Overview
What is tinea capitis (ringworm of the scalp)?
What are the types of dermatophytosis?
How does the clinical presentation of tinea capitis vary?
When were the causes and treatment of tinea capitis (scalp ringworm) first identified?
What is the pathophysiology of tinea capitis (scalp ringworm)?
What causes tinea capitis (scalp ringworm)?
What is the role of dermatophytes in the pathophysiology of tinea capitis (scalp ringworm)?
How is in vivo hair invasion characterized in the pathophysiology of tinea capitis (scalp ringworm)?
How are dermatophytes transmitted in tinea capitis (scalp ringworm)?
How does the causative agent of tinea capitis (scalp ringworm) vary by geographic location?
How are the dermatophytic fungi that cause tinea capitis (scalp ringworm) classified?
How is dermatophytosis characterized?
What are the common causes of tinea capitis (scalp ringworm)?
What is the incidence of tinea capitis (scalp ringworm) in the US?
What is the global incidence of tinea capitis (scalp ringworm)?
How does the incidence of tinea capitis (scalp ringworm) vary by sex?
How does the incidence of tinea capitis (scalp ringworm) vary by age?
What is the prognosis of tinea capitis (scalp ringworm)?
How is the classification and severity of tinea capitis (scalp ringworm) determined?
How is ectothrix infection in tinea capitis (scalp ringworm) defined?
What is the prognosis of endothrix infections in tinea capitis (scalp ringworm)?
What are the AAP recommendations for children during tinea capitis (scalp ringworm) treatment?
Presentation
What is the disease course of tinea capitis (scalp ringworm)?
Which presentations are characteristic of tinea capitis (scalp ringworm)?
Which physical findings suggest tinea capitis (scalp ringworm)?
How is tinea capitis (scalp ringworm) diagnosed?
What should be included in the physical exam of tinea capitis (scalp ringworm)?
Which physical findings of skin lesions suggest tinea capitis (scalp ringworm)?
What are the physical findings of dermatophyte id reactions in tinea capitis (scalp ringworm)?
What is the distribution of tinea capitis (scalp ringworm) lesions?
What increases the risk of cervical lymphadenopathy in tinea capitis (scalp ringworm)?
What are possible complications of tinea capitis (scalp ringworm)?
DDX
Which conditions should be included in the differential diagnoses of tinea capitis (scalp ringworm)?
How is seborrheic dermatitis differentiated from tinea capitis (scalp ringworm)?
How is impetigo differentiated from tinea capitis (scalp ringworm)?
How is secondary syphilis differentiated from tinea capitis (scalp ringworm)?
What are the differential diagnoses for Tinea Capitis?
Workup
What is the role of serology in the diagnosis of tinea capitis (scalp ringworm)?
How is tinea capitis (scalp ringworm) diagnosed?
How are infected hairs collected for diagnosis of tinea capitis (scalp ringworm)?
What is needed to definitively diagnosis tinea capitis (scalp ringworm)?
How are hair samples handled before evaluation for tinea capitis (scalp ringworm)?
What is the role of kerion sampling in the diagnosis of tinea capitis (scalp ringworm)?
What can be determined by microscopic exam of infected hairs in tinea capitis (scalp ringworm)?
What is the role of cultures in the diagnosis of tinea capitis (scalp ringworm)?
What is the role of Wood lamp exam in the diagnosis of tinea capitis (scalp ringworm)?
When is Wood lamp exam indicated in the workup of tinea capitis (scalp ringworm)?
What findings on dermoscopy and videodermatoscopy suggest tinea capitis (scalp ringworm)?
What is the role of skin biopsy in the diagnosis of tinea capitis (scalp ringworm)?
Which histologic findings are characteristic of tinea capitis (scalp ringworm)?
Treatment
What is the basis for treatment selection for tinea capitis (scalp ringworm)?
What is the role of griseofulvin in the treatment of tinea capitis?
Which medications are effective for treatment of tinea capitis (scalp ringworm)?
How can tinea capitis (scalp ringworm) be prevented?
Why should asymptomatic tinea capitis (scalp ringworm) be treated?
Who must be evaluated for tinea capitis (scalp ringworm)?
How may tinea capitis (scalp ringworm) spread among children?
Medications
What is the treatment of choice for tinea capitis (scalp ringworm)?
What agents are effective and safe for treatment of tinea capitis (scalp ringworm)?
What is the role of itraconazole in the treatment of tinea capitis (scalp ringworm)?
What is the role of terbinafine for the treatment of tinea capitis (scalp ringworm)?
What is the role of fluconazole for the treatment of tinea capitis (scalp ringworm)?
What may be required for treatment of ectothrix infections of tinea capitis (scalp ringworm)?
What is the role of ketoconazole for the treatment of tinea capitis (scalp ringworm)?
How are steroids used in the treatment of tinea capitis (scalp ringworm)?
Which medications in the drug class Antifungal agents are used in the treatment of Tinea Capitis?
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Gray-patch ringworm (microsporosis) is an ectothrix infection or prepubertal tinea capitis seen here in an African American male child. Gray patch refers to the scaling with lack of inflammation, as noted in this patient. Hairs in the involved areas assume a characteristic dull, grayish, discolored appearance. Infected hairs are broken and shorter. Papular lesions around hair shafts spread and form typical patches of ring forms, as shown. Culture from the lesional hair grew Microsporum canis.
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Typical lesions of kerion celsi on the vertex scalp of a young Chinese boy. Note numerous bright yellow purulent areas on skin surface, surrounded by adjacent edematous, erythematous, alopecic areas. Culture from the lesion grew Trichophyton mentagrophytes. Courtesy of Skin Diseases in Chinese by Yau-Chin Lu, MD. Permission granted by Medicine Today Publishing Co, Taipei, Taiwan, 1981.
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Discrete patches of hair loss or alopecia caused by Trichophyton violaceum infection of the vertex scalp of a young Taiwanese boy. Courtesy of Skin Diseases in Chinese by Yau-Chin Lu, MD. Permission granted by Medicine Today Publishing Co, Taipei, Taiwan, 1981.
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Photomicrograph depicting an endoectothrix invasion of a hair shaft by Microsporum audouinii. Intrapilary hyphae and spores around the hair shaft are seen (hematoxylin and eosin stain with Periodic acid-Schiff counterstain, magnification X 250).
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Fungal hyphae and yeast cells of Trichophyton rubrum seen on the stratum corneum of tinea capitis. Periodic acid-Schiff stain, magnification 250X.
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Pronounced inflammatory tissue reaction with follicular pustule formation surrounding a hair follicle seen in a patient with clinical form of infection, termed kerion celsi. No fungal hyphae or spores were identified in the lesion in either tissue sections or culture. Fluorescein-labeled Trichophyton mentagrophytes antiserum cross-reacted with antigens of dermatophyte in the infected hairs within the pustule (hematoxylin and eosin stain, magnification X 75).
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Wood lamp examination of a gray-patch area on the scalp. In Microsporum canis infection, scalp hairs emit a diagnostic brilliant green fluorescence. Trichophyton tonsurans does not fluoresce with Wood lamp.
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Tinea capitis, presenting as alopecia with scale, in an African American child.