Tinea capitis scalp ringworm dermatologic disorders. Sebum, the skin oil stimulated by teenage hormones, has a negative impact on the ability of fungi to penetrate the hair shaft, thus preventing tinea capitis infection in teenagers and adults. Tinea capitis has the potential to cause significant problems. For the treatment of tinea capitis caused by the trichophyton species, in this study, griseofulvin given for 6 weeks is similar in efficacy to terbinafine, itraconazole, and fluconazole given for. Openurl1crossref2pubmed3 these investigators, representing 3 university medical centers in italy, report on 15 cases of tinea capitis observed in infants less than 1 year of age. Apr 22, 2019 oral antifungals are needed to effectively treat tinea capitis. Nov 19, 2015 tinea capitis is a disease caused by superficial fungal infection of the skin of the scalp, eyebrows, and eyelashes, gray patch ringworm. Trichophyton and microsporum species of dermatophyte fungi are the major causes of tinea capitis.
Jul 14, 2010 pending culture results, the choice of initial treatment should be based on the patients history eg, ethnic origin, contact with animals, practice of some particular sports, clinical presentation eg, the black dot pattern of tinea capitis is commonly caused by t. Which medications in the drug class antifungal agents are. What are the aap recommendations for children during tinea. Hairs in the involved areas assume a characteristic dull, grayish. Tinea capitis is a common superficial fungal infection of the scalp and hair 1, 2. Feb 21, 2020 gray patch ringworm microsporosis is an ectothrix infection or prepubertal tinea capitis seen here in an african american male child. Apr 18, 2020 tinea capitis scalp see the image below tinea capitis. Ringworm on the scalp can also cause what is sometimes called black dota patch of hair loss with black dots on the scalp caused by hairs that are broken off just below the surface of the skin. It can show up in a number of ways, but often as scaly patches of hair loss on.
Apr 05, 2020 gray patch ringworm microsporosis is an ectothrix infection or prepubertal tinea capitis seen here in an african american male child. Feb 02, 2014 tinea capitis can occur in three distinctly different forms. Describe that treatment of hair, nails, and beard compared with that for other body sites. Hairs in the involved areas assume a characteristic dull, grayish, discolored appearance. Tinea corporis and tinea capitis american academy of. Furthermore, the use of topical antifungal treatment alone may contribute to the. Jul 31, 2018 emergency department care certain forms of tinea can easily be identified and treated with antifungals in the emergency department. This an exogenous infection that is characterized by invasion of dermatophytes into hair follicles and keratinized layer of hairy skin leading to hair loss, scaling, kerion, agminate folliculitis, favus, black dot, grey patch type, erythema or impetigolike lesions. Guidelines for the management of tinea capitis 55 q2000 british association of dermatologists, british journal of dermatology, 143,5358 therapy is generally needed.
Tinea capitis is a mild dermatophytosis affects the scalp and the hair shafts and is clinically presented as single or multiple patches of skin. Feb 21, 2020 ketoconazole is rarely used to treat tinea capitis. Tinea capitis must be treated with systemic antifungal agents because topical agents do not penetrate the hair shaft. Tinea capitis scalp ringworm dermatologic disorders msd.
Tinea corporis and tinea capitis stony brook school of medicine. There were 10 boys and 5 girls ranging in age from 45 days12 months mean. The signs and symptoms of ringworm of the scalp may vary, but it usually appears as itchy, scaly, bald patches on the head. Gray patch tinea capitis gptc it begins with an erythematous, scaling, welldemarcated patch on the scalp that spreads centrifugally for a few weeks or months, ceases to spread, and persists indefinitely, sometimes for years round grayish, scaly. Tinea capitis is a disease of prepubertal children with common in age group of 5 15 years. The differential diagnosis for tinea capitis includes atopic dermatitis, seborrheic dermatitis, psoriasis, bacterial folliculitis or abscess, trichotillomania, alopecia areata, head lice, and scarring alopecia, such as discoid lupus. The concept of carriers is controversial but describes patients whose symptoms and clinical signs are minimal but who are still mycologically positive and presumed capable of transmitting infection. Ringworm of the scalp tinea capitis is a fungal infection of the scalp and hair shafts. Feb 21, 2020 graypatch ringworm microsporosis is an ectothrix infection or prepubertal tinea capitis seen here in an african american male child. The clinical appearance is typically single or multiple lesions of. However, the diagnosis should probably be confirmed with a. Tinea capitis causes the gradual appearance of round patches of dry scale, alopecia, or both. Tinea capitis pictures, symptoms, treatment, contagious. Tinea capitis must be treated with systemic antifungal agents, since topicals cannot penetrate the hair shaft.
Tinea capitis is a common infection of the scalp hair caused by dermatophyte fungi and occurring predominantly in children. Prevalence of tinea capitis in school going children from. There is no currently approved treatment for tinea capitis in childhood the uk apart from griseofulvin taken 6 to 8 weeks remains an effective therapy. British association of dermatologists guidelines for the. In terms of treatment, the standard therapy for tinea capitis remains oral. Mar 08, 2003 tinea capitis requires systemic treatment because antifungal creams are unable to penetrate the hair shaft sufficiently to clear the infection. It is a broadspectrum synthetic antifungal compound of the azole group. Tinea capitis scalp ringworm dermatologic disorders merck.
Also called tinea capitis, it causes small patches of itchy, scaly skin. Swollen stubs of broken off hairs are visible within the patch of alopecia fig. Tinea capitis in infants american academy of pediatrics. How long does tinea capitis need to be treated in order to. This skin condition is commonly known as ringworm of the hair although the worm has nothing to do with the condition. All clinically diagnosed cases of tinea capitis which presented to our out patient department over a period of one year were included in the study. 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 and are broken and shorter. Although topical antifungal therapies have minimal adverse events, topical antifungal agents alone are not recommended for the treatment of tinea capitis because these agents do not penetrate to the root of the hair follicles deep within the dermis. The infection is often contracted from another human or an animal through direct contact. Many clinicians diagnose and treat superficial fungal infections based.
In the united states, tinea capitis most commonly affects children of african heritage between three and nine years of age. Tinea capitis often presents as gray scaly patches accompanied by mild hair loss. The standard drug regi men for the treatment of tinea capitis in the pediatric population is a 6 to 8week course of highdose griseofulvin given once daily. Tinea capitis requires systemic antifungal treatment. Tinea capitis is an infection of scalp hair follicles and the surrounding skin, caused by dermatophyte fungi, usually species in the genera microsporum and trichophyton. Terbinafine, itraconazole, and fluconazole are the preferred agents for tinea capitis. Tinea capitis red book 2015 aap pointofcaresolutions. The predominant pathogen varies by geographical location.
Ringworm of the scalp, a highly contagious infection, is most common in toddlers and schoolage children. Scalp ringworm, or tinea capitis, largely disappeared in great britain after oral griseofulvin was. Gray patch ringworm microsporosis is an ectothrix infection or prepubertal tinea capitis seen here in an african american male child. What are the aap recommendations for children during tinea capitis. Tinea capitis requires systemic treatment because antifungal creams are unable to penetrate the hair shaft sufficiently to clear the infection. May 15, 2017 tinea capitis, gray patch type, white hair patch, poliosis presentation a 7yearold african american boy is being evaluated for his annual well child visit at the outpatient academic general pediatrics clinic of childrens hospital of michigan chm. How to treat gray patch ringworm forlessfilms35s diary. Oral antifungals are needed to effectively treat tinea capitis. Topical topical treatment alone is not recommended for the management of tinea capitis. National athletic trainers association position statement.
Other oral antifungal treatments for tinea capitis also frequently reported in the literature include terbinafine, itraconazole, and fluconazole. Gray patch refers to the scaling with lack of inflammation. This disease is primarily caused by dermatophytes that invade the hair shaft. Grey patch type of tinea capitis with tinea facieii openi. Tinea capitis scalp ringworm etiology, pathophysiology, symptoms, signs. Tinea capitis is a fungal infection of the scalp that most often presents with pruritic, scaling areas of hair loss. What are the aap recommendations for children during tinea capitis scalp ringworm treatment. Tinea capitis, commonly known as ringworm of the scalp, is a fungal infection often seen in children. Recognize the wide variation in presentations of tinea capitis and corporis.
Graypatch ringworm microsporosis is an ectothrix infection or prepubertal tinea capitis seen here in an african american male child. Tinea capitis is a disease caused by superficial fungal infection of the skin of the scalp, eyebrows, and eyelashes, with a propensity for. Tinea capitis, tinea corporis, and pityriasis versicolor are common superficial fungal infections in the pediatric population. Griseofulvin is also effective and may be used in resourcepoor settings where other antifungals are not available. Gray patch tinea capitis also begins as a welldemarcated erythematous, scaling. Add a short course of oral prednisone for a kerion or severe inflammation. Tinea capitis is the most common dermatophyte infection worldwide. Explain why systemic therapy is necessary to eradicate tinea capitis. Confirm tinea capitis by potassium hydroxide wet mount, fungal culture, or sometimes wood light examination.
Apr 16, 2015 gray patch tinea capitis presents as circular patches of alopecia with prominent scaling. Apr 15, 2020 graypatch ringworm microsporosis is an ectothrix infection or prepubertal tinea capitis seen here in an african american male child. Tinea capitis red book 2015 red book online aap point. Scarring with permanent alopecia can occur in the absence of treatment. Tinea corporis and tinea capitis american academy of pediatrics. Its clinical manifestations range from mild scaling with little hair loss to large inflammatory and pustular plaques with extensive alopecia. The effective therapy rate of this treatment is generally high, in the range of 88100%. How are infected hairs collected for diagnosis of tinea. When orally administered, it is active against anthropophilic. Tinea capitis develops when dermatophyte fungal elements invade. Treat with oral terbinafine or griseofulvin in addition to a topical antifungal. Assistant professor of pediatrics, wayne state university, childrens hospital of michigan, detroit, mich after completing this article, readers should be able to.
1050 696 1280 1412 1463 913 778 72 1020 135 825 1323 100 1588 814 586 768 797 1116 1336 1386 198 1461 1448 827 1123 274 11 1272 289 932 844