Clinical Burden of Primarily Misdiagnosed Tinea capitis: A Comparative Statistical Analysis
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Tinea capitis has been recognized as the most commonly misdiagnosed scalp disease. Inappropriate medication and delayed intervention leads to a broad array of complications from prolongation of treatment to scarring of the scalp. The financial deficits and problems imparted on patients continue to be a clinical and social burden. Objective: The clinical and financial aspects between the initially misdiagnosed group and the properly diagnosed group were analyzed, to provide the epidemiologic basis and to address improvements for misdiagnoses of tinea capitis. Methods: A retrospective review of electronic and written chart was performed on all patients diagnosed of tinea capitis at Daegu Catholic University Medical Center (DCUMC) from January 2006 to June 2016. A total of 100 patients were included in the study and an initially misdiagnosed group and initially diagnosed group were evaluated. Results: Significant differences between the groups were not observed in variables including age, sex and occupation. The highest diagnostic precision was observed in dermatologists (78.4%) by using standard microscopic (31.0%) and culture studies (13.0%). Misdiagnosis rate was highest in pediatrics (34.9%) and erroneous examination such as laboratory test (48.4%) and Gram stain (19.4%) were countered in the misdiagnosed group. Additional clinic visits, prescriptions and extra trips to clinics resulted financial disadvantage in the misdiagnosed group. Conclusion: The misdiagnosed tinea capitis was found to arise from unawareness of the disease that leads to inappropriate approach and medication prescription. The duration, complications and financial loss were reported to be higher in misdiagnosed group based on the study.
Abstract
Background: Tinea capitis has been recognized as the most commonly misdiagnosed scalp disease. Inappropriate medication and delayed intervention leads to a broad array of complications from prolongation of treatment to scarring of the scalp. The financial deficits and problems imparted on patients continue to be a clinical and social burden. Objective: The clinical and financial aspects between the initially misdiagnosed group and the properly diagnosed group were analyzed, to provide the epidemiologic basis and to address improvements for misdiagnoses of tinea capitis. Methods: A retrospective review of electronic and written chart was performed on all patients diagnosed of tinea capitis at Daegu Catholic University Medical Center (DCUMC) from January 2006 to June 2016. A total of 100 patients were included in the study and an initially misdiagnosed group and initially diagnosed group were evaluated. Results: Significant differences between the groups were not observed in variables including age, sex and occupation. The highest diagnostic precision was observed in dermatologists (78.4%) by using standard microscopic (31.0%) and culture studies (13.0%). Misdiagnosis rate was highest in pediatrics (34.9%) and erroneous examination such as laboratory test (48.4%) and Gram stain (19.4%) were countered in the misdiagnosed group. Additional clinic visits, prescriptions and extra trips to clinics resulted financial disadvantage in the misdiagnosed group. Conclusion: The misdiagnosed tinea capitis was found to arise from unawareness of the disease that leads to inappropriate approach and medication prescription. The duration, complications and financial loss were reported to be higher in misdiagnosed group based on the study.
참고문헌 (24)
- Zienicke HC, "Dermatophytosis in children and adolescents:epidemiological, clinical, and microbiological aspects changing with age", J Dermatol, 18, pp.438~446 (1991)
- Hay RJ, "Tinea capitis: current status", Mycopathologia, 182, pp.87~93 (2017)
- Elewski BE, "Tinea capitis: a current perspective", J Am Acad Dermatol, 42, pp.1~20 (2000)
- Thoma-Greber E, "Surgical treatment of tinea capitis in childhood", See comment in PubMed Commons below Mycoses, 46, pp.351~354 (2003)
- Hubbard TW, "The predictive value of symptoms in diagnosing childhood tinea capitis", Arch Pediatr Adolesc Med, 153, pp.1150~1153 (1999)
- Pomeranz AJ, "Management errors leading to unnecessary hospitalization for kerion", Pediatrics, 93, pp.986~988 (1994)
- 현동녘, "소아 백선의 임상 및 균학적 관찰", 대한의진균학회지, 14(2), pp.69~78 (2009), 대한의진균학회
- Krowchuk DP, "Current status of the identification and management of tinea capitis", Pediatrics, 72, pp.625~631 (1983)
- Gupta AK, "Tinea capitis: an overview with emphasis on management", Pediatr Dermatol, 16, pp.171~189 (1999)
- Stein DH, "Pediatric Dermatology", pp.1415~1421 (1988), Churchil Livingstone
- Ormsby OS, "Montgomery H. Diseases of the skin", pp.1074~ (1984), Lea & Febiger
- Davidson AM, "A clinical and mycological study of suppurative ringworm", Can Medical Assoc J, 31, pp.587~591 (1934)
- John AM, "The kerion: an angry tinea capitis", Int J Dermatol (2016)[DOI]
- Suh DC, "Tinea capitis in the United States:diagnosis, treatment, and costs", J Am Acad Dermatol, 55, pp.1111~1112 (2006)
- Ely JW, "Diagnosis and management of tinea infections", Am Fam Physician, 90, pp.702~710 (2014)
- McGinley KJ, "Antifungal activity of dermatological shampoos", Arch Dermatol Res, 272, pp.339~342 (1982)
- Rath S, "Bayesian analysis of two diagnostic methods for paediatric ringworm infections in a teaching hospital", J Mycol Med, 25, pp.191~199 (2015)
- Torok RD, "Tinea capitis mimicking dissecting cellulitis", Pediatr Dermatol, 30, pp.753~754 (2013)
- Feetham JE, "Kerion celsi: a misdiagnosed scalp infection", Arch Dis Child, 101, pp.503~ (2016)[DOI]
- Stein LL, "Inflammatory tinea capitis mimicking dissecting cellulitis in a postpubertal male: a case report and review of the literature", Mycoses, 56, pp.596~600 (2013)
- Barnali Chowdhury, "Histopathologically Confirmed Tinea Capitis Misdiagnosed as Psoriasis", 대한의진균학회지, 21(4), pp.135~137 (2016), 대한의진균학회[DOI]
- Mirmirani P, "Epidemiologic trends in pediatric tinea capitis: a population-based study from Kaiser Permanente Northern California", J Am Acad Dermatol, 69, pp.916~921 (2013)
- Pomeranz AJ, "Tinea capitis: epidemiology, diagnosis and management strategies", Paediatr Drugs, 4, pp.779~783 (2002)
- Williams JV, "Prevalence of scalp scaling in prepubertal children", Pediatrics, 115, pp.1~6 (2005)