​Dermatology - Tinea Capitis

​Dermatology - Tinea Capitis 
Tinea is an infection of keratinized cutaneous tissues that is caused by a specific group of fungus known as dermatophytes. The arthrospores of these species can live in skin scales for up to a year.
Transmission occurs most frequently from person to person, followed by transmission from animals, and finally transmission from soil. Tinea capitis is a dermatophytic infection that affects the scalp and hair, and it is most commonly found around the age of children.


Tinea capitis can manifest itself in a variety of ways, including non-inflammatory scaling patches, scaling and broken-off hairs, or severe, painful inflammation with painful, swampy nodules that drain pus (kerion) and end in scarring alopecia, particularly in cases when there is secondary infection. The restoration of hair typically takes place after antifungal medication has been administered.
lesions (plural)
Scaling that is not caused by inflammation tends to manifest as diffuse or confined alopecia. The term "gray patch" refers to a condition that causes partial alopecia and is characterized by a circular form, relatively sharp borders, and fine scale. It is characterized by a large number of hairs that have broken off and a dull gray coating of arthrospores. The smaller patches eventually come together to form larger patches. Patients with dark hair may experience "black dot" lesions, which are broken-off hairs that are located close to the scalp and give the appearance of "dots" (swollen hair shafts). In most cases, the lesion is widespread and poorly defined, and there is a possibility that low-grade folliculitis is present.
Kerion and favus are inflammatory masses that are characterized by swampy, purulent, inflamed nodules and plaques. These masses are typically painful and drain pus from many holes, similar to honeycombs. Rather than breaking off, hairs fall out and can be tugged out without causing any discomfort. It is possible for follicles to expel pus, sinus development, and grains that resemble mycetoma. A thick crust is there, and the hairs that are close to it have matted. Most cases feature a single plaque, but when the entire scalp is affected, it is possible for several lesions to develop. A significant number of patients exhibit concomitant lymphadenopathy.

The presence of fungal hyphae can be determined through direct microscopy of the hair shaft (which is obtained by plucking), as well as through the collection of scalp scales using a brush that has been covered with a drop of potassium hydroxide (KOH).
The differential diagnosis consists of seborrheic dermatitis, psoriasis, atopic dermatitis, lichen simplex chronicus, alopecia areata, and chronic cutaneous lupus erythematosus. Additionally, impetigo, ecthyma, and crusted scabies are also considered in cases of kerion or favus.


The most effective oral antidermophytic drug is Systemic Terbinafine 250-mg tablet, which features an allylamine as its active ingredient. Alternatives include fluconazole pills of 100, 150, or 200 milligrams or oral suspensions of 10 or 40 milligrams per milliliter, as well as itraconazole capsules of 100 milligrams or oral solution of 10 milligrams per milliliter.