Abstract:

A 5-month-old male infant had erythema around frontal hairline for 3 months.Physical examination showed large erythema with clear boundary,hair loss or broken hair,follicular pustules and skin abscesses.Based on the microscopic examination of the KOH preparation,culture and DNA extracted PCR-sequencing identification,infant kerion due to Trichophyton tonsurans was diagnosed.Treatment of oral itraconazole (33 mg/d),topical wash with 2% ketoconazole shampoo,then 1% naftifine-0.25% ketoconazole cream were administrated.During the therapeutic session,sporadic annular scaly papules and erythema were appeared over the head and face,which was considered as secondary dermatophytid reaction,be deal with by adding prednisone (5 mg/d) orally and changing topical drug with 1% luliconazole cream.Antifungal susceptibility test in vitro showed that 1% luliconazole cream is superior to 1% naftifine-0.25% ketoconazole cream.After 9 weeks treatment of itraconazole and 5 weeks of prednisone,the lesions resolved,and new hair grew back without scarring or alopecia.No recurrence after treatment was observed with one-year follow-up.

Key words: Trichophyton tonsurans, kerion, dermatophytid, infant