OPTIMIZED EXTERNAL THERAPY FOR SEVERE ZOOANTHROPONIC TRICHOPHYTOSIS

Zooanthroponic trichophytosis caused by Trichophyton verrucosum, Trichophyton mentagrofites, var.gypseum belongs to widespread dermatomycosis in the rural areas of the Uzbekistan. Suppurative mycosis forms (Celsus kerion) are often accompanied by suppurative manifestations, intoxication as well as secondary infection with bacterial microflora. Use of a combination drug mupiroban along with systemic and topical therapy promotes accelerated regression of inflammatory process that elevates therapeutic efficacy.

Trichophytosis dominates in the pattern of scalp and smooth dermal layer mycosis in the Uzbekistan and poses a pressing medical and social problem. It was noted that morbidity rate was unevenly distributed in diverse regions of the Uzbekistan that depends on local environmental conditions, climate in arid zone being additionally aggravated by action of technogenic factors. In the Uzbekistan, more common is trichophytosis caused by zoophilous fungi, which role increases during mycosis epidemiologic outbreaks. Fungus culturing method detects Tr. Ectothrix megaspores (Tr. faviforme) in around 90% cases that causes acute purulent lesions on the smooth skin, scalp and face as well as sycosis; fungal spores in pathological samples preserve viability for many years in dry premises.  Tr. ectothrixmicroides (Tr. mentagrophytesvar. gypseum) hold the second place among fungi seeded from patient samples. Trichophyton gypsum culture is presented as a loose sheath at the base of hair, prone to polymorphic shape causing spontaneous mycosis in various animal species, whereas in human resulting in acute purulent skin and scalp lesions.  Tr. mentagrophytes most prominently exerts proteolytic and keratolytic activity. Infiltrative-suppurative form of zooanthroponic trichophytosis may be often complicated by intoxication, lymphadenitis, disturbed patient general condition and display a progredient course after applying standard therapy wioth systemic and topical antimycotic drugs. In most cases, patients are noted to have secondary infection of mycotic foci due to activated skin microflora as well as increased colonization by staphylococci and opportunistic microorganisms of the intestinal group.

Over the last years, infiltrative-suppurative form of zooanthroponic trichophytosis (Celsus kerion) with atypical course and suppurative events have been recorded at higher rate. In such cases, dermal lesions are often associated with lymphadenitis, abscess formation, eczematization, potential development of allergic reactions, erythema nodosum, dermatophytic granulomas, finally resulting in cicatricial alopecia.