소아에서 피부사상균증의 임상 및 균학적 관찰

Abstract

Background: Dermatophytoses account for 5~15% of disorders seen in pediatric clinics. Clinical charateristics and therapeutic strategies of children are differ from adults.

Objective: We performed retrospective study in order to observe clinical and mycological features of dermatophytoses in pediatric patients including therapeutic strategies.

Methods: This clinical and mycological investigation was made with 404 cases of dermatophytoses among out-patients in the Department of Dermatology of Severance Hospital, Yonsei University College of Medicine, from February, 1996 to January, 2001.

Results: Dermatophytoses showed high incidence in 14~15 years of age group (54 cases), less than 1 year of age group (35 cases) and 13~14 years of age group (32 cases). The ratio of male to female was 1.3 : 1. Especially in patients with tinea cruris, which was the most prominent diseases showing male predominance, the sex ratio was 3.4 : 1. The incidence of each type of dermatophytoses was the highest in Tinea (T.) corporis (21.6%), followed by T. capitis (20.3%), T. pedis (19.8%), T. cruris (13.6%), Onychomycosis (13.6%), T. faciei (7.5%) and T. manus (3.6%). The mean-duaration before diagnosis was longest in onychomycosis (529 days), followed by T. cruris (367 days), T. pedis (273 days), T. capitis (144 days), T. manus (139 days), T. corporis (138 days) and T. faciei (77 days). The most common cultured organism was Microsporum (M.) canis (24 cases) followed by Trichophyton (T.) mentagrophytes (22 cases), T. rubrum (20 cases) and M. gypseum (1 case). The treatment with topical antifungal agents (62%) was more commonly used than the treatment with oral antifungal agents (38%). The type of dermatophytoses that is the most resistant to topical and oral antifungal agents was tinea capitis caused by M. canis.

Conclusion: The incidence of T. capitis in children was much higher than that in adults and the response to antifungal agents in children showed resistance to first-line therapy in T. capitis caused by M. canis.