Tinea Types: Common Dermatophyte Infections Case 8 Tinea Capitis

February 1, 2004
Joe Monroe, PA-C
Joe Monroe, PA-C

The parents of a 3-year-old girl sought evaluation of their daughter’s hair loss.During the past several months, a large patch of alopecia with scaling had developed.The differential diagnosis included seborrhea, trichotillomania, andtinea capitis.

The parents of a 3-year-old girl sought evaluation of their daughter's hair loss.During the past several months, a large patch of alopecia with scaling had developed.The differential diagnosis included seborrhea, trichotillomania, andtinea capitis.In seborrhea, scaling typically occurs throughout the scalp without thepatches of alopecia seen in this patient. Broken-off hairs--a key to trichotillomania--were absent here. A potassium hydroxide preparation of scrapingsthat contained hairs from the affected area were positive for the "endothrix"phenomenon--the finding of fungal elements inside the hair shaft. Palpable,tender suboccipital lymph nodes were also detected. Both of these findings arecommon in tinea capitis and essentially confirm the diagnosis.Treatment with oral griseofulvin suspension and econazole cream for 6weeks was successful. The child's hair grew back.