Skin Disorders
Bookmark and Share
   Abscess
   Acne
   Acquired Melanocytic Nevocellular Nevi
   Acral Lentiginous Melanoma
   Acute HIV Syndrome
   Acute Lymphangitis
   Acute Sun Damage
   Adult T Cell Leukemia
   Adverse Cutaneous Drug Reactions
   Albinism
   Alopecia Areata
   Androgenetic Alopecia
   Aphthous Ulcer
   Atherosclerosis
   Bacillary Angiomatosis
   Bacterial Infections
   Basal Cell Carcinoma
   Basal Cell Nevus Syndrome
   Behcet's Syndrome
   Benign Cutaneous Neoplasms
   Calciphylaxis
   Candidiasis
   Capillary Hemangioma of Infancy
   CVL
   Cat-Scratch Disease
   Chancroid
   Chromomycosis
   Chronic Lupus Panniculitis
   Chronic Venous Insufficiency
   Clark Melanocytic Nevus
   Congenital Nevomelanocytic Nevus
   Crest Syndrome
   Cryoglobulinemia
   Cutaneous Candidiasis
   Cutaneous Larva Migrans
   Cutaneous Lupus Erythematosus
   Cutaneous and Mucocutaneous Leishmaniasis
   Cutaneous Pseudomonas Aeruginosa Infections
   Cutaneous Reactions to Arthropod Bites
   Cutaneous T Cell Lymphoma
   Dermatitis
   Dermatofibroma
   Dermatofibroma
   Dermatoheliosis
   Dermatomyositis
   Dermatophytoses
   Dermatophytosis
   Desmoplastic Melanoma
   Disseminated Coccidioidomycosis
   Disseminated Cryptococcosis
   Disseminated Gonococcal Infection
   Disseminated Intravascular Coagulation
   Donovanosis
   Drug Hypersensitivity Syndrome
   Drug-Induced Acute Urticaria
   Drug-Induced Pigmentation
   Eosinophilic Folliculitis
   Erysipelas and Cellulitis
   Erythema Infectiosum
   Erythrasma
   Erythropoietic Protoporphyria
   Exanthematous Drug Reactions
   Exfoliative Erythroderma Syndrome
   Extramammary Paget's Disease
   Eye Stye
   Fixed Drug Eruption
   Gangrenous Cellulitis
   Genital Candidiasis
   Giant Cell Arteritis
   Glucagonoma Syndrome
   Graft Versus Host Disease
   Hand-Foot-and-Mouth Disease
   Herpes Gestationis
   Herpes Simplex Virus: Genital Infections
   Herpes Simplex Virus Infection
   Herpes Simplex Virus: Infections Associated Systemic Immunocompromise
   Herpes Simplex Virus
   Herpes Zoster
   Hirsutism
   Histoplasmosis
   HIV Associated Lipodystrophy Syndrome
   Human Papillomavirus: Mucosal Infections
   Human Papillomavirus: Squamous Cell Carcinoma In Situ
   Human Papillomavirus
   Hypersensitivity Vasculitis
   Hypertrophic Scars and Keloid
   Ichthyosis
   Impetigo and Ecthyma
   Infectious Exanthems
   Infectious Folliculitis
   Infective Endocarditis
   Infestations of the Skin
   Kaposi's Sarcoma
   Kawasaki's Disease
   Keratoacanthoma


Home :: Tinea Capitis

Tinea Capitis

Tinea capitis is a dermatophytic trichomycosis of the scalp. Clinical presentations vary widely, ranging from mild scaling and broken-off hairs to severe, painful inflammation with painful, boggy nodules that drain pus and result in scarring alopecia.

Causes of Tinea Capitis

Noninflammatory lesions Invasion of hair shaft by the dermatophytes, principally M.audouinii (child-to-child, via barber, hats, theater seats), M. canis (young pets-to-child and then child-to-child) or T.tonsurans. Inflammatory lesions: T tonsurans, M.canis, T.verrucosum, and others. Spores enter through breaks in hair shaft or scalp to cause clinical infection.

Scalp hair traps fungi from the environment or fomites. Asymptomatic colonization is common Trauma assists inoculation. Dermatophytes initially invade stratum corneum of scalp, which may be followed by hair shaft infection. Spread to other hair follicles then occurs. Eventually, infection regresses with or without an inflammatory response. Clinical appearance varies with type of hair invasion, level of host resistance, degree of inflammatory host response: few dull-grey, broken-off hairs with little scaling to severe painful inflammatory mass covering entire scalp. Partial hair loss with inflammation in all cases. Kerion is associated with a high degree of hypersensitivity to fungal hapten. Types of hair invasion:

Microsporum types:

  1. Small-spored ectothrix; hair shaft is invaded in mid-follicle. Intrapiliary hyphae grow inward toward hair bulb. Secondary extrapiliary hyphae burst, growing over surface of hair shaft.
  2. Large-spored ectothrix have similar arrangement.

Trichophyton types:

  1. Large-spored ectothrix (in chains); arthrospores spherical, arranged in straight chains, confined to external surface of hair shaft. Spores are all larger than those of small-spored Microsporum ectothrix.
  2. Entothrix type; intrapiliary hyphae fragment into arthroconidia within hair shaft making it fragile, with subsequent breakage close to scalp surface.

Symptoms of Tinea Capitis

  • Itching of the scalp, may be slight or absent
  • Skin (scalp) lesions that are: Round, scaly, Gray or reddened (skin redness or inflammation), Bald-appearing patches (hair is broken off, not actually missing), Possibly small black dots on the scalp
  • Occasionally localized area of swelling, raw skin, or pus-filled lesion on the scalp (kerion)

Diagnosis

Doctors can diagnose ringworm on sight, or they may take a skin scraping. This is examined under a microscope, or put on an agar plate in a microbiology laboratory and allowed to grow. Some of the fungi fluoresce under a black light examination.

Treatment

Topical antifungal agents Topical agents are ineffective in management of tinea capitis. Duration of treatment should be extended until symptoms have resolved and fungal cultures negative.

Oral antifungal agents Of the systemic antifungals available, terbinafine and itraconazole are superior to ketoconazole and all three to griseofulvin. Side effects in increasing order: terbinafine<itraconazole<ketoconazole<   griseofulvin.

  • Terbinafine 250 mg qd. Reduce dosing according to weight in pediatric patients.
  • Itraconazole 100-mg capsules or oral solution (10 mg/mL). Treatment duration: 4 to 8 weeks. Pediatric Dose 5 mg/kg/d, Adult Dose 200 mg/d

Adjunctive therapy

  • Prednisone 1 mg/kg/d for 14 days for children with severe, painful kerion.
  • Systemic antibiotics For secondary S. aureus or group A Streptococcus infection, erythromycin, dicloxacillin, or cephalexin

Surgery Drain pus from kerion lesions.

Prevention

Important to examine home and school contacts of affected children for asymptomatic carriers and mild cases of tinea capitis. Ketoconazole or selenium sulfide shampoo may be helpful in eradicating the asymptomatic carrier state.

More Skin Disorders
 
   Langerhans Cell Histiocytosis
   Leg Ulcers
   Lentigo Maligna
   Leprosy
   Leukemia Cutis
   Livedo Reticularis
   Localized Infection
   Lupus Erythematosus
   Lyme Borreliosis
   Lymphogranuloma Venereum
   Lymphomatoid Papulosis
   Malignant Melanoma of the Mucosa
   Mammary Paget's Disease
   Mastocytosis Syndromes
   Measles
   Melasma
   Merkel Cell Carcinoma
   Metastatic Cancer to the Skin
   Molluscum Contagiosum
   Mycetoma
   Mycobacterium Fortuitum Complex Infection
   Mycobacterium Marinum Infection
   Mycobacterium Ulcerans Infection
   Necrobiosis Lipoidica
   Neisseria Gonorrhoeae Infections
   Neurofibromatosis
   Nodular Melanoma
   Nodular Vasculitis
   Nongenital Herpes Simplex Virus Infection
   North American Blastomycosis
   Onychomycosis
   Oral Hairy Leukoplakia
   Oropharyngeal Candidiasis
   Other Viral Infections
   Papulosquamous Conditions
   Pediculosis Capitis
   Pediculosis Pubis
   Pediculosis
   Photoallergic Drug Induced Photosensitivity
   Phototoxic Drug Induced Photosensitivity
   Phytophotodermatitis
   Pitted Keratolysis
   Pityriasis Versicolor
   Polyarteritis Nodosa
   Polymorphous Light Eruption
   Porphyria Cutanea Tarda
   Port-Wine Stain
   Premalignant and Malignant Skin Tumors
   Pressure Ulcers
   Pruritic Urticarial Papules
   Pseudoxanthoma Elasticum
   Pyogenic Granuloma
   Radiation Dermatitis
   Raynaud's Disease
   Reiter's Syndrome
   Rocky Mountain Spotted Fevers
   Rosacea
   Rubella
   Xanthelasma
   Xanthomas
   X-Linked Hyper-IgM Syndrome
   Xeroderma Pigmentosum
   Yaws
   Yellow Fever
   Yellow Nail Syndrome
   Zygomycete
   Zinc Deficiency

Skin Disorders || Contact Us || Tweet

Copyright © Skin-disorders.net All Rights Reserved.

Disclaimer - The data contained in the Skin-disorders.net Web pages is provided for the purpose of educational purposes and information only. It is not intended nor implied to be a substitute for professional medical advice and shall not create a physician - patient relationship. We are not responsible for any consequence resulted from using this information. Please always consult your physician for medical advices and treatment.