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Deng R, Chen X, Zheng D, Xiao Y, Dong B, Cao C, Ma L, Tong Z, Zhu M, Liu Z, Lu S, Fu M, Jin Y, Yin B, Li F, Li X, Abliz P, Liu H, Zhang Y, Yu N, Wu W, Xiong X, Zeng J, Huang H, Jiang Y, Chen G, Pan W, Sang H, Wang Y, Guo Y, Shi D, Yang J, Ran Y, Hu J, Yang L, Bai S, Yu J, Wang X, Li R. Epidemiologic features and therapeutic strategies of kerion: A nationwide multicentre study. Mycoses 2024; 67:e13751. [PMID: 38825584 DOI: 10.1111/myc.13751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/13/2024] [Accepted: 05/26/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Kerion is a severe type of tinea capitis that is difficult to treat and remains a public health problem. OBJECTIVES To evaluate the epidemiologic features and efficacy of different treatment schemes from real-world experience. METHODS From 2019 to 2021, 316 patients diagnosed with kerion at 32 tertiary Chinese hospitals were enrolled. We analysed the data of each patient, including clinical characteristics, causative pathogens, treatments and outcomes. RESULTS Preschool children were predominantly affected and were more likely to have zoophilic infection. The most common pathogen in China was Microsporum canis. Atopic dermatitis (AD), animal contact, endothrix infection and geophilic pathogens were linked with kerion occurrence. In terms of treatment, itraconazole was the most applied antifungal agent and reduced the time to mycological cure. A total of 22.5% of patients received systemic glucocorticoids simultaneously, which reduced the time to complete symptom relief. Furthermore, glucocorticoids combined with itraconazole had better treatment efficacy, with a higher rate and shorter time to achieving mycological cure. CONCLUSIONS Kerion often affects preschoolers and leads to serious sequelae, with AD, animal contact, and endothrix infection as potential risk factors. Glucocorticoids, especially those combined with itraconazole, had better treatment efficacy.
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Affiliation(s)
- Ruixin Deng
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Xiaoqing Chen
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Dongyan Zheng
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yuanyuan Xiao
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Bilin Dong
- Department of Dermatology, Wuhan No. 1 Hospital, Wuhan, China
| | - Cunwei Cao
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhongsheng Tong
- Department of Dermatology, Wuhan No. 1 Hospital, Wuhan, China
| | - Min Zhu
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zehu Liu
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Sha Lu
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meng Fu
- Department of Dermatology, Xijing Hospital, Xi'an, China
| | - Yun Jin
- Department of Dermatology, Dermatology Hospital of Jiangxi Province, Nanchang, China
| | - Bin Yin
- Department of Dermatology, Chengdu Second People's Hospital, Chengdu, China
| | - Fuqiu Li
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, China
| | - Xiaofang Li
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Palida Abliz
- Department of Dermatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Hongfang Liu
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Yu Zhang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Nan Yu
- Department of Dermatology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Weiwei Wu
- Department of Dermatology, The Fifth People's Hospital of Hainan Province, Haikou, China
| | - Xincai Xiong
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jingsi Zeng
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huaiqiu Huang
- Department of Dermatology and Venereology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanping Jiang
- Department of Dermatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Guanzhi Chen
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Weihua Pan
- Department of Dermatology, Shanghai Changzheng Hospital, Naval Military Medical University, Shanghai, China
| | - Hong Sang
- Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ying Wang
- Department of Dermatology, Changhai Hospital of Shanghai, Shanghai, China
| | - Yun Guo
- Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Dongmei Shi
- Department of Dermatology, Jining First People's Hospital, Jining, China
| | - Jianxun Yang
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yuping Ran
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Jin Hu
- Department of Dermatology, The Affiliated Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | | | - Shuang Bai
- The Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Jin Yu
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Xiaowen Wang
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Ruoyu Li
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
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