Tinea capitis
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Etiology
- Trichophyton tonsurans (most common)
Epidemiology
- predominantly affects black children
- less commonly occurs in adults
Pathology
- fungal forms within the hair shaft
- hair fiber breakage
* histopathology images[5][8]
Clinical manifestations
- non-inflammatory
- one or multiply scaly plaques or patches
- broken hair &/or stubs (black dots)
- alopecia with minimal inflammation
- inflammatory
- pruritic
- lymphadenopathy common
Laboratory
(see Tinea)
Differential diagnosis
Management
- oral terbinafine, fluoconazole or itraconazole for ~6 weeks[4]
- oral griseofulvin for ~12 weeks (older treatment)[4]
- ketoconazole is less effective
- topical antifungal agents are generally ineffective
- clean contaminated combs
- evaluate family members, close contacts
More general terms
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 918, 997-1000
- ↑ Journal Watch 22(9):72, 2002 Friedlander SF, Aly R, Krafchik B, Blumer J, Honig P, Stewart D, Lucky AW, Gupta AK, Babel DE, Abrams B, Gourmala N, Wraith L, Paul C; Tinea Capitis Study Group. Terbinafine in the treatment of Trichophyton tinea capitis: a randomized, double-blind, parallel-group, duration-finding study. Pediatrics. 2002 Apr;109(4):602-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/11927703
- ↑ Journal Watch 24(24):186, 2004 Fleece D, Gaughan JP, Aronoff SC. Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials. Pediatrics. 2004 Nov;114(5):1312-5. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15520113
- ↑ 4.0 4.1 4.2 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
- ↑ 5.0 5.1 5.2 Kao GF, Elston DM (images) Medscape: Tinea Capitis http://emedicine.medscape.com/article/1091351-overview
- ↑ Gonzalez U, Seaton T, Bergus G et al Systemic antifungal therapy for tinea capitis in children. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD004685. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17943825
- ↑ 7.0 7.1 DermNet NZ. Tinea capitis (images) http://www.dermnetnz.org/fungal/tinea-capitis.html
- ↑ 8.0 8.1 8.2 Fremerey C, Nenoff P. Tinea Capitis in a Newborn. N Engl J Med 2018; 378:2022. May 24, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29791821 Free full text https://www.nejm.org/doi/full/10.1056/NEJMicm1711862
- ↑ 9.0 9.1 Elston CA, Elston MD Identifying Lesions on Skin of Color. Medscape. 2021. May 10 https://reference.medscape.com/slideshow/identifying-lesions-6007985
Elston CA, Elston DM Identifying Lesions on Skin of Color. Medscape. October 25, 2022 https://reference.medscape.com/slideshow/identifying-lesions-6007985