Vellus Research Articles

CDK4/6 plus aromatase inhibitor-induced alopecia in breast cancer patients.

e12537 Background: Cyclin-dependent kinase (CDK) 4 and 6 inhibitors are a novel therapy for metastatic breast cancer, and have shown to double the risk of alopecia. This study analyzed CDK4/6 plus aromatase inhibitor-induced alopecia (CDKIA), its impact on quality of life (QoL), and response to topical dermatologic therapy. Methods: The study analyzed a retrospective cohort of breast cancer patients diagnosed with CDKIA, evaluating clinical features, QoL, and response to therapy. CDKIA was also compared with endocrine-therapy induced alopecia (EIA). Results: 39 female CDKIA patients (median age 62 years [range 34-81]) were included, and 36 (92%) had standardized clinical images. CDKIA was most commonly attributed to a CDK inhibitor and letrozole in 23 patients (59%). CDKIA was similar to androgenetic alopecia (AGA) in every patient. Compared to EIA, CDKIA took less time to develop, was more severe, was associated with diffuse alopecia more frequently, and consisted of more vellus hairs on trichoscopy (Table). The Hairdex questionnaire, an alopecia-specific QoL survey, showed that CDKIA patients experienced worse QoL than EIA patients ( P < 0.05) and were most affected emotionally ( P < 0.01). There was a moderate to significant alopecia improvement in 11 of 13 CDKIA patients (85%) after treatment with topical minoxidil. Conclusions: CDKIA was clinically similar to AGA in association with diffuse alopecia. Patients with CDKIA had a negative emotional impact on appearance-based QoL. However, topical minoxidil may improve the severity of CDKIA. Baseline characteristics of CDKIA and EIA patients. [Table: see text]

Maintenance of optimised hair growth from viable terminal scalp hair follicles at baseline with oral finasteride in male pattern hair loss and first evidence of a "drug dependency" and a post-finasteride "rebound effect".

Analytical measures for the pharmacodynamics understanding of drug induced scalp hair responses are lacking. The present study measured in detail dynamics of hair productivity on two scalp test sites showing male pattern hair loss. The natural regression decay rate established after 2years without treatment was followed by treatment with daily oral intake of 1mg finasteride. While terminal hair (diameter ≥40μm) were maintained "on-drug," within 30months "off-drug" MPHL significantly worsened as 94% terminal hair miniaturised and became unproductive. Accordingly, the viable drug responding follicles were qualified as "finasteride dependent" unravelling a hereto unreported "rebound effect" after interruption of the drug intake. Interestingly, the transformation of terminal hair into miniaturised hair occurred only after 12months without treatment, that is the time necessary to complete a clinically significant full hair cycle initiated during the drug intake. This explains why exogen hair release and miniaturisation occurred only between 12 and 30months "off-drug" while resistant hair grew also slower. Drug dependency and rebound phenomenon are new findings along with evidence against the hypothesis claiming that terminal hair growth arises from initial vellus hair follicles in drug-treated MPHL.

Simulation of UV power absorbed by follicular stem cells during sun exposure and possible implications for melanoma development.

The incidence of melanoma in children is extremely rare. However, there is convincing evidence supporting a higher risk of developing melanoma in individuals who have experienced excessive sun exposure during their childhood. A possible explanation for this phenomenon is that prior to puberty, the melanocyte stem cells in the bulge region of hair follicles are much shallower in the dermis, resulting in their increased vulnerability to sun exposure. To validate this hypothesis, a Monte Carlo simulation of light transport is applied to quantify the dose of solar UV power absorbed in the stem-cell layers at different depths in both child and adult skins. The simulated results suggest that the stem cells in vellus hair follicles would absorb over 250times higher UV photons than those in the terminal hair follicles. Due to the thinner epidermis in child skin, the stem cells in vellus hair follicles absorb about 1.9 and 3.2times greater ultraviolet A and ultraviolet B, respectively, than those in adult skin. These findings provide a possible explanation to why children are particularly vulnerable to sun exposure.

Fibrosing Alopecia in a Pattern Distribution (FAPD) in 16 African-Descent and Hispanic Female Patients: A Challenging Diagnosis

Background: Fibrosing alopecia in a pattern distribution (FAPD) has only been described in Caucasian patients, and it is not clear whether it can develop in dark-skin ethnicities. Materials and Methods: Sixteen Brazilian female patients, 12 of African descent and 4 Hispanic, with progressive scarring alopecia in a pattern distribution were analyzed. Results: Dermatoscopic features showed perifollicular erythema and scaling (14/16), hair fiber diameter diversity (16/16), loss of follicular ostia (16/16), and follicular keratosis (3/16). Late stages showed a honeycomb pigmented network (12/16), a hyperpigmented perifollicular halo (12/16), and small white patches (12/16). Histopathological features showed lichenoid perifollicular infiltrate (14/16), follicular miniaturization (16/16), concentric fibrosis (16/16), perifollicular lymphocytic infiltrate (16/16), and vellus hair involvement (10/16). Premature desquamation of the inner root sheath was found in 11 patients. Conclusions: The concomitant findings of cicatricial pattern hair loss (with or without the recess of the front hair line), hair fiber diversity, perifollicular erythema and scaling, a whitish perifollicular halo, and histological findings of androgenetic alopecia, with vacuolar interface alteration of the upper portion of the follicular epithelium, are the main key features to suggest the diagnosis of FAPD. FAPD is a possible diagnosis in patients of color with cicatricial pattern hair loss. Clinical, dermatoscopic, and histopathological examination allow a proper final differential diagnosis.

Serum biotin and zinc in male androgenetic alopecia.

Male androgenetic alopecia (MAGA) is caused by the conversion of the terminal to vellus hair. Zinc is one of the most studied trace elements in hair disorders and biotin is one of the most prescribed supplement for its treatment. The study aimed to evaluate serum zinc and biotin levels in MAGA patients to answer the question if there is a value to add zinc or biotin as a supplements in the MAGA treatment. Sixty MAGA patients and 60 age, sex, and body mass index-matched healthy volunteers were included. We measured serum biotin and zinc in all participants. Zinc (µg/dL) was lower significantly in patients compared to controls (P=0.01), suboptimal biotin (ng/L) levels were in patients, and within normal values in controls (P=0.01). A positive significant correlation was found between serum zinc and serum biotin (r=0.489, P=0.001). Serum zinc and biotin showed a nonsignificant correlation with age and disease duration. A non-significant relation was obtained between the MAGA grades, and zinc (P=0.485) and biotin levels (P=0.367). Serum zinc showed subnormal value and adding zinc supplement in MAGA treatment is recommended. Serum biotin showed a suboptimal level in MAGA patients that is not correlated with patients' age or disease severity. Biotin supplement in MAGA treatment may add value to hair quality and texture. We recommend future biotin evaluation in serum combined with its metabolites in MAGA patients' urine.

A cross-sectional study of the histopathology and immunology of alopecia areata: Unearthing the role of the Janus kinase-signal transducer and activator of transcription pathway.

Alopecia areata is an autoimmune disease that occurs as a result of the loss of the inherent immune privilege of the hair follicle. It has been recently demonstrated that the interferon-γ/interleukin-15 feedback loop that signals via the Janus kinase-signal transducer and activator of transcription pathway is critical to the breakdown of this immune privilege. To evaluate the immunological distribution of CD4+ T-cells, CD8+ T-cells, phosphorylated signal transducer and activator of transcription 1 and study its relation with the clinical and histopathological findings of the disease. A total of 30 patients of alopecia areata were included in the study. Following a detailed history and clinical examination, a scalp biopsy was performed. Histopathology was studied and immunohistochemistry was done to demonstrate the positivity and distribution of CD4+ T-cells, CD8+ T-cells and phosphorylated signal transducer and activator of transcription 1. The follicular count, number of anagen and terminal hair were found to be decreased, whereas the catagen, telogen and vellus hair were found to be increased in number. A peribulbar CD4+ T-cell infiltrate was seen in 70% cases, whereas a CD8+ T-cell infiltrate was seen in 83.3% cases. An intrabulbar CD4+ T-cell infiltrate was seen in 26.7% cases, whereas a CD8+ T-cell infiltrate was seen in 70% cases. Among the 25 hair follicles dermal papilla identified, 36.8% cases were found to be positive for phospho-signal transducer and activation of transcription-1. The drawbacks of our study included a small sample size and the use of only vertical sectioning for the scalp biopsy samples. Phosphorylated signal transducer and activator of transcription 1 positivity as an indicator of signalling via the Janus kinase-1/2 pathway was seen in 36.8% of our cases highlighting the integral role of this pathway in the pathogenesis of alopecia areata.

New insights into leukotrichia in nonsegmental vitiligo: A cross-sectional study.

Leukotrichia has been considered a predictor of poor outcome in vitiligo. However, studies considering the different clinical aspects of leukotrichia in vitiligo patients are few. Our aim was to conduct a detailed clinical study to provide insights into the relevance and associations of leukotrichia in non-segmental vitiligo. In this cross-sectional study, vitiligo patients attending the dermatology outpatient clinic and phototherapy unit at Cairo University Hospital over a period of 6 months (April-September 2016) were included. Family history, clinical details, the Vitiligo Global Issues Consensus Conference classification, the Dermatology Life Quality Index, Vitiligo Area and Severity Index, Vitiligo Extent Score, Vitiligo Disease Activity Score and Vellus Score were determined and these measurements were correlated to leukotrichia. Out of the 101 patients studied, leukotrichia was found in 47 (46.5%) patients, with vellus hair involved in 37 (78.7%), terminal hairs in 30 (63.8%) and both in 20 (42.5%) patients. Vellus hair involvement was significantly higher in generalized bilaterally symmetrical vitiligo than in acrofacial or unclassified vitiligo. The incidence of scalp leukotrichia also was higher in generalized symmetrical vitiligo than in acrofacial vitiligo. The Vellus Score showed significant associations with Vitiligo Area and Severity Index, Vitiligo Extent Score and the Dermatology Life Quality Index. This was a short-term study with a small sample size. Prognostic and therapeutic correlations were not studied; prospective longitudinal studies are needed for further evaluation. Leukotrichia was found in almost half of the studied sample and its frequency varied among the different types of vitiligo.

Comparative Analysis of skin Condition after Using Cleansing Oil and Cleansing Water for removing Facial Makeup

Background/Objectives: The purpose of facial makeup is to make skin look beautiful and appealing withoutgiving any physiochemical stimulation to the skin. To do this, it is important to clear the skin by removingthe cosmetics after applying makeup.Method: After removing facial makeup using cleansing oil and cleansing water available in the Koreanmarket, skin oil content, water content, and pH were measured with a skin analyzer and ingredients ofcosmetic film were determined with a dermascope and scanning electron microscope.Findings: Shortly after applying daily makeup, the cosmetic film was evenly applied to the face skin. Astime passes, the cosmetic film formed a thick cosmetic film with the sebum and sweat components secretedfrom the skin as well as inorganic components of cosmetics. Scanning electron microscope observationshowed that most cosmetic membranes consisted of spherical silica, nanometer sized iron oxide and titaniumdioxide, and micrometer sized talc and ultramarine. Vellus hairs distributed on the skin were covered withcosmetic ingredients. Thus, cuticle layer was not observed. Face skin washed with cleansing water andcleansing oil was clean without observation of cosmetic ingredients.Improvements/Applications: Cleansing oil is more effective than cleansing water in maintaining skin oilcontent and acidity while cleansing water is more effective than cleansing oil in moisturizing the skin

Eruptive vellus hair cysts in a child

Eruptive vellus hair cysts in a child

Clinico-Dermoscopic Pattern of Beard Alopecia Areata: A Cross-Sectional Study.

Background:Alopecia areata (AA) is an autoimmune condition affecting hair-bearing regions of the body. Few studies worldwide have focused exclusively on beard alopecia areata (BAA).Aims:To describe the clinical associations, comorbidities, and dermoscopy of BAA.Materials and Methods:Forty-six patients with BAA were recruited for this hospital-based cross-sectional study. Patients with disease onset of less than 1 month, patches showing extension, and appearance of new patches within the past 1 month were grouped under active disease. Dermoscopy was performed using handheld polarized dermoscope. Chi-square test was applied to know the various associations. P value <0.05 was considered statistically significant. STATA 11.2 was used for analysis of data.Results:The mean age was 31.07 ± 8.72 years. The majority (50%) belonged to 20–29 age group. Twenty-two (48%) patients had active disease. Fourteen (30.43%) patients had extra-beard manifestation of AA. Statistically significant association was noted between active disease and extra-beard manifestation (P = 0.034). Diabetes mellitus and hypertension were noted in one and three patients, respectively. Alcohol abuse was noted in six patients and smoking in five patients. Dermoscopic findings such as black dots, short vellus hair, tapering hair, nonfollicular white dots, regrowing hair, yellow dots, and black dots were similar to findings noted in AA. Uncommon findings such as peripilar sign, i-hair, perifollicular hemorrhage, and tulip hair were observed in BAA.Limitations:Small sample size, lack of follow-up.Conclusion:Trichoscopy of BAA may reveal newer nonfollicular findings, in addition to the follicular findings already described in literature for AA.

Concentrated Growth Factor from Autologous Platelet Promotes Hair Growth in Androgenetic Alopecia

Studies have shown that platelet concentrates can induce the proliferation of the dermal papilla and the vascularization of the perifollicular tissue, as well as accelerate the telogen-to-anagen transition, thereby promoting the regrowth of hair improving the appearance of hair loss. Herein, we report on the application of a new, modified form of platelet concentrates, namely, concentrated growth factors (CGFs), in 15 cases of androgenetic alopecia (AGA). 15 cases of androgenetic alopecia were treated with the use of monthly, subcutaneous injections of autologous CGF in the scalp. A total of 3 injections were administered 4 weeks apart, and the patients were followed up for 6 months. Assessments were performed before the treatments and at 4, 8, 12 and 24 weeks after the first treatment. The treatment outcomes were assessed by taking macroscopic photographs and trichoscopic photomicrographs, as well as by using the Global Aesthetic Improvement Scale (GAIS) and the patient satisfaction survey. In order to determine the safety of the treatment, the injection area was observed for signs of infection or mass evaluation. The photographs showed significant improvement in hair appearance after injections of CGF. The hair photomicrographs showed that CGF promoted the regrowth of hair in balding areas, with an increased hair density and an increased ratio of terminal to vellus hair. The GAIS suggested that CGF treatments were effective in treating AGA, and the majority of patients were satisfied with their improvement. In addition, treatments resulted in a faster rate of hair growth and a decrease in the greasy and unpleasant sensation of the hair of the patients. At the last visit, none of the 15 patients reported experiencing side-effects during the follow-up period. To conclude, the application of CGF can be an effective method in the treatment of androgenetic alopecia.

A semiquantitative grading scale for frontal and vertex of androgenetic alopecia.

Depending on the severity and region of baldness, numerous researchers proposed different classifications of alopecia. However, these previous classifications have some limitations. The study aimed to establish a semiquantitative grading scale for frontal and vertex androgenetic alopecia (AGA) in both males and females. Standardized pictures from 1,602 AGA cases were obtained. Three sets of reference photographs with different alopecia extents from scale 0 to 5 were developed with detailed description. The photographs covered the vertex, frontal of men, and vertex + frontal (V+F) area of the scalp of women. Hair density and the ratio of vellus and terminal hairs in the alopecia area were quantitatively measured by DermDOC® dermoscopy. Hair coverage rate of alopecia area was calculated by Photoshop software. Multirater consensus method was used to test the reliability and validity of the alopecia scale. Fleiss-Kappa coefficients of the three sets of reference photographs for interobserver analysis reached 0.81-0.89. The overall Kendall's coefficients for intraobserver assessment totaled 0.934-0.963. This new grading scale is a more sensitive and objective quantitative grading scale for alopecia and treatment response compared with the existing classification.

Modern view on treatment of microsporia of children, taking into account the etiology, pathogenesis and features of clinical course of dermatosis

Objective — to analyze publications and summarize literature data on the optimization of the treatment of microsporia of children, taking into account the etiology, pathogenesis and features of the clinical course of dermatosis. Materials and methods. Based on a retrospective analysis of scientific sources and the results of our own research, information on the treatment of microsporia in children is systematized, taking into account the etiology, pathogenesis and features of the clinical course of dermatosis. Results and discussion. Mycotic skin lesions occupy one of the leading places in the structure of dermatovenerological diseases. The high prevalence of fungal infections shows that 20—25 % of the world’s population has skin mycoses, making them one of the most common forms of infection. An important role in the pathogenesis of microsporia is played by various changes in the immune status, the expression of which determine the clinical course of mycosis, its prediction and the choice of rational therapy. Conclusions. At present, complex treatment with the use of systemic antimycotic terbinafine and 2 % sertaconazole nitrate cream is considered effective and safe for microsporia of smooth skin with predominant lesion of vellus hair. Systemic antimycotic grisofulvin combined with the original drug antral proved to be effective and safe in the treatment of microsporia of the scalp in children and adults. Introduction of the probiotic-vitamin-mineral complex Bion 3 Kid in combination with systemic antimycotics griseofulvin, terbinafine and 2 % sertaconazole nitrate cream into the complex of treatment of microsporia contributed to increasing effectiveness of treatment, accelerating clinical and mycological recovery, preventing recurrence of the disease and the occurrence of concurrent cold-related diseases.

Effects of platelet-rich plasma in the complex therapy of patients with androgenic alopecia

Features of platelet-rich plasma in the complex therapy in patients with androgenic alopecia are analyzed. A comparative evaluation of the clinical efficacy of the three treatment methods was carried out: topical applications of a5% solution of minoxidil, intradermal injection of platelet-rich plasma, and combination of these techniques. A solution of minoxidil was applied to the dry skin of the scalp 1 ml twice a day without washing throughout the observation period. The course of treatment consisted of 4 procedures with an interval of 4 weeks. Clinical efficacy was assessed by the dynamics of morphometric indices of hair growth. It was established that after complex therapy in the form of minoxidil applications and injections of plasma rich plasma, the hair density increased by 32% (p=0,00004), the diameter of the hair shafts by 26% (p=0,00004). At the same time, the share of vellus hair decreased by 30% (p=0,00082), and the proportion of telogen hair decreased by 39% (p=0,00008). The results of using complex therapy significantly exceeded the clinical effect of platelet-rich plasma and topical applications of a 5% solution of minoxidil. The data obtained allows to suggest that plasma enriched with platelets and minoxidil potentiate each other’s effects, and their complex application seems promising for the treatment of androgenetic alopecia.

SnapshotDx Quiz: December 2018

SnapshotDx Quiz: December 2018

Familial frontal fibrosing alopecia: A cross-sectional study of 20 cases from nine families.

Frontal fibrosing alopecia (FFA) is a scarring alopecia whose prevalence is increasing. The pathogenesis of this disease is not well known. Genetic, environmental, hormonal and autoimmunity related factors have been considered; however, only a few cases of familial frontal fibrosing alopecia have been reported. A cross-sectional study was performed at University Hospital in Granada (Spain). Twenty patients with frontal fibrosing alopecia belonging to nine different families were included, and clinical and dermoscopic features were analysed. Overall, 90% of the patients studied were women (mean age 61.4 years). About 50% of the patients had grade II frontal fibrosing alopecia at the time of diagnosis, whilst 35% had grades III or V. Mean recession was 2.83 cm in the frontal area and 1.99 cm in the temporo-parietal area. Daughters presented a shorter recession area and earlier debut of the disease than mothers. Androgenetic alopecia was found in only two patients (10%). The dermoscopic signs most commonly found were perifollicular erythema (85%), hyperkeratosis (85%), and absence of vellus hair in the hairline (78.9%). This study adds to the growing evidence that there is a genetic component to frontal fibrosing alopecia. The clinical pattern of frontal fibrosing alopecia was not different from that found in non-familial cases, but the debut of the disease in daughters of mothers with frontal fibrosing alopecia may be earlier.

The Higher Number and Longer Duration of Kenogen Hairs Are the Main Cause of the Hair Rarefaction in Androgenetic Alopecia

The progressive reduction of the number of terminal hairs and the simultaneous increase in the number of vellus hairs (hair miniaturization) are the current explanation of human baldness. In a 2.5-year study on 43 male subjects with androgenetic alopecia (AGA), we found that oral finasteride augmented the total number of hairs by 55%, but failed to decrease the prevalence of vellus hairs. While our data may explain why, in AGA, hairs become progressively softer and combable, they cannot explain why areas of hair rarefaction develop. We propose that the longer duration and higher frequency of kenogen hairs are the real mechanism through which the scalp hairs rarefy.

The value of dermoscopy in diagnosing eyebrow loss in patients with alopecia areata and frontal fibrosing alopecia

Alopecia areata and frontal fibrosing alopecia are common causes of eyebrow loss (madarosis). Assessment of trichoscopic markers of eyebrow loss in alopecia areata and frontal fibrosing alopecia. The analysis included 50 patients with scalp alopecia areata with madarosis, 50 patients with scalp frontal fibrosing alopecia with madarosis and 50 healthy controls. In every case, trichoscopy of the eyebrow area was performed. Empty follicular and eccrine duct openings were observed in all patients and presented predominantly as yellow dots. Exclamation mark hairs were only detected in patients with alopecia areata (30%). Tapered hairs, broken hair, black dots and Pohl-Pinkus constrictions were observed in 14%, 36%, 26% and 4% of patients with alopecia areata, respectively, 4%, 16%, 2% and 0% of patients with frontal fibrosing alopecia, respectively, and they were not present in healthy controls. Dystrophic hairs and whitish areas were observed only in patients with frontal fibrosing alopecia (28% and 32%, respectively). Eyebrow regrowth in distinct directions was present in 32% of patients with frontal fibrosing alopecia, 8% of patients with alopecia areata and 4% of healthy controls. Diffuse erythema was detected in 60% of patients with alopecia areata and frontal fibrosing alopecia and 56% of healthy controls. Vellus hairs and upright regrowing hairs were observed in patients with alopecia areata (62% and 58%, respectively), frontal fibrosing alopecia (60% and 84%, respectively) and healthy controls (100% and 100%, respectively). Trichoscopy of the eyebrow area is useful in diagnosing patients with isolated eyebrow loss. The most characteristic trichoscopic features of eyebrow loss in alopecia areata include exclamation mark hairs, tapered hairs, broken hairs and black dots. Frontal fibrosing alopecia of the eyebrows is characterized by the presence of dystrophic hairs, white areas and eyebrow regrowth in distinct directions.

Optimization of smooth skin microsporia treatment

Objective — to optimize the treatment of patients with smooth skin microsporia with predominantly affected vellus hair of children and adults by using complex terbinafine antimycotic therapy, an antifungal drug, 2 % cream of sertaconazole nitrate and probiotic-vitamin-mineral complex.Materials and methods. 90 patients with smooth skin microsporia aged 4 to 19 years were monitored. Among them there were 3 adults and 87 children (53 girls and 34 boys). In 85 patients, the defeat of vellus hair was observed. 22 patients had concomitant colds: acute respiratory viral infections (18 cases) and their complications (2 cases of pharyngitis and 2 cases of bronchitis). All patients were divided into 3 groups. All of them were prescribed terbinafine depending on the body weight: less than 20 kg — 62.5 mg/day (1/4 tablets), 20 to 40 kg — 125 mg/day (1/2 tablet), over 40 kg — 250 mg/day (1 tablet). Systemic therapy was combined with external treatment with 2 % cream of sertaconazole nitrate. In the 2nd and 3rd groups, the patients were prescribed the original probiotic-vitamin-mineral complex Bion 3 Kid depending on the age: from 4 to 12 years — 1 chewable tablet per day, from 12 years and older — 2 tablets within 30 days. The duration of treatment in the 1st group was 1 to 5 weeks, depending on the localization of the pathological process, in the 2nd group — from 1 to 4 weeks, in the 3rd group — from 2 to 6 weeks.Results and discussion. Due to the treatment, clinical and etiological recovery was achieved in all 90 patients with microsporia. The duration of treatment in the three groups was 1 to 6 weeks, depending on the localization of the pathological process. The duration of treatment in the 1st group was 1 to 5 weeks, in the 2nd group — from 1 to 4 weeks, in the 3rd group — from 2 to 6 weeks. Introduction of the original probiotic-vitamin-mineral complex Bion 3 Kid into the complex treatment with systemic antimycotics terbinafine and 2 % cream of sertaconazole nitrate provided an opportunity to improve the results of treatment and shorten the duration of treatment by 7 days. There was a good tolerability of drugs without changes in the parameters of general and biochemical blood tests, urine tests after the termination of the course of therapy.Conclusions. The optimization of complex treatment of patients with microsporia with systemic antimycotic terbinafine and 2 % cream of sertaconazole nitrate in combination with a probiotic-vitamin-mineral complex made it possible to improve the effectiveness of treatment, accelerate clinical and mycological recovery, prevent recurrence of the disease and the occurrence of concomitant colds during treatment. The original probiotic-vitamin-mineral complex Bion 3 Kid is effective and safe in case of microsporia of smooth skin in children. This complex method proved to be effective and safe in the treatment of patients with microsporia of smooth skin with a predominant lesion of vellus hair in children and adults, as well as for the treatment of patients with microsporia with concomitant colds and their complications.

Modern complex treatment of microsporia of smooth skin

Objective — to determine clinical efficacy of antifungal agent 2 % sertaconazole nitrate cream in complex treatment of microsporia of smooth skin mainly affecting the vellus hair in children and adults.Materials and methods. We observed 80 patients with microsporia of smooth skin aged from 2 to 53 years including 9 adults and 71 children (49 girls and 22 boys). There were injured vellus hair in 75 patients presented. All patients were divided into 3 groups depending on treatment assigned. All patients of 3 groups were prescribed terbinafine depending on body weight: for less than 20 kg of body weight — 62.5 mg/24­hour period (1/4 of pill); 20 to 40 kg — 125 mg/24­­hour period (1/2 of pill), more than 40 kg — 250 mg/24­­hour period (1 pill). System therapy was combined with on skin treatment. Patients of the 1st group were prescribed 2 % sertaconazole nitrate cream, patients of the 2nd group — ketoconazole cream, patients of the 3rd group — terbinafine cream. Treatment duration in the 1st group ranged from 1 to 5 weeks depending on localization of pathological process. Treatment duration in the 2nd and 3rd groups ranged from 2 to 6 weeks. Results and discussion. All 80 patients with microsporia have clinically and etiologically recovered as a result of treatment. Treatment duration for all three groups ranged from 1 to 6 weeks depending on localization of the pathological process. Treatment duration in the 1st group ranged from 1 to 5 weeks. The inclusion of 2 % sertaconazole nitrate cream in complex treatment of patients with microsporia allowed to improve treatment results and to shorten treatment duration by 7—14 days. There was good tolerability in adults and children without changing the general and biochemical blood and urine tests after completion of therapy. Conclusions. Antifungal agent 2 % sertaconazole nitrate cream is effective and safe in case of microsporia of smooth skin in children. Complex treatment of patients with microsporia by means of antimycotic terbinafine and 2 % sertaconazole nitrate cream has contributed to improvement of treatment results, reduction of treatment duration, acceleration of clinical and mycological recovery. This complex treatment method showed its effectiveness in treatment of patients with microsporia of smooth skin mainly affecting the vellus hair in children and adults.