Favus - Causes, Symptoms and Treatment

Favus is a disease of the scalp , but occurring occasionally on any part of the skin, and even at times on mucous membranes. Favus is caused by Trichophyton violaceum. Favus typically affects scalp hair but also may infect glabrous skin and nails. The causative agent of mouse favus is T mentagrophytes var quinckeanum , also termed Trichophyton quinckeanum , which can cause favus in humans, although rarely. Favus of the Scalp.—The characteristic feature of this affection is the presence of tiny yellowish crusts, usually with a hair in the center. The typical eruptions of favus are about the size of a split pea, rounded, hollowed-out in the center, of sulphur-yellow color and with a hair passing through the center. The spores would appear to enter through the unbroken cutaneous surface, and to germinate mostly in and around the hair follicle and sometimes in the shaft of the hair. Favus is 1 of 3 primary patterns of hair infection. Hair is able to grow, and frequently, long hairs are observed in the disease state. The most characteristic feature is the formation of air spaces between hyphae within the infected hair. These air spaces (air tunnels) form as a result of autolysis of the hyphae. Arthroconidia rarely are seen within the hair. Such infected hair commonly is termed favus-type hair. In the sera of patients. Favus papyroides is characterized by small loci on the scalp that are covered by a brittle substance similar to parchment. Favus impetigoides is characterized by yellowish (honey-colored) crusts imitating impetigo that are located on the scalp.

Favus shows no racial or ethnic preference. Favus appears in both children and adults. Favus usually is acquired during childhood or adolescence and typically persists into adulthood. Favus may be spread by contagion usually from cats, dogs and mice. Favus usually begins on the scalp, often in childhood, and persists for many years as unsightly, crusted plaques. According to the severity of the disease, 3 main stages are described.First stage: Only erythema of the scalp is seen, primarily around follicles. Hairs are not loose or broken. Second stage: Formation of scutula is seen with the beginning of hair loss. Third stage: The most severe stage involves large areas of the scalp (at least one third); extensive hair loss, atrophy, and scarring result. Formation of new scutula at the periphery of plaques is common. The scutulum, a yellow cup-shaped crust that surrounds a hair and pierces its center, is characteristic. Scutula form a dense plaque, each composed of mycelia and epidermal debris. Often, a secondary bacterial infection occurs in the plaque. Plaque removal leaves an erythematous moist base. The dense masses of yellow crusts may be solitary or numerous, and in patients who are severely affected. Favus usually is controlled by griseofulvin, the standard treatment of tinea capitis; however, a longer treatment course than usual for tinea capitis may be advisable.

Causes of Favus

Common Causes and Risk factors of Favus

T schoenleinii.
T violaceum.
T mentagrophytes var quinckeanum.
M gypseum..
Vegetable parasite

Sign and Symptoms of Favus

Common Sign and Symptoms of Favus

Crusts yellow in colour.
Grouped in patches.

Treatment for Favus

Common Treatment for Favus

Favus usually is controlled by griseofulvin, the standard treatment of tinea capitis; however, a longer treatment course than usual for tinea capitis may be advisable.
Favus is uncommon; therefore, no clinical trials with newer antifungals are available.
T schoenleinii is sensitive to newer antifungal drugs, similar to other dermatophytes. Terbinafine, itraconazole, and fluconazole in a similar dosage schedule to tinea capitis may eradicate the fungus and cure the disease.
Additional topical agents, such as shampoo (2% ketoconazole, 2.5% selenium sulfide), lotion, and cream may be helpful.
General hygiene of the scalp must be improved, and debris and crusts must be removed.

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