A Case Report of Tinea Capitis in Children: Utility of Trichoscopy
Downloads
Background: Tinea capitis (TC) is the most prevalent pediatric superficial dermatophyte infection. Scalp dermoscopy or "trichoscopy” represents a valuable, noninvasive technique for the evaluation of patients with hair loss due to TC. Purpose: To characterize trichoscopic findings in children with clinical findings suggestive of TC. Case: A 13-year-old boy was presented with a scaled plaque on his scalp that had appeared 1 month earlier. A physical examination revealed a scaly, nonerythematous, rounded lesion in the parietal area of the head. Wood's lamp yielded a blue fluorescence. Microscopic morphology from fungal culture found the typical spindle-shaped macroconidia of Microsporum canis. Trichoscopy showed mainly comma hair, corkscrew hair, morse code hair, bent hair, and zig zag hair. The patient was started on oral griseofulvin 20 mg/kg/day and antifungal shampoo for 8 weeks. The patient was cured after two months of treatment and trichoscopy returned to normal. Discussion: Fungal culture remains the gold standard in TC diagnosis, but it needs time. Trichoscopy can be an additional tool to help evaluate the diagnosis, aetiology, and follow up of this disorder. The presence of characteristic trichoscopic features (comma hairs, corkscrew hairs, Morse code-like hairs, zigzag hairs, bent hairs, block hairs, and i-hairs) is predictive of TC. The present analysis confirmed that trichoscopy is a useful method in differentiating between Microsporum and Trichophyton TC, which is important from the perspective of a different therapeutic approach. Conclusion: Trichoscopy is not only of value in the diagnosis of TC but also for the etiologic agent and follow-up after treatment in this case.
Craddock LN, Schieke SM. Superficial fungal infection. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick's Dermatology Ninth Edition. New York: McGraw-Hill Education; 2019. p. 2925–52.
Burnat AW, Ciechanowicz P, Rakowska A, Sikora M, Rudnicka L. Trichoscopy of tinea capitis : a systematic review. Dermatol Ther (Heidelb) 2020; 10(1): 1-10.
Adesiji YO, Omolade FB, Aderibigbe IA, Ogungbe O, Adefioye OA, Adedokun SA, et al. Prevalence of tinea capitis among children in Osogbo, Nigeria, and the associated risk factors. Diseases 2019; 7(13): 1-13.
Michaels BD, Del Rosso JQ. Tinea capitis in infants: recognition, evaluation, and management suggestions. J Clin Aesthet Dermatol 2012; 5(1): 49–59.
Hay RJ. Tinea capitis: current status. Mycopathologia 2017;182(1–2): 87–93.
Aqil N, BayBay H, Moustaide K, Douhi K, Elloudi S, Mernissi FZ. A prospective study of tinea capitis in children: making the diagnosis easier with a dermoscope. J Med Case Rep 2018;1(2): 383.
Dhaille F, Dillies AS, Dessirier F, Reygagne P, Diouf M, Baltazard T, et al. A single typical trichoscopic feature is predictive of tinea capitis ” a prospective multicenter study. Br J Dermatol 2019; 2(1): 1-6.
Rudnicka L, Olszewska M, Rakowska A. Atlas of trichoscopy: dermoscopy in hair and scalp disease. London: Springer; 2012: p.361-71.
Elghblawi E. Tricoscopy findings in tinea capitis. A rapid method of diagnosis. Eur J Pediat Dermatol 2016; 2(6): 71-4.
Leecharoen W, Leeyaphan C, Bunyaratavej S. Tinea capitis incognito in adult: a case report. Thai J Dermatol 2018; 34(3): 225-30.
Rudnicka L, Rakowska A, Kerzeja M, Olszewska M. Hair shafts in trichoscopy: clues for diagnosis of hair and scalp diseases. Dermatol Clin 2013;3(1): 695–708.
Park J, Kim J, Kim H, Yun S, Kim S. Trichoscopic findings of hair loss in Koreans. Ann Dermatol 2015; 27(5): 539–50.
Hughes R, Chiaverini C, Bahadoran P, Lacour JP. Corkscrew hair: a new dermoscopic sign for diagnosis of tinea capitis in black children. Arch Dermatol 2011; 14(7): 355–6.
Rudnicka L, Olszewska M, Rakowska A, Slowinska M. Trichoscopy update 2011. J Dermatol Case Rep 2011; 5(1): 82–8.
Rudnicka L, Olszewska M, Waskiel A, Rakowska A. Trichoscopy in hair shaft disorders. Dermatol Clin 2018; 3(6): 421–30.
Bourezane Y, Bourezane Y. Analysis of trichoscopic signs observed in 24 patients presenting tinea capitis: hypotheses based on physiopathology and proposed new classification. Ann Dermatol Venereol 2017; 144(8–9): 490–6.
Khunkhet S, Vachiramon V, Suchonwanit P. Trichoscopic clues for diagnosis of alopecia areata and trichotillomania in Asians. Int J Dermatol 2017; 5(6): 161–5.
Shim W, Jwa S, Song M, Kim H, Ko H, Kim B, et al. Dermoscopic approach to a small round to oval hairless patch on the scalp. Ann Dermatol 2014; 26(2): 214–20.
Lacarrubba F, Tosti A. Scalp dermoscopy or trichoscopy. Curr Probl Dermatol 2015; 4(7): 21–32.
Isa RI, Amaya BY, Pimentel MI, Arenas R, Tosti A, Cruz AC. Dermoscopy in tinea capitis: a prospective study on 43 patients. Med Cutan Ibero Lat Am 2014; 42: 18–22.
Campos S, Brasileiro A, Galhardas C, Apetato M, Cabete J, Serrí£o V, et al. Follow-up of tinea capitis with trichoscopy: a prospective clinical study. J Eur Acad Dermatol Venereol 2017; 31(11): 478–80.
Richarz NA, Barboza L, Monson M, Gonzalez MA, Vicente A. trichoscopy helps to predict the time point of clinical cure of tinea capitis. Australas J Dermatol 2018; 1(1): 1–2.
Alkeswani A, Cantrell W, Elewski B. Treatment of tinea capitis. Skin Appendage Disord 2019; 1(1): 1–10.
Gupta AK, Mays RR, Versteeg SG, Piraccini BM, Shear NH, Piguet V, et al. Tinea capitis in children: a systematic review of management. J Eur Acad Dermatol Venereol 2018; 32(12): 2264–74.
Copyright (c) 2022 Berkala Ilmu Kesehatan Kulit dan Kelamin
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
- Copyright of the article is transferred to the journal, by the knowledge of the author, whilst the moral right of the publication belongs to the author.
- The legal formal aspect of journal publication accessibility refers to Creative Commons Atribusi-Non Commercial-Share alike (CC BY-NC-SA), (https://creativecommons.org/licenses/by-nc-sa/4.0/)
- The articles published in the journal are open access and can be used for non-commercial purposes. Other than the aims mentioned above, the editorial board is not responsible for copyright violation
The manuscript authentic and copyright statement submission can be downloaded ON THIS FORM.
