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
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