We examined the epidemiological trends in 23 cases of tinea capitis encountered at the Department of Dermatology, Kanazawa Medical University Hospital, from 1998 to 2007. The patients were 11 males and 12 females, aged from 1 y.o. to 81 y.o. (mean 34.2 y.o.). KOH examination for dermatophytes and fungal culture of hair shafts from all patients gave positive results. The distribution of clinical types was black dot ringworm (BDR) (14 cases), kerion celsi (6 cases) and gray patch (3 cases). The predominant causative agent was Trichophyton (T.) tonsurans (8 cases), followed by Microsporum canis (5 cases), T. violaceum (5 cases), T. rubrum (4 cases), and T. glabrum (1 case). T. tonsurans has been detected since 2002, and it was isolated only from adolescent patients doing contact sports such as judo or wrestling. T. violaceum was identified from two different families. In one family, a boy developed BDR three years after the two other siblings who had been cured. All the patients were treated with oral antimyicotic agents; terbinafine (TBF) in 10 cases, griseofulvin (GRF) in 9 cases, itraconazole in 1 case, and sequential administration of GRF and TBF in 3 cases. The treatment period with TBF was shorter compared with GRF; mean 46.4 days and 54.3 days, respectively. Topical application of antimycotics or antibiotics was also prescribed for 15 patients. It did not aggravate any of the cutaneous lesions.
A 66-year-old female patient presented with redness and swelling in her right leg. She had been diagnosed with cellulitis and treated with antibiotics, but there was no improvement of symptom; thus she visited our department. Since she had no fever, and inflammatory markers were low in her blood despite swelling of the leg, we suspected thrombosis. Based on MRI, she was diagnosed with secondary deep vein thrombosis caused by primary retroperitoneal fibrosis. An 87-year-old male patient had swelling in an area extending from the right leg to the dorsum of the foot. He had been diagnosed with cellulitis and treated with antibiotics, but there had been no improvement of symptoms. At his visit to our department, a distended and tortuous superficial vein was found in his right leg, but he had no fever, and inflammatory markers were low in his blood. Based on a CT scan, he was diagnosed with deep vein thrombosis. Cellulitis is a typical disease that may cause redness and swelling in the lower extremities. However, deep vein thrombosis may show similar symptoms in many cases, and it is important to consider this disease as a differential diagnosis.
We report here 35 cases of pediatric burn patients (0–7 years old) treated in our hospital between January 2005 and March 2008. Twenty (8 boys, 12 girls) of 35 cases were hospitalized, and 15 (9 boys, 6 girls) were outpatients. We analyzed their age, sex, cause, sites and depth of injury, and treatment procedures. Their average age was 1.66 years; 28 cases were younger than 2 years old, and the peak was 11 cases of 1 year-old boys. More than 80% of the children had been scalded by tipping boiled water or other liquid from the top down to the front chest. Accordingly, the burn injuries were observed mainly on the face and front chest, and the burn depths of these regions tended to be deeper. As local treatment, we utilized wet dressings with basic fibroblast growth factor (bFGF) spray for all the patients. bFGF spray facilitated the wound healing, and all of the cases with superficial dermal burns were completely epithelized within 1 week; 11 of 12 cases with deep dermal burns experienced more than 90% epithelization in 3 weeks. Only two cases needed surgical treatment.