapitis ini memberi tampilan "black dot" yang terdiri atas rambut patah tepat di dekat orifisium folikel rambut dan meninggalkan conidia-filled stub area skalp.…”

Section: Pembahasanunclassified

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Kerion Celsi Yang Disebabkan Oleh Tricophyton Verrucosum Pada Pasien Imunokompromais

N¹,

Basuki²

2019

MDVI

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ABSTRAKKerion celsi merupakan manifestasi inflamasi pada infeksi dermatofita zoofilik diskalp. Salah satu penyebabnya adalah Trichophyton verrucosum. Imunitas seluler pada pasien imunokompromais terganggu sehingga rentan terinfeksi dermatofita.Pria, 73 tahun mengeluh benjolan bernanah di kepala yang nyeri dan gatal sejak 3 bulan sebelum konsultasi. Pada pemeriksaan dermatologis parietal skalp didapatkan alopesia berbatas tegas dengan boggy eritematosa 5 cm dan pustul folikular. Pemeriksaan dengan lampu Wood tidak menunjukkan fluoresensi. Pemeriksaan mikroskopik dengan KOH 20% didapatkan hifa dan artrokonidia ektotriks. Numerical rating score (NRS) nyeri 8, dan gatal 4. Identifikasi kultur kerokan kulit kepala dan rambut menunjukkan Trichophyton verrucosum. Pasien didiagnosis kerion celsi ,diterapi dengan griseofulvin microsized 20 mg/kg berat badan/hari selama 8 minggu, dan prednison 0,5 mg/kg berat badan/hari selama 10 hari yang kemudian diturunkan perlahan. Ditambahkan krim terbinafine HCL 1 % didahului kompres basah dua kali sehari. Setelah 8 minggu, perbaikan NRS mencapai nol, tanpa efek samping.Kerion celsi seringkali terjadi pada anak, jarang pada dewasa. Pada kasus ini terjadi pada pasien neoplasma berusia lanjut dalam kemoterapi. Usia lanjut, kanker paru, kemoterapi geftinib, diabetes mellitus dan kontak langsung dengan hewan peliharaan merupakan faktor risiko kondisi imunokompromais dan inokulasi patogen sehingga mempermudah dermatofita menginvasi rambut. ABSTRACT Kerion celsi is manifestation of inflammation in zoophilic dermatophytes scalp infection. One of its causative agents is Tricophyton verrucosum. Disturbed cellular immunity on immunocompromised patient bring susceptibility for dermatophyte infection.Male, 73 years old, complained painful and itch bump since 3 months. Dermatological examination of parietal scalp showed well defined alopecia with 5 cm boggy erythematous and with follicular pustule. Wood lamp showed no fluorescence. Microscopic examination with potassium hydroxide 20% showed hyphae and ectothrix arthroconidia. Numerical rating score (NRS) of initial pain was 8 and itch was 4. Identification of skin scraping and hair cultures showed Tricophyton verrucosum. Patient was diagnosed as kerion celsi and treated with microsized griseofulvin 20 mg/kg body weight/day and oral prednisone 0.5 mg/kg body weight/day which being tapered off in 10 days. Terbinafine cream 1% twice, prior twice daily wet gauze compress also being given. After 8 weeks, NRS reach zero without any side effects.Kerion celsi often happen on children. Within this case, it occurred in a geriatric patient with neoplasma during chemotherapy. Old age, lung cancer, geftinib chemotherapy, diabetes mellitus and direct contact with infected domestic animal were risk factors for immunocompromised state and pathogen inoculation that may facilitate dermatophyte hair invasion.

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Inflammatory ringworm due to Microsporum audouinii, case of a severe form in an immunocompetent girl in Mauritania

Ousmane

Ball

2023

IDCases

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Successful treatment of severe kerion Celsi in an immunocompromised girl with evacuation of pus, terbinafine and short course glucocorticosteroids

Cited by 7 publications

References 13 publications

Infections, Infestations and Neoplasms of the Scalp

Infections, Infestations and Neoplasms of the Scalp

Kerion Celsi Yang Disebabkan Oleh Tricophyton Verrucosum Pada Pasien Imunokompromais

Inflammatory ringworm due to Microsporum audouinii, case of a severe form in an immunocompetent girl in Mauritania

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