Scab

Scab is a chronic infection caused by dermatophytic Trychophyton schoenleinii. Affects the scalp but can also affect the skin and nails glabra. Usually starts on the scalp in childhood and persist for many years in the form of plates crusted. Stage involves severe loss of hair on large areas scalp, atrophy and alopecia scar. Pe pielea glabra favusul este o eruptie papuloveziculara si papuloscuamoasa. Onicomicoza tinea favosa este similara cu alte forme de tinea unghuium. Glabra is a scab, skin rash and papuloscuamoasa papuloveziculara. Onychomycosis tinea favosa is similar to other forms of tinea unghuium.
Desi favusul nu este foarte contagios pot fi afectati citiva membrii ai familiei, acestia necesitind tratament simultan. Although scab is not very contagious, can be affected several family members, they required treatment time. Prognosticul tratamentului depinde de stadiul in care este descoperita afectiunea. The prognosis of treatment depends on the stage of disease is discovered. Boala de lunga durata, severa poate determina alopecie cicatriciala ireversibila. Long-term disease, can cause severe irreversible scar alopecia.

Tratamentul este sIstemic. Treatment is systemic. Se foloseste griseofulvina. Se poate opta si pentru agenti topici cum sunt sampoanele, lotiunile cu antifungice. Griseofulvin is used. You can opt for topical agents such as shampoos, lotions antifungal.
Favusul nu arata o tendinta de remitere spontana . Alopecia cicatriciala cu atrofia pielii este frecventa in afectiunile de lunga durata. Scab does not show a tendency to spontaneous remission. alopecia scar with skin atrophy is common in long-term diseases. La acesti pacienti scalpel si pielea glabra sunt afectate. In these patients glabra scalpel and skin are affected.

Patogenie si cauze Pathogenesis and causes
Favusul este o dermatofitie superficial determinate de obicei de T. Scab, is a dermatophytic surface often caused by T. schoenleinii . schoenleinii. La cei mai multi pacientii favusul este o forma severa de tinea capitis, totusi poate apare desi rar, ca onicomicoza, tinea barbae sau tinea corporis. In most patients scab is a severe form of tinea capitis, although rarely, however, may occur as onychomycosis, tinea barbae or tinea corporis.
Favusul este unul dintre cele trei forme de infectie a parului: ectotrix, endotrix si favus. Scab is one of the three forms of infection of hair: ectotrix, endotrix and scab. Tipic parul nu este infectat grav ca in trichifitoza cauzata de Trtchophyton tonsurans . Typical hair is not as serious infection caused by Trtchophyton in trichifitoza tonsurans. Parul poate creste, frecvent fiind observate fire lungi de par. Hair can grow, often being observed long hairs. Cel mai characteristic element este formarea de spatii de aer intre hifele parului infectat. The most characteristic feature is the formation of air spaces between the hyphae infected hair. Acestea sunt tunele de aer prin autoliza hifelor. They are air by autolysis of hyphae tunnels. Artroconidia este rar observata in par. Artroconidia is rarely seen in the hair.

Semne si simptome Signs and symptoms
Favus apare la copii si adulti. Scab occurs in children and adults. Este dobindit de obicei in copilarie sau adolescent si persista in perioada de adult. It is usually acquired in childhood or adolescence and persist into adulthood. Favusul debuteaza pe scalp, in copilarie si persista pentru multi ani sub forma de placi crustoase. Scalp scab begins in childhood and persist for many years in the form of plates crusted.

In functie de severitatea bolii suntdescrise 3 stadii: Depending on severity suntdescrise three stages:
-primul stadiu-se observa doar eritem al scalpului in jurul foliculilor, parul nu este rupt sau cazut First stage, only see the redness around the follicles of the scalp, hair is not broken or fallen
-stadiul doi-formarea scutulei este observata la inceputul pierderii parului Two-stage training-scutulei is observed at the beginning of hair loss
-stadiul trei-cel mai sever stadiu implica pierderea parului de pe suprafete intinse ale scalpului, atrofia pielii si cicatrice. Three-stage the most severe stage involves large areas of hair loss on the scalp, skin atrophy and scarring.

Examen fizic Physical Exam
Scutula este o crusta galbena in forma de cupa care inconjoara firul de par . Scutula is a crusty yellow cup-shaped surrounding hair. Aceasta formeaza o placa densa, fiecare compusa din micelii si resturi epidermice. Frecvent apare o infectie bacteriana secundara in placa. Inlaturarea placii lasa o baza umeda eritematoasa. Masele dense de cruste galbene pot fi solitare sau numeroase iar pacientii care sunt afectati sever implica intreg scalpul. This forms a dense plate, each consisting of micelles and epidermal debris. Often there is a secondary bacterial infection in plaque. Motherboard removal leaves a moist erythematous base. Masses of dense crusts may be solitary or numerous yellow and patients who are severely affected involve the entire scalp . Este prezent si un miros specific. And an odor is present. Pielea glabra poate prezenta crustificare galbena similara. Glabra may crustificare yellow skin similar.
Pe pielea glabra favusul este o eruptie papuloveziculara sau papuloscuamoasa in care este evident scutula. Tinea favosa este o alta forma de onicomicoza. Glabra is a scab, skin rash or papuloscuamoasa papuloveziculara is evident in scutula. Favosa Tinea is another form of onychomycosis.

Alte manfestari atipice ale favusului cuprind: Other atypical Ages of scab include:
-favus pitiroides mimeaza matreata sau dermatita seboreica ; sunt prezenta scuame medii numeroase; inlaturarea scuamelor de pe suprafata descopera zone de piele rosie, umeda si cicatriciala -Scab pitiroides mimics dandruff or seborrheic dermatitis , this scaling environments are numerous, remove scales on the skin surface areas reveals red, wet and scar
-favus psoriaziformis este un favus care imita psoriazisul pe pielea scalpului sic ea glabra; in loc de scutula galbena pacientii prezinta scauame albe care mimeaza leziunile din psoriazis -Scab is a scab that mimics psoriaziformis psoriasis on her scalp sic glabra; scutula yellow instead of white patients have scauame mimicking lesions of psoriasis
-favus folicularis este caracterizat de papule galbene, conice in jurul foliculilor, parul arata caracteristicele tipice ale favusului Folicularis-scab is characterized by yellow papules, bevel around hair follicles, hair shows characteristics typical scab
-favus impetigoides este caracterizat de imitarea impetigoului prin cruste galbene ca mierea localizate pe scalp; frecvent formeaza placi mari care nu se amelioreaza cu tratament antibacterian -Scab impetigoides Impetigo is characterized by imitation honey-crusted yellowfin located on the scalp, often forming large plates that do not improve with antibacterial therapy
-favus papiroides este caracterizat de mici loci pe scalp care sunt acoperiti de o substanta stralucitoare similara parchetului; sub aceasta este prezenta scutula Papiroides-scab is characterized by small loci on the scalp are covered with a substance similar shiny floors, as it is this scutula
-favus herpetiformis este o variant atipica a favus corporis; sunt localizate pe trunchi si extremitati papule mici, pustule, vezicule , cruste, placi scuamoase rotunde, eritematoase; aceasta forma de favus arata o forma anulara si este similara leziunilor tineei corporis. -Scab, herpetiformis is an atypical variant of scab corporis, are located on the trunk and extremities small papules, pustules, blisters , scabs, scaly plates round, erythematous, this form of scab shows a cancellation form and is similar to tinea corporis lesions.

Diagnostic Diagnosis
Studii de laborator: Laboratory studies:
-cultura si microscopie optica pentru examinarea si confirmarea micologica -Culture and microscopy for the examination and confirmation of mycological
-tratarea cu solutie de hidroxid de potasiu a specimenelor de examinat la microscop -Treatment with potassium hydroxide solution specimens examined under the microscope
-caracteristic se vor observa spatiile tubular cu aer dintre hife -Characteristic is observed hollow air spaces between the hyphae
-examinarea fragmantelor de scutulum arata filament segmentare si spori Show scutulum fragmantelor-examining the segmentation and increase the filament
-cultura organismului se face pe mediu Sabourand plus cloramfenicol si cicloheximida pentru a inhiba cresterea bacteriilor. Body-culture medium is made and cicloheximida Sabourand plus chloramphenicol to inhibit bacterial growth.

Examen histologic. Sectiunile de biopsie arata micelii in scutulum si stratul cornos al epidermului, care este atrophic. Histological examination. Micelles in sections of biopsy shows scutulum and stratum corneum of the epidermis, which is atrophic. Marginile scutulei arata hife bine pastrate. Scutulei edges show well-preserved hyphae. Central leziunii contine micelii degenerate si debriuri granulare. Central lesion containing micelles debriuri degenerate and granular. In derm este present un infiltrate inflamator moderat-sever. The dermis is currently a moderately severe inflammatory infiltrates.
Diagnosticul diferential se face cu urmatoarele afectiuni: candidoza citanata, foliculita , lupus eritematos discoid, pseudopelada, placile de psoriazis, dermatita seboreica, tinea capitis, pediculosis capitis. The differential diagnosis is made with the following conditions: Candida citanata, folliculitis , lupus erythematosus discoid, pseudopelada, psoriasis plaques, seborrheic dermatitis, tinea capitis, pediculosis capitis.

Tratament favus Scab treatment

Desi favusul nu este foarte contagios afectiunea se observa la mai multi membrii ai familiei. Although scab is not very contagious disease is seen in more than family members. La cei mai multi pacienti implica pierderea parului de aceea este necesar tratamentul systemic. In most patients that involve hair loss treatment is systemic. Agentii topici aditionali precum sampoanele, lotiunile si cremele cu ketoconazole si sulfit de selenium sunt de ajutor. Igiena generala a capului trebuie imbunatatita, iar crustele si debriurile trebuie inlaturate. Additional topical agents such as shampoos, lotions and creams with ketoconazole and selenium sulfide are helpful. General hygiene should be improved head and scales and debriurile should be removed.
Favusul este controlat de obicei cu griseofulvina, tratamentul standard in tinea capitis . Terbinafina, itraconazole si fluconazole in doze similar cu cele pentru tinea capitis pot eradica fungul si vindeca boala. Scab is usually controlled with griseofulvin, the standard treatment in tinea capitis. Terbinafine, itraconazole and fluconazole in doses similar to those for tinea capitis, can eradicate the fungus and cure disease. Favusul nu prezinta tendinta de remitere spontana. Scab shows no tendency to spontaneous remission. Alopecia cicatriciala cu atrofia pielii este comuna in boala de lunga durata. Alopecia scar with skin atrophy is common in long-term illness. La acesti pacienti sunt afectate scalpel si pielea glabra. These patients are affected by scalpel and skin glabra.