Traumatic hair bearing skin wound combined with kerion celsi: A rare case [Travmatik saçli deri yarasi ile kerion celsi birlikteli?i: Nadir bir olgu]

Abstract

Traumatic hair bearing skin wound combined with kerion celsi: a rare case Introduction: Kerion celsi is a hypersensitivity reaction to a dermatophytic infection in hair bearing skin which is caused by dermatophyte species such as T mentagrophytes, T verrucosum, T rosaceum (T megninii), T tonsurans, T violaceum, and T soudanense in children who have hypersensitivity againist the components of dermatophytes. Differential diagnosis is very difficult when a scalp wound is associated with the history of traumatic scalp injury. Presented here was a rare case of kerion celsi who had traumatic scalp wound. Material and Methods: A 7-year-old boy presented to our clinic, complaining of a head wound which caused from hitting it to a heater 15 days ago. On the examination, a 5 × 5 cm wound on the vertex of the scalp was diagnosed with painful draining scalp abscesses, purulent discharge, itchy plaques, hair loss, pruritus and scaling. It seemed to be an infected and traumatic wound of hair bearing skin. For the treatment, wound care and a parenteral antibiotic were initiated, and then a surgical debridement was performed to take out necrotic tissues and drain abscess formations. However, any evident for healing didn't appear. Results: After considering kerion celsi, by using fungal cultures, examination of scalp brush samples under microscope and histopathologic investigation of the debridement materials, diagnosis was achieved. Systemic and topical antifungal treatment healed the wound completely. Conclusions: Although association of a traumatic scalp wound with a dermatophytic infection is a rare instance, if there is a scalp wound with crusting, serious ooze, pus, and keratin debris in childhood, and especially if there is a resistant againist usual treatment modalities, kerion celsi should be considered in differential diagnosis.