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There are the following clinical varieties of mycosis: superficial chin-clipping mycosis and deep chin-clipping mycosis.
Deep beard clipping mycosis
Deep chin mycosis is a zoonotic mycosis of the hairy skin of the chin, cheeks and under the jaw, less often the upper lip, which runs rapidly with suppuration of the affected hair follicles, inflammatory tumors, enlargement of the surrounding lymph nodes and fever.
It is most common in men and almost always affects farmers, vets, and other owners contact with large animals. Most cows are infected with this fungus. After the first contact with cattle, young boys may develop a scalp infection and a “kerion” reaction. All men with mature stubble can develop an infection.
The causes of the disease
Deep mycosis is caused by zoophilic fungi:
- T. verrucosum – causes mycosis in cattle,
- T. mentagrophytes var. granulosum (granular variety),
- T. mentagrophytes var. gypseum (flour variety) – occur in domestic animals and rodents.
The fungal spores are located outside the hair, and infection in humans is most common in the countryside.
The mechanism of mycosis formation
A deeply cut (kerion) fire is preceded by its appearance a few days earlier foci of superficial mycosis with pustules against the background of an acute inflammatory reaction. Around the hair follicles, there are “cauliflower” bumps, prone to softening, in which the hair is loosely attached and not broken. The course of the infection is acute with a systemic reaction and enlargement of the surrounding lymph nodes. It usually takes several weeks for new, healthy hair to reappear at the site of an infection that is resolving.
Symptoms and location
Deep chin mycosis is most often located on:
- cheeks,
- chin,
- upper lip,
- submandibular area.
This infection presents as severe, deep folliculitis with erythema, nodular or lumpy cauliflower-like infiltrates with a papillary surface, with peeling and pustules. In addition, boils are formed.
Deep lesions can coalesce to form abscesses that often occupy the entire front surface of the neck, and the surrounding lymph nodes become markedly enlarged. It should be mentioned that shaving your beard promotes the spread of infection.
The hair in the focus is preserved, but can be easily removed. After pressing the focus of deep mycosis droplets of pus and purulent-bloody exudate appear in the places after the hair follicles – this phenomenon is referred to as “fungal purulent sieve” or “colander” (Fig. G-33 and G-34).
Diagnosis of mycosis
A preparation lightened with KOH / DMSO usually allows the presence of a fungus localized extrapolally (ectotrix), while culture on Sabouraud’s medium allows for the identification of the species. However, it should be emphasized that Trichophyton verrucosum grows very slowly, even for several weeks.
Deep beard shearing mycosis should be differentiated from:
- actinomycetes,
- staphylococcal folliculitis,
- inflammation of the hair follicles caused by Candida fungi,
- other types of folliculitis.
Deep chin mycosis – treatment
To treat mycosis, the following are administered orally:
- antibiotics
- azole,
- terbinafine.
Topical treatment is cleansing with topical anti-inflammatory agents and topical antifungal agents.
What’s the prognosis?
After 4-6 weeks it can happen self-healing and build-up of immunity. Recurrences of deep mycosis are rare, but basic sanitary measures should be maintained when working with infected animals.
DIG. G-32. Beard clipping mycosis with a deep reaction.
DIG. G-33. Clinical picture of deep upper lip mycosis caused by Trichophyton mentagrophytes var. granulosum.
DIG. G-34. Clinical picture of deep chin mycosis caused by Trichophyton verrucosum.
Superficial beard clipping
Superficial chin mycosis is a mycosis caused anthropophilic fungi islocalized within the hairy chin, less frequently than deep chin tinea. This ailment is relatively rare in our latitude.
Symptoms of superficial mycosis
The lesions are superficially located on the skin of a hairy beard. The hair is broken unevenly, a few millimeters above the skin, and leaves dotted trunks in the hair follicles that are darker in brunettes. In more severe cases, there are oval lesions typical for mycosis, showing greater activity on the periphery (herpes circinatus trichophyticus). In addition, persistent exfoliating, annular lesions of various degrees of advancement are often observed (Fig. G-35).
Superficial chin mycosis should be differentiated from the bacterial changes that may accompany mycosis.
Superficial chin mycosis – treatment
In general therapy, azoles and terbinafine are administered. In contrast, topical antifungal agents are recommended.
DIG. G-35. Clinical picture of superficial mycosis of the chin.
Also read:
- Fungal infections of the skin
- Mycosis of smooth skin – symptoms, diagnosis, photos
- Mold fungus in the organism – methods of mold fungus in the organism, diet
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