Title: Difficulties in the diagnosis and therapy of skin and hair mycoses in children
- Wiaczesław Niczyporuk, Elżbieta Krajewska-Kułak, Cecylia Łukaszuk, Marianna Bartoszewicz, Ewa Bokiniec
- Original articles
- Clinical Dermatology
- Start page:
- Final page:
- mycoses, incorrect diagnosis and therapy
Introduction: Constant development in the diagnosis and therapy of mycoses did not change the fact that skin mycoses in children constitute still high percentage of dermatoses. Aim of study: The analysis of case records of patients hospitalized at the Department of Dermatology and Venereology at Medical University in Białystok in the years 1981-1998 and their verification and evaluation of the percentage of incorrect diagnosis and therapy in ambulatory. Material and methods: The analysis included 1181 case records of children up to 18 years old. Results: Fungal infection was diagnosed in 222 patients. The inappropriate preliminary diagnosis of mycosis was established in 27.9% of children. Most children were from rural region, mainly boys. The greatest difficulties in the diagnosis and therapy referred mainly to tinea superficialis capitis (51.9%) and tinea superficialis cutis glabrae (32.5%), the lowest to tinea profunda capitis and cutis glabrae (14.3%). Ambulatory diagnosis was initially mainly psoriasis, eczema, allergic dermatitis, folliculits and pyodermia. The inappropriate therapy in children included mostly topical and/or systemic corticosteroids (61.3%) and antibiotics (24.2%). During hospitalization final diagnosis of mycosis was established in 91.9% of children already after first mycological investigation. Conclusions: Ambulatory mistakes in the diagnosis of skin mycosis made by pediatrists, internists and dermatologists are due to the lack of konwledge of the clinical picture of dermatomycosis and its similarity to other dermatoses. In every case of mycosis suspicion mycological examination should be performed before introducing therapy.