Mycosis of large folds, ICD code 10. How mycosis of smooth skin manifests itself, and how to deal with it. Complications and prevention

1 Causes and routes of infection
2 Incubation period of microsporia in humans
- 3.1 Smooth skin
- 3.2 Scalp
4 Features in children
5 Microsporia during pregnancy
7 Treatment of pathology
- 7.1 Medicines
- 7.2 Folk remedies
8 Complications and prevention

If laboratory diagnostics confirm the diagnosis of microsporia in a person, you should immediately begin therapy using antifungal medications and folk remedies. Once on the skin, the infection spreads, affecting more and more new areas of the body. The initial stage of the disease is quickly cured, but with an advanced form, therapy continues for a long time and must be under the supervision of a specialist.

Causes and routes of infection

Microsporia disease is caused by a fungus of the genus Microsporum, which, in addition to the scalp, body and nail plates It also affects the hair follicles, which is why the hair gradually becomes thinner, and if the disease is not treated at the initial stage, you can lose a significant amount of hair. The main routes of transmission of the disease are contact - from person to person or from animal to person, and object - through objects contaminated with spores.

According to the international classification of diseases, microsporia has code B35 “Dematophy.”

The fungus more often penetrates the skin tissue through damage and injured areas of the epidermis. Microsporia of smooth skin and hair threatens people with dry skin type, the presence of abrasions and rough calloused areas. The disease is not transmitted virulently, and if you wash your hands well after contact with the carrier, you will be able to avoid contracting the infection, since the mycospores die.

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Incubation period of microsporia in humans

The incubation period for microsporia in humans lasts on average about a week. During this time, flaky spots appear on the body, having a clear outline and a tendency to increase. If the lesions are localized in the area of the hairline, then the hair breaks at the site of formation, and the accompanying symptoms are disturbing. Based on these signs, you can understand that an adult or a child has ringworm.

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Microsporia is a fungal disease that affects the skin and hair.

The most common pathogen that provokes the development of microsporia in adults and children is considered to be a type of Microsporium fungus called Microsporum canis. It has a zoonotic form of spread, and symptoms depend on the location and depth of penetration into the epidermis. There are microsporia of smooth tissues and hairy parts.

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Smooth skin

The first signs of microsporia of smooth skin are visible to the naked eye. At the site where the fungus invades, a clear pink spot forms, which at first looks small, but quickly increases in size, penetrating into the deeper layers of the dermis. The formation peels off, additional spots appear, the number of which does not exceed 2-3 pieces. A skin rash can occur both on an open area - face, forearm, neck, and on a closed area of the body - torso, arm, leg. Sometimes the patient may feel slight discomfort at the site of the lesion, but most often in the initial stages the disease does not cause physical discomfort.

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Scalp

Microsporia of the scalp most often affects children under 14 years of age; this pathology does not affect adults, since a specific organic acid is present on the skin under the scalp, which prevents the fungus from gaining a foothold on the tissues and prevents its proliferation. The affected areas for this type of microsporia are most often localized:

in the area of the crown;
on the temporal lobe;
in the parietal region.

The lesions are round in shape, the number of lesions does not exceed 2, and the size of the lesion reaches up to 6 cm in diameter. At the initial stage, the affected area peels off, but the hair follicle is already infected. After 5-7 days, a significant length of the hair shaft is affected, it becomes thinner and breaks off at the base. The lesion looks like “mowed grass.”

Anthroponotic microsporia is the most common form of infection. The source of transmission of the anthropophilic fungus Microsporum ferrugineum is an infected person. After 6-8 days of the incubation period, small round formations with unclear outlines and slight peeling appear in areas affected by the fungus. The hair in this area quickly thins out, becomes faded, and if treatment is not started in a timely manner, the hair shafts begin to break off at the base, and the patient loses a significant amount of hair.

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Microsporia is the most common fungal infection.

There are also rare varieties of microsoporosis, these include the following forms:

Seborrheic, in which the hair becomes thin, dull, covered yellow color scales, which cause the hair shaft to break soon.
Trichophytoid, in which the hair shaft breaks off much below the base, so there are no bald spots or signs of baldness in the affected areas.
Exudative, in which small, blistering, frequent rashes filled with serous fluid—exudate—appear at the site of the epidermal lesion. If the disease is not treated early, the affected areas begin to fester and become inflamed. In this case, the patient’s condition worsens, body temperature rises, and signs of intoxication appear.

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Features in children

Microsporia in children under 14 years of age is considered one of the most common fungal diseases, which every third child encounters. When treating microsporia in a child, it is important to follow the doctor’s recommendations; the disease is treated mostly without complications, but only if the course of therapy was chosen correctly and according to the age criterion of the little patient. The prevalence of fungal disease in children is caused by the following factors:

Insufficient personal hygiene, most often unwashed hands.
Undeveloped or weakened immunity.
Contact with infected yard animals.
Constant trauma to the skin - abrasions, micro-wounds, scratching.

Medicine has an interesting and inexplicable fact. According to observations, young children with red hair almost never experience ringworm.

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Microsporia during pregnancy

During pregnancy, the body's protective functions weaken and the expectant mother's chances of contracting an infectious disease increase, and microsporia is no exception. During this period, it is important to pay attention to the symptoms in a timely manner and begin adequate treatment that will take into account the woman’s condition. The medications are selected by a dermatologist, and if you follow all the recommendations, the disease goes away in a short time.

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Before treating this type of deprivation, you should consult a doctor.

Before you begin to treat microsporosis, it is important to make an accurate diagnosis and make sure that the disease was caused by this particular type of fungus. Fluorescent diagnostics of the lesion site, which uses a Wood's lamp, as well as microscopy and the culture method, will help determine the diagnosis.

A cultural diagnostic method will help to accurately determine whether microsporosis, caused by the fungus Microsporium canis, is progressing in the body. The infected material or scraping is placed in a special Sabouraud nutrient medium, in which already on the 3-4th day the growth of a fungal colony will be noticeable under a microscope. A fluorescent diagnostic device will help determine:

type of pathogen;
degree of hair damage;
how effective is the therapy;
whether loved ones who had direct contact with the carrier are infected;
does the animal have an infection?

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Treatment of pathology

It is important to start treatment of microsporia in humans as early as possible, then complications and serious consequences can be avoided. Under no circumstances should you try to cope with the problem at home and take medications at your own discretion. Tablets, ointments and appropriate use traditional methods determined by a dermatologist based on a diagnostic study.

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Medicines

For local therapy, the medicine is selected individually. The most common ones are presented in the table:

Antimycotic antibiotics will help cure a child and an adult from scalp lichen; one of the most effective is Griseofulvin. The drug is toxic; when prescribed, the doctor prescribes maintenance therapy. Treatment of lichen in a person will take an average of 1.5-2 months; the person will be healthy if the scraping test is negative.

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Folk remedies

It is contraindicated to treat microsporia at home, as it can provoke even more serious complications. Previously, to treat microsporia at home, garlic lotions were used, which were applied to the affected area and left for at least an hour. Iodine is also effective, but it burns the skin and a scar may remain at the site of the lichen, so if a person has microsporia on the face, this method is definitely not suitable.

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Complications and prevention

If you do not begin to treat foci of infection spread throughout the patient’s body, inflammation may develop. Sometimes when the scalp is damaged, complications develop in the form of infiltrates, suppuration and inflammation, which causes severe discomfort in the patient. Since microsporia is transmitted by contact, prevention of microsporia consists of isolating the carrier and proper treatment, a thorough examination of others and disinfection of the room in which the patient was located.

Ankle fractures according to ICD-10: classification of injuries and their codes

Fractures and their classification
General clinical picture
Outer ankle injury
Injury to the bones of the inner ankle
Fracture healing

Ankle fracture is a common injury of the lower extremities; peak injury rates are recorded in winter period. People at risk include retirement age, children, athletes, as well as women wearing shoes on high heels. Full recovery from injury takes at least 2 months, and 10% of cases result in disability.

In medical practice, it is customary to assign a specific code to each disease. These numbers are compiled in a document called the International Classification of Diseases (ICD-10). The number 10 indicates the serial number of the revision. A fracture of the ankle has a code according to ICD 10 - S82, class Injuries, poisoning and some other consequences of external causes, block Injuries of the knee and lower leg.

Fractures and their classification

There are two types of bone integrity disorders:

open - with rupture of soft tissues and skin. Fragments of bones are visible from the wound, blood flows;
closed - there are no breaks in the skin, no bleeding is observed.

In some cases, bone fragments may become dislodged. According to this factor, fractures with and without displacement are distinguished.

Injuries are also classified according to the location of the injury. Fractures are distinguished:

outer ankle;
inner ankle.

There are other classifications.

General clinical picture

Experts identify a number of common signs:

numbness of the lower extremities;
severe pain, localized not in the area of damage, but slightly above or below;
attacks of nausea, dizziness and general weakness;
chills;
impaired joint mobility.

The clinical picture develops quite quickly - within half an hour after the injury.

If the patient complex shape fracture, you can additionally observe the following symptoms:

paleness of the skin due to damage to blood vessels and nerve structure;
numbness of the foot and ankle in general;
limb deformity.

Outer ankle injury

The outer (lateral) side of the leg is damaged much more often than the inner or medial side. This is due to the natural weakness of the fibula. Most often, a dislocation of the ankle joint leads to the development of a fracture.

A closed fracture of the lateral malleolus has its own ICD 10 code: S82.6. Trauma has a number of features:

accompanied by sharp pain and crunching coming from the outside of the ankle;
damage occurs due to direct impact on the ankle;
the outer part of the joint swells, a small amount of blood accumulates under the skin;
leaning on the outer part is difficult or completely impossible due to the incorrect position of the foot and, as a result, independent movement becomes difficult.

Injury to the bones of the inner ankle

If the lateral part of the ankle is damaged due to a dislocation of the ankle, then the trigger for violating the integrity of the medial part is most often a direct blow. Trauma due to dislocations is less common.

The ICD 10 code for a fracture of the lateral malleolus is S82.5. Its features:

the victim often develops hemarthrosis (accumulation of a large volume of blood in the joint cavity). This makes movement difficult and can cause the development of secondary arthrosis;
behind the medial area there is a bundle of vessels and nerves extending to the foot; as a result of a violation of the integrity of the bone, they are damaged, and heavy bleeding begins.

Otherwise clinical pictures Fractures of the outer and inner parts of the ankle are similar.

The medial area of the ankle is the area where large muscles are located. When fractures occur, they often cause displacement of bone fragments, which creates difficulties during treatment. It is these injuries that often lead to the development of complications.

Fracture healing

The International Classification of Diseases, or ICD, describes the codes for all diagnoses accepted in medicine. For example, a healed ankle fracture has not one ICD 10 code, but several:

M84.0 – poor healing of the fracture;
M84.1 – fracture non-union or pseudarthrosis;
M.84.2 – delayed fracture healing.

These codes apply not only to traumatic injuries to the ankle, but also to fractures of other bones.

The body puts all its efforts into restoring damaged tissues. Over the course of two to three days, the released blood forms clots; over time, they are filled with special cells that play an important role in the formation of callus. These cells also create a special structure that eliminates the possibility of displacement of bone fragments. In medicine it is called the granular bridge.

It will take at least ten days for the resulting callus to strengthen. Complete restoration of the ankle bone's blood supply takes about a year.

What can reduce the rate of bone recovery:

complexity of injury, location;
peculiarity of ankle bone tissue;
correct first aid;
age of the patient;
compliance with the doctor's recommendations;
a history of chronic diseases, inflammatory processes, excess body weight;
psychological state of the patient.

Experts also identify factors that slow down the formation of calluses:

deficiency or excess of vitamins;
disruption of the endocrine glands;
lack of weight;
taking certain medications.

In children, the process of bone fusion is much faster than in adults. At the same time, due to their nature, it is difficult for children to strictly adhere to bed rest. It is also difficult for them not to lean on the injured limb for a long time. Excessive activity negatively affects tissue fusion, slowing it down and causing complications.

Women who are pregnant or breastfeeding take a very long time to recover from an ankle injury. Fusion slows down due to the fact that the level of calcium and other important minerals decreases during this period.

The rate of healing of displaced ankle fractures is influenced by the following factors:

how accurately and correctly the surgeon combined the fragments;
compliance with bed rest after surgery;
whether all particles of muscle and connective tissue have been removed from the crack.

Closed and open fractures heal differently, but in both cases much depends on the patient. By following your doctor's recommendations, not putting stress on your leg and eating right, you can significantly speed up recovery.

Tags: Treatment of joints

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There are several signs by which it is possible to divide fungal infections of toenails into types. To begin with, it is worth considering the key feature of classification - the pathogen. Varieties of pathogenic fungi in this case are combined into three groups:

Dermatophytes (molds). The most common causative agents of onychomycosis on the feet. These include the genera Alternaria and Aspergillus.
Nondermatophytes. Second in frequency of occurrence. They are represented by fungi of the genera Epidermophyton (Epidcrmophyton), Microsporum (Microsporum) and Trichophyton.
Yeast fungi of the well-known genus Candida. The rarest representatives of pathogens.

Onychomycosis is also classified according to the pathological changes that occurred to the nail plate during its development:

The normotrophic variant, that is, the thickness of the nail does not change during the life of the pathogen.
Hypotrophic variant (it can also be called atrophic or onycholytic). The thickness of the nail is reduced; in some cases, the nail completely peels off from its bed.
Hypertrophic option. Thickness, on the contrary, tends to thicken.

Well, without a doubt, onychomycosis can be characterized by the localization of pathological changes:

Proximal (upper) – the upper part of the nail plate is affected.
Distal (lower) - pathological changes are localized mainly along the free edge of the plate.
Lateral (lateral) – the sides of the nail change.
Total – the entire nail suffers.

Along with all the listed classifications, there is the most important one - international (ICD 10). It is she who helps doctors navigate filling out medical documentation and encoding onychomycosis as an independent nosological entity.

How can you become infected?

The main mechanism of transmission of fungi is contact with a surface contaminated with them. Moreover, this contact may not be noticed in Everyday life. Or you can create certain conditions that will contribute to the proliferation of fungi on the nails and periungual tissues.

The list of the main causes of infection with one or another type of fungus includes:

Neglect of wearing individual shoes in in public places such as swimming pools, baths, saunas, locker rooms, showers, etc.
Buying and wearing shoes made of artificial materials, closed, and not the right size (this is especially true in the summer, when the foot sweats more).
Lack of daily and regular foot hygiene.
Using other people's pedicure tools, as well as visiting pedicurists in unverified and dubious establishments of the relevant profile.
Wearing someone else's shoes, especially the shoes of a person with clear signs fungal infection on the nails.

Nail fungus in ICD 10

To find onychomycosis, you need to pay attention to subsection B35-B49 called “Mycoses”. This group unites all fungal infections of the human body, including nails. More specifically, code B35 is “Dermatophytosis” (the origin of this name can be guessed from the classification of onychomycosis by type of pathogen). The nail fungus itself is hidden under the code B35.1.

External manifestations

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Symptoms as such develop gradually, so a long period may not be recognized by humans at all as signs of pathology. In addition, they vary in severity in each patient. But still, we can give a single list of the main changes in onychomycosis:

Changing the color of the nail plate from transparent to whitish, yellow, greenish, brown (shades of the listed colors are possible).
Change in the thickness of the nail plate according to three types in accordance with the classification.
Tarnishing, loss of shine on the surface of the nail.
The appearance of more pronounced striations.
Increased brittleness of the nail, the possibility that it will crumble.
The edge of the nail may become uneven and pitted.
With psoriatic origin of onychomycosis, the nails can be subjected to onycholysis (destruction) with the symptom of “greasy spot”.
On those close to the nail soft tissues you can find burrs, peeling skin.

Onychomycosis, like any other independent disease, is included in the accepted Russian Federation ICD 10 classification. When making this diagnosis, doctors must include the nail fungus code in the medical documentation of each patient. The patients themselves may not know about the existence of this code (this is not fundamental information for them), but if you are aware of the matter, then this only increases your erudition and awareness of your pathology. But it is precisely the awareness that the population sometimes lacks in order to prevent infection and further development of fungus on the toenails.

Mycosis of smooth skin is a disease caused by dermatophyte fungi. The disease can occur on any areas of smooth skin, including the face and neck, with the exception of the groin folds, armpits, feet and palms. Some types of the disease are contagious, which necessitates timely diagnosis and treatment of mycosis of smooth skin.

Mycosis of smooth skin is a disease caused by dermatophyte fungi

Mycoses of smooth skin are a group of dermatological diseases caused by the action of pathogenic microflora. Mycosis of smooth skin is assigned in the international classification code according to ICD-10 B35.4, which corresponds to mycosis of the trunk. This disease is caused by a variety of fungi, including molds, yeasts and dermatophytes. Infection occurs in the following ways:

from person to person;
from an infected animal to a person;
through dust and soil.

In some cases, mycosis of smooth skin can be caused by opportunistic fungi. Smooth skin candidiasis can also be classified in this group of diseases.

Factors predisposing to the development of this dermatological pathology:

lack of personal hygiene;
profuse sweating;
metabolic disorders and excess weight;
weakened immunity;
endocrine disorders and hormonal imbalances;
some chronic diseases.

All of these factors lead to a decrease in local immunity. Conditions are created on the skin that are favorable for the development of fungus. A special place among the causes of mycosis is given to personal hygiene. Prolonged skin contact with sweat leads to irritation. Sweat itself acts as an excellent breeding ground for various microorganisms and bacteria, which greatly increases the risk of developing fungal infections of the epidermis.

Thus, to get a fungal disease, contact with a carrier alone is not enough. Since pathology is caused not only by dermatophytes, the development of mycosis is noted against the background of a general weakening of the body and a decrease in the protective function of the epidermis.

Types of mycoses and characteristic symptoms

Mycoses of smooth skin, the symptoms of which depend on the pathogen, should be treated in a timely manner. Some types of disease are highly contagious. A common feature of all mycoses of smooth skin is the destruction of keratin, as a result of which the epidermis becomes thinner, peeling begins and itching may appear.

Types of mycoses:

dermatomycosis;
keratomycosis;
candidiasis.

Dermatomycosis or dermatophytosis is a lesion of smooth skin and hairy areas of the body by dermatophytes. These fungi spread easily from person to person. In cases where the pathology affects smooth skin, swelling and redness of the epidermis, profuse peeling and itching are observed.

Mycosis of smooth skin is difficult to distinguish from other dermatological diseases from photographs. For an accurate diagnosis and treatment, it is recommended to consult a dermatologist.

Keratomycosis is a group of diseases characterized by impaired skin pigmentation due to the destruction of keratin. The most common disease of this group is lichen versicolor, which also belongs to mycoses of smooth skin. This disease is accompanied by the appearance of spots of all shades of brown. The spots stand out against the background of a healthy epidermis only in color; there is no itching or swelling, but thinning and flaking of the skin in the affected area may be observed. Most often, the disease affects the skin of the back, chest or abdomen.

Smooth skin candidiasis is a disease caused by a yeast fungus of the genus Candida. Characteristic symptoms: red spots and stripes similar to diaper rash, swelling of the skin, severe itching, peeling of the skin around the spot.

Mycosis of smooth skin in children

Characteristic symptoms are the formation of spots of various shapes and peeling of the affected skin

Mycosis of smooth skin in children is a common disease among infants and children over three years of age. In infants, the disease is associated with imperfections in their own immune system. The fungus affects the skin of the body, face, buttocks, and legs. The reason is infection with the yeast fungus Candida from the mother during childbirth. Often, candidiasis of smooth skin in infants develops due to irritation of the epidermis, including against the background of contact or diaper dermatitis.

Children over three years old begin to actively explore the world. This is the age of communication with stray animals and other children. Mycosis of smooth skin in this age group Not unusual. Most often, children are diagnosed with dermatophytosis on the skin of the body, face or hands. It is a contagious disease transmitted from person to person and from animal to person. Dermatophytosis can affect not only smooth skin, but also hairy areas of the body. This disease leads to changes in the structure of the epidermis in the affected area, hair loss, and the appearance of a rash. Characteristic symptoms are the formation of a regularly shaped spot, severe itching and peeling of the affected skin.

Diagnosis of the disease

For smooth skin mycoses, treatment depends on the accuracy of the diagnosis. Since mycoses are a large group of diseases with varied symptoms, it is necessary to carry out a differential diagnosis, excluding non-infectious dermatological diseases such as dermatitis, eczema, psoriasis.

The procedure for examining a patient:

history taking and visual examination;
taking a scraping for analysis;
general and biochemical analysis blood.

To carry out the analysis, scales are taken from the affected area, which are then examined under a microscope. This study takes literally a few minutes and allows you to quickly make an accurate diagnosis.

Treatment principle

The symptoms and signs of smooth skin mycosis are quite specific, so you should consult a doctor as soon as the first symptoms appear.

Mycoses themselves are not dangerous, but only with timely treatment and strong immunity. An neglected fungus can lead to the development of systemic mycosis, which affects the entire body as a whole, including internal organs.

Treatment for cutaneous mycosis includes:

using lotions to relieve itching and discomfort;
use of creams and ointments against fungus;
systemic therapy (in advanced cases);
immunomodulatory therapy (if necessary);
adjusting the diet (to speed up recovery).

Fungal infections of smooth skin can be easily treated with external means. With timely treatment, it is possible to get rid of mycosis in an average of two weeks.

External preparations

For mycosis of smooth skin in adults and children, medications are prescribed

Local preparations are a variety of gels, creams and ointments for fungus. They are selected taking into account the causative agent of the disease. For dermatophytosis and keratomycosis of smooth skin, medications with a wide spectrum of antifungal activity are used:

Lamisil;
Exoderil;
Naftifin;
Terbinafine;
Griseofulvin.

These medications are applied to the affected area up to two times a day. Additionally, the doctor may prescribe antiseptics. For example, for dermatophytosis on the skin, an iodine solution is often used, which has a fungicidal effect and prevents the spread of pathogenic microflora to healthy areas of the epidermis.

When infected with yeast fungus, the following medications are prescribed:

Clotrimazole;
Candide;
Pimafucin;
Nizoral;
Ketoconazole;
Nystatin.

These drugs are also effective against a number of pathogens of mycoses, but are most active against the fungus of the genus Candida.

On average, treatment with the listed ointments and creams takes about two weeks. Treatment of the epidermis should be continued for a week after the symptoms of the disease disappear, in order to avoid re-development of mycosis.

Mycosis of smooth skin in children over 6 years of age is treated with the same drugs, drug therapy and traditional treatment Not recommended for infants without a doctor's prescription.

Systemic drugs

Antifungal tablets or systemic antifungal drugs are prescribed in the following cases:

large affected area;
re-development of the fungus;
deep systemic mycosis;
severe immunodeficiency.

Fungal tablets: Fluconazole, Nystatin, Griseofulvin. The duration of treatment and dosage are selected individually for each patient.

Folk remedies

Recipes traditional medicine– an indispensable remedy for the treatment of fungal infections

Treatment can be supplemented folk remedies. For leather treatment the following is used:

tea tree oil with water (3 drops of oil per 100 ml of water);
baking soda solution (1 part baking soda to 1 part water);
decoction of calamus root (2 tablespoons of root per glass of water);
a solution of iodine and soda (1 part iodine and soda to 3 parts water);
lemon juice.

Lotions and compresses are made with these solutions. The above products should be used for three weeks.

In addition to drug and folk therapy, proper nutrition is necessary; a diet against fungi and a diet for mycosis of smooth skin are based on the exclusion of sweet, fatty, and spicy foods.

Prevention

Having figured out how mycosis of smooth skin can be transmitted, you should carefully monitor your own health to prevent the development of the disease. Basic rules of prevention:

personal hygiene;
minimum contact with stray animals;
strengthening the immune system;
proper nutrition.

Children under 6 years of age must be explained in detail about the specifics of personal hygiene, and the child must not be allowed to come into contact with street animals.

from person to person;
from an infected animal to a person;
through dust and soil.

In some cases, mycosis of smooth skin can be caused by opportunistic fungi. Smooth skin candidiasis can also be classified in this group of diseases.

Factors predisposing to the development of this dermatological pathology:

lack of personal hygiene;
profuse sweating;
metabolic disorders and excess weight;
weakened immunity;
endocrine disorders and hormonal imbalances;
some chronic diseases.

All of these factors lead to a decrease in local immunity. Conditions are created on the skin that are favorable for the development of fungus. A special place among the causes of mycosis is given to personal hygiene. Prolonged skin contact with sweat leads to irritation. Sweat itself acts as an excellent breeding ground for various microorganisms and bacteria, which greatly increases the risk of developing fungal infections of the epidermis.

The group of systemic mycoses of the skin includes fungal diseases that affect the skin, mucous membranes and internal organs. They are characterized by a long course and torpidity to the treatment used. Some of them (actinomycosis, chromomycosis, mold mycoses, etc.) are relatively rare in our country, others (histoplasmosis, coccidioidosis) are extremely rare, although in a number of countries the number of registered patients is significant.

Fungal infections are currently one of the most important health problems. From potential “diseases of the future” they have become actual “diseases of the present”. This is facilitated by the immunosuppressive effect of modern civilization on the human body. There is no doubt that the list of fungi that can cause disease in humans will be constantly updated, and some of them, according to Dupont, have already become “stars.”

These are Candida tropicalis - in patients with leukemia, C. Albicans - in drug addicts, Cryptococcus neoformans - in patients with AIDS, Rhizopus spp - during treatment with iron-binding drugs, Malassezia sp - during perfusion of solutions rich in lipids, as well as Penicillium marneffei, which causes 40% of opportunistic infections occur in AIDS patients in Thailand.

Mycosis fungoides is a malignant tumor of lymphoid tissue, characterized by excessive proliferation of T-helper cells in the skin. In later stages, lymph nodes and internal organs are affected. Sézary syndrome (Sézary reticulosis, erythroderma reticularis) is a type of mycosis fungoides characterized by erythroderma with peeling and itching, melasma, lymphadenopathy, alopecia, as well as leukocytosis and the presence of atypical macrophages in the blood.

Typically, mycosis fungoides begins as persistent, scaly patches that do not respond well to topical treatment with emollients and steroid medications. On average, it takes 7 years from the onset of skin lesion development to diagnosis. In this early phase, the disease is often diagnosed as plaque parapsoriasis.

Over time, the spots thicken and become plaques. Skin tumors gradually form and lymph nodes may be involved. Lesions of visceral organs in this poorly differentiated lymphoma appear late. The average life expectancy for patients with this disease at the stage of spots and plaques is 12 years, at the tumor stage - 5 years, at the stage of damage to the lymph nodes and visceral organs - 3 years.

Both sexes are affected by mycosis fungoides, with men slightly more common. The disease occurs mainly at the age of 40-60 years. Frequency. 0.29 cases per 100,000 population. IN last years cases of registration of mycosis fungoides have become more frequent, possibly due to improved diagnosis, especially in the early stages of the disease.

All mycoses of the skin are called Tinea (fungal diseases of the skin and ringworm) indicating the location of the skin lesions (for example, mycosis of smooth skin, mycosis of the scalp, mycosis of the skin of the beard area, mycosis of the skin of the hands, mycosis of the feet, and so on). This classification is explained by the clinic of mycoses of the skin.

Causes and risk factors

As mentioned earlier, doctors do not name the exact reasons for the development of mycosis fungoides of the skin. They only put forward theories that superficially explain the appearance of pathology in a particular person. None of them have yet received guaranteed confirmation.

Pathology, which is one of the diseases listed in the international medical classification, destroys epidermal tissue. This occurs due to the proliferation of T cells. The disease is considered to be oncological, although it is not clear why lymphoma suddenly begins to develop.

The genetic theory of the development of mycosis fungoides is also considered. This is because a special gene sequence was discovered in patients with this diagnosis.

The causes of malignant disease include chromosomal abnormalities. They are capable of causing any of existing species cancer.

Experts have repeatedly discussed the autoimmune theory of the development of mycosis fungoides. It was never possible to prove or disprove it.

Experts name risk factors that increase the likelihood of developing the disease in a particular person. These include ages over 40 years. Doctors were unable to see the dependence of the appearance of pathology on gender, place of residence, skin color and climatic conditions.

Currently large group actinomycetes are regarded as bacteria. And the disease itself is like pseudomycosis. There are aerobic actinomycetes, which are more often found in soil, air, water, and on cereals, and anaerobic actinomycetes, which are more often found on the mucous membranes of animals and humans.

The most common causative agents of the disease are anaerobic actinomycetes - Actinomyces israelii and Actinomyces boves. Actinomycetes that are saprophytic in the oral cavity and in the human intestine can lead to the development of the disease through auteinoculation; in these cases, the weakening of the protective immunological properties of the body and the activation of the pathogenicity and virulence of the pathogen contribute.

In other cases, actinomycetes, widespread in nature, enter the human body through the mouth, respiratory tract and intestinal mucosa. The pathogen can also penetrate through damaged skin and mucous membranes if soil, dust, or parts of plants get on the wound surface.

The reasons for the development of mycosis fungoides are still unclear. To date, the motives for uncontrolled T-cell proliferation are not known. It is assumed that the occurrence of mycosis fungoides may be associated with persistent viral infection. Thus, a number of studies report the detection in a primary cell culture obtained from the lymph node of a patient in the infiltrative-plaque stage of mycosis fungoides of viral particles morphologically characteristic of type C retroviruses.

In addition, the DNA of primary cell cultures obtained from patients with mycosis fungoides revealed the presence of a sequence related to the HTLV-1 gag gene. A certain role in the occurrence of malignant lymphomas is assigned to genetic factors. It has been proven that development various types solid tumors and leukemia is associated with the appearance and further increase of chromosomal abnormalities.

In recent years, publications have appeared on chromosomal rearrangements in GM, which contribute to the activation of oncogenes and inactivation of tumor suppression genes during the development of the lymphoproliferative process. Currently, the literature is widely discussing the position that significant pathogenetic factors of GM can be carriers of xenogeneic information, leading to pathological disruptions in the functioning of various systems and cells of the macroorganism.

First of all, such changes were observed in immunocompetent cells, epidermocytes, macrophage elements of the skin, the skin receptor apparatus and the production of cytokines. The information available in domestic and foreign literature on the state of immune homeostasis convincingly indicates persistent pathological changes in both the cellular and humoral components of immunity.

Analysis of the immune status showed that in the majority of patients with GM, with a normal number of B-lymphocytes in the vascular bed, the average content of T-cells is significantly reduced compared to the indicators of healthy donors. There was a decrease in both T-suppressor and T-helper lymphocytes, and the number of the latter decreased more significantly.

Relative lymphopenia is considered by many authors to be the most common hematological sign of GM. Others, in addition, note the presence of absolute lymphopenia in the tumor stage of the disease. The functional activity of lymphocytes in patients with GM, according to a number of authors, is reduced.

Others report the absence of significant differences in the nature of proliferation of peripheral blood lymphocytes in patients and healthy individuals. It has been established that the course of the pathological process in GM is accompanied by a decrease in the activity of natural killer cells. The results of studies of the state of the humoral immunity are contradictory.

A number of studies have not revealed significant disturbances in the production of immunoglobulins by B lymphocytes. At the same time, there are indications of the presence of obvious IgM and latent IgA and IgG deficiency of antibody formation in GM. Other researchers have found an increase in the amount of IgA and IgM in the blood of patients with GM, as well as a significant increase in the concentration of IgG.

In this case, the increase in the level of immunoglobulins is explained by the helper phenotype of the tumor substrate in GM. Thus, changes in indicators of immune status in patients with GM are characterized by significant variability and the absence of signs that have unconditional diagnostic significance.

Inguinal epidermophthia. The causative agent - Epidermophyton floccosum affects the stratum corneum. Athlete's foot. The causative agent is Tr mentagrophytes var interdigitale.

Dermatophytosis is a mycoses caused by pathogenic fungi that affects the skin (usually within the epidermis) and its appendages: hair and nails. These fungi, usually called dermatophytes, belong to the genera Trichophyton, Microsporum and Epidermophyton. These microorganisms cannot use carbon dioxide from the air for their nutrition and therefore require ready-made organic substances.

Fractures and their classification
General clinical picture
Outer ankle injury
Injury to the bones of the inner ankle
Fracture healing

Ankle fracture is a common injury of the lower extremities; peaks in injuries are recorded in the winter. The risk group includes people of retirement age, children, athletes, and women who wear high-heeled shoes. Full recovery from injury takes at least 2 months, and 10% of cases result in disability.

Ankle fractures according to ICD-10: classification of injuries and their codes

Types of mycoses:

dermatomycosis;
keratomycosis;
candidiasis.

Dermatomycosis or dermatophytosis is a lesion of smooth skin and hairy areas of the body by dermatophytes. These fungi spread easily from person to person. When the pathology affects smooth skin, swelling and redness of the epidermis, excessive peeling and itching are observed.

Diagnostic criteria

Complaints and anamnesis:

1. Complaints - about rashes, itching, spread of rashes, itching, changes in the nail plates.

2. History of the disease - the onset of the disease is often associated with contact with a sick person, visiting baths, saunas, and wearing impersonal shoes.

Physical examination

1. Tinea versicolor- non-inflammatory spots from pale yellow to Brown, located around the hair follicles, prone to fusion to form foci with small scalloped outlines, with moderate peeling on the surface; positive Balser test with 5% iodine solution.; detection of fungal elements in the scales.

2. Trichosporia nodosum (piedra)- the presence of oval, spindle-shaped or irregular nodules on the surface of the hair; color varies from white to light brown (white piedra) and black (black piedra); microscopic detection of fungal spores.

3. Athlete's foot- typical localization is the skin of the inguinal and intergluteal folds, under the mammary glands, less often in the axillary region; round spots Pink colour with clear boundaries; foci of polycyclic outlines with a pronounced continuous edematous peripheral ridge; bubbles, micropustules, erosions, crusts, scales; detection of septate branching short mycelium.

4. Mycosis of feet and hands- the skin is congestively hyperemic, moderately lichenified; hyperkeratosis, increased skin pattern, floury peeling; the lesion can involve interdigital folds, fingers, lateral surfaces of the feet and hands, and the rear; maceration, scraps of exfoliating epidermis; Erosion and cracks are often added; subjectively - moderate itching, burning, sometimes pain.

5. Onychomycosis(three types) - normotrophic: the color of the nails changes, there are yellowish spots and stripes in the thickness of the nail, the shine and thickness of the nails do not change; hypertrophic type - nails are brownish-gray, dull, thicken and deform until onychogryphosis forms, and are partially destroyed (especially on the sides); the onycholytic type is characterized by a dull brownish-gray color of the affected part of the nail, its atrophy and rejection from the nail bed, the exposed area is covered with loose hyperkerotic layers.

6.Mycosis of smooth skin- pink or pink-red spots with a bluish tint, rounded in outline, clear boundaries, the surface of the spots is covered with small scales, along the periphery there is an intermittent ridge of juicy papules; extensive lesions with scalloped contours.

7.Mycosis of the scalp- rounded lesions, sharply delimited (diameter up to 2-3 cm or more); tightly seated pityriasis scales of a grayish-white color; hair breaking off at the same level (3-4 mm above the skin); "stumps" of hair.
Trichophytosis infiltrative-suppurative (scalp, beard and mustache area): sharply demarcated hemispherical or flattened nodes of bluish-red color with a bumpy surface; osteofolliculitis, erosions, crusts, scales; sharply dilated mouths of hair follicles filled with pus; hair is loose and easily removed; enlarged and painful regional lymph nodes. To diagnose microsporia of the scalp, the fluorescence method is used.

8. Candidiasis of smooth skin and folds- small bubbles with a thin flabby tire, which easily open and form erosions; erosive areas have a crimson color with a purple or liquid tint; the wet surface has a characteristic varnish shine. Candidiasis of the nail folds and nails: swelling, hyperemia of the periungual fold; the nail plate is brown, lumpy, with stripes and indentations.

Laboratory research: detection of mycelial threads, spores during microscopic examination, growth of colonies of pathogenic fungi during bacteriological examination.