tinea%20capitis
TINEA CAPITIS
Tinea capitis  is a contagious dermatophytosis affecting the hair shaft and follicles of the scalp, eyebrows and eyelashes.
It is most common in the crowded areas as infection originates from contact with a pet or an infected person and asymptomatic carriage persists indefinitely.
It primarily affects children 3-7 years of age.
The causative agents are the genus Trichophyton and Microsporum.
Cardinal clinical feature is the combination of inflammation with hair breakage and loss.

Introduction

  • Infection of the scalp & hair follicles including surrounding skin caused by contagious dermatophytosis
  • Most common in crowded areas as infection originates from contact w/ a pet or an infected person, & asymptomatic carriage persists indefinitely
  • Primarily affects children
    • Also occurs in adults, women more commonly afflicted than men

Signs and Symptoms

  • Patients usually present w/ patches of hair loss on the scalp w/ accompanying scaling &/or black dots within the hair follicle orifice 
  • Patients present w/ any of several different clinical patterns of Tinea capitis infection
  • Cervical or occipital lymphadenopathy is typically present

Patterns of Clinical Infection

  • Host T-lymphocyte response determines clinical infection patterns

Seborrheic Dermatitis Type

  • Diffuse or patchy, fine, white, adherent scales on the scalp resembling dandruff
  • There are tiny perifollicular pustules &/or hair stubs (hair shafts breaking above the scalp surface) from the scalp

Black Dot Pattern

  • Patient has areas of noninflammatory hair loss that are well demarcated; hairs are broken off at the follicular orifice & debris left in the opening appears as a black dot
  • Color of “dot” will depend on hair color; bald spots may be a few to several centimeters in diameter

Grey Patch Pattern

  • Patient has circular patches w/ hair loss & fine scaling w/c is dull grey in color
  • Greying is caused by the spores covering the affected hair

Inflammatory Forms/Kerion

  • Intense inflammation manifests as single or multiple, boggy, tender areas of alopecia w/ pustules on &/or in surrounding skin
  • Hypersensitivity to fungus may form a boggy, indurated, tumorlike mass that exudes pus & referred to as kerion, which may lead to a scarring hair loss

Diffuse Pustular Type

  • Discrete pustules or scabbed areas without scaling or significant hair loss
  • Pustules result from superimposed bacterial infection

Favus

  • An inflammatory variant characterized by yellow cup-shaped crusted lesions called scutula
  • Commonly seen in the Middle East & North Africa, caused by T. schoenleinii
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Jairia Dela Cruz, 30 Aug 2019
Infection with hepatitis B virus (HBV) does not appear to independently affect pregnancy outcomes, although it contributes to prolonged infertility, higher odds of secondary infertility, ovulatory disorders and reduced implantation rate, a study has found.
Dr. Joseph Delano Fule Robles, 23 Jan 2019

Scientists from the Department of Microbiology, University of Hong Kong (HKU) recently discovered a compound with broad antiviral activity against viruses causing Middle East Respiratory Syndrome (MERS), avian flu (H7N9), severe acute respiratory syndrome (SARS) and Zika fever.

Pank Jit Sin, 27 Jun 2019

How does it feel to be told one has contracted HIV? How equipped are doctors when breaking the news to a patient that he or she has been diagnosed with HIV? Are we able to provide people living with HIV (PLHIV) the counselling and skills required to take them through this difficult period of life? MIMS Doctor speaks to Dr Julian Hong, a general physician practicing in Singapore, about the challenges faced by both patients and doctors when faced with the difficult topic of HIV.