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Kerion and dermatophytic granuloma. Mycological and histopathological findings in 19 children with inflammatory tinea capitis of the scalp.
Int J Dermatol. 2006 Mar; 45(3):215-9.IJ

Abstract

BACKGROUND

Inflammatory tinea capitis or kerion is the result of a hypersensitivity reaction to a dermatophytic infection. Majocchi's granuloma, in contrast, usually begins as a suppurative folliculitis and culminates in a granulomatous reaction.

OBJECTIVES

To present clinical, mycological and histopathological findings for 19 cases of kerion of the scalp in children.

METHODS

Nineteen children were investigated (14 boys and five girls) with a mean age of 6.5 years. A potassium hydroxide (KOH) exam and culture in Sabouraud dextrose agar were performed, followed by a biopsy with hematoxylin and eosin, periodic acid-schiff (PAS) and Gomori-Grocott stains. The same investigations were carried out in four control cases of noninflammatory tinea capitis.

RESULTS

Clinical history varied from 2 to 16 weeks (mean 6.6 weeks). Diagnosis was confirmed by a positive KOH exam: all cases except one had a positive culture. The following dermatophytes were isolated: Microsporum canis (32%), Trichophyton mentagrophytes (27%), Trichophyton tonsurans (21%), Trichophyton rubrum (10%) and Microsporum gypseum (5%). The histopathological findings were: suppurative folliculitis (SF) 11%, SF plus suppurative dermatitis 37%, suppurative and granulomatous dermatitis (SGD) 26% and SGD plus fibrosing dermatitis 26%. Fungi were observed in 63% of the histopathological sections. Perifollicular infiltrates (PF) around the parasitized hair follicles were identified in the four noninflammatory control cases due to M. canis.

CONCLUSIONS

Kerion Celsi is an inflammatory or suppurative type of tinea capitis caused by zoophylic dermatophytes (M. canis and T. mentagrophytes), but also by antrophophylic (T. tonsurans and T. rubrum) and geophylic (M. gypseum) dermatophytes. Histopathological findings showed a spectrum from mild suppurative folliculitis to dense granulomatous infiltrates without a clear relationship with the clinical features.

Authors+Show Affiliations

Arenas R
Dermatology Department, "Manuel Gea Gonzalez" General Hospital, Mexico City, Mexico. dermages@prodigy.ne.mx
Toussaint S
No affiliation info available
Isa-Isa R
No affiliation info available

MeSH

BiopsyChildChild, PreschoolFemaleGranulomaHumansMaleMicrosporumSkinTinea CapitisTrichophyton

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16533218

Citation

Arenas, Roberto, et al. "Kerion and Dermatophytic Granuloma. Mycological and Histopathological Findings in 19 Children With Inflammatory Tinea Capitis of the Scalp." International Journal of Dermatology, vol. 45, no. 3, 2006, pp. 215-9.
Arenas R, Toussaint S, Isa-Isa R. Kerion and dermatophytic granuloma. Mycological and histopathological findings in 19 children with inflammatory tinea capitis of the scalp. Int J Dermatol. 2006;45(3):215-9.
Arenas, R., Toussaint, S., & Isa-Isa, R. (2006). Kerion and dermatophytic granuloma. Mycological and histopathological findings in 19 children with inflammatory tinea capitis of the scalp. International Journal of Dermatology, 45(3), 215-9.
Arenas R, Toussaint S, Isa-Isa R. Kerion and Dermatophytic Granuloma. Mycological and Histopathological Findings in 19 Children With Inflammatory Tinea Capitis of the Scalp. Int J Dermatol. 2006;45(3):215-9. PubMed PMID: 16533218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kerion and dermatophytic granuloma. Mycological and histopathological findings in 19 children with inflammatory tinea capitis of the scalp. AU - Arenas,Roberto, AU - Toussaint,Sonia, AU - Isa-Isa,Rafael, PY - 2006/3/15/pubmed PY - 2006/7/11/medline PY - 2006/3/15/entrez SP - 215 EP - 9 JF - International journal of dermatology JO - Int J Dermatol VL - 45 IS - 3 N2 - BACKGROUND: Inflammatory tinea capitis or kerion is the result of a hypersensitivity reaction to a dermatophytic infection. Majocchi's granuloma, in contrast, usually begins as a suppurative folliculitis and culminates in a granulomatous reaction. OBJECTIVES: To present clinical, mycological and histopathological findings for 19 cases of kerion of the scalp in children. METHODS: Nineteen children were investigated (14 boys and five girls) with a mean age of 6.5 years. A potassium hydroxide (KOH) exam and culture in Sabouraud dextrose agar were performed, followed by a biopsy with hematoxylin and eosin, periodic acid-schiff (PAS) and Gomori-Grocott stains. The same investigations were carried out in four control cases of noninflammatory tinea capitis. RESULTS: Clinical history varied from 2 to 16 weeks (mean 6.6 weeks). Diagnosis was confirmed by a positive KOH exam: all cases except one had a positive culture. The following dermatophytes were isolated: Microsporum canis (32%), Trichophyton mentagrophytes (27%), Trichophyton tonsurans (21%), Trichophyton rubrum (10%) and Microsporum gypseum (5%). The histopathological findings were: suppurative folliculitis (SF) 11%, SF plus suppurative dermatitis 37%, suppurative and granulomatous dermatitis (SGD) 26% and SGD plus fibrosing dermatitis 26%. Fungi were observed in 63% of the histopathological sections. Perifollicular infiltrates (PF) around the parasitized hair follicles were identified in the four noninflammatory control cases due to M. canis. CONCLUSIONS: Kerion Celsi is an inflammatory or suppurative type of tinea capitis caused by zoophylic dermatophytes (M. canis and T. mentagrophytes), but also by antrophophylic (T. tonsurans and T. rubrum) and geophylic (M. gypseum) dermatophytes. Histopathological findings showed a spectrum from mild suppurative folliculitis to dense granulomatous infiltrates without a clear relationship with the clinical features. SN - 0011-9059 UR - https://www.unboundmedicine.com/medline/citation/16533218/Kerion_and_dermatophytic_granuloma__Mycological_and_histopathological_findings_in_19_children_with_inflammatory_tinea_capitis_of_the_scalp_ DB - PRIME DP - Unbound Medicine ER -