Scaly Tinea Capitis

Diagnosis: Scaly Tinea Capitis

scaly patch with hair loss.

Clinical Presentation

scaly patch with hair loss.

Clinical History

Submitted by Alaa Saad. Originally posted November 23, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Alopecia areata • Seborrheic dermatitis • Psoriasis (scalp) • Trichotillomania • Discoid lupus erythematosus • Impetigo of scalp • Bacterial folliculitis

Key Learnings

• Most common dermatophyte infection in children — Trichophyton tonsurans predominates in North America • "Black dot" pattern: T. tonsurans (endothrix — breaks hair at scalp surface) • Kerion: intense inflammatory response — boggy, purulent mass (not an abscess — do not I T. tonsurans does NOT • Systemic antifungals REQUIRED — topical antifungals alone do not penetrate hair follicle • Griseofulvin has been standard therapy; terbinafine increasingly used • Id reaction (dermatophytid): generalized papulovesicular eruption during treatment — not an allergy to medication

Tags: scaly, tinea, capitis, alaa saad