Superficial fungal infection of the skin : Dermatophytes and Tinea Capitis

Superficial fungal infection of the skin : Dermatophytes and Tinea Capitis

Superficial fungal infections of the skin are one of the most common dermatologic conditions seen in clinical practice. Therefore, recognition is important for primary care physicians.

However, making the correct diagnosis can be difficult, because these infections can have an atypical presentation or be confused with similar-appearing conditions.

Superficial fungal infections can be divided into three broad categories: dermatophytic infections, Pityriasis versicolor and cutaneous candidiasis.

Dermatophytes

Specifically Trichophyton, Epidermophyton and Microsporum species, are responsible for most superficial fungal infections. The term "Tinea" refers exclusively to dermatophyte infections.
Dividing infections into the body region most often affected can help in identification of the problem.
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Tinea Capitis

Tinea capitis is a dermatophytic infection of the head and scalp, usually found in infants, children, and young adolescents. Most infections occur in preschool-aged children. Around puberty, sebum production by sebaceous glands becomes active, and as a result, it tends to disappear.

Commonest presentation is scaly patches on the scalp with variable degree of hair loss and generalized scaling that resembles seborrhic dermatitis may occur on the scalp. Cervical lymphadenopathy can occur when there is secondary bacterial infection.

Keroin is a form of Tinea capitis with accentuated inflammatory response. It is boggy, nodular tender mass which may form pus. An unusual scaling reaction known as favus may give the scalp a waxy or doughy appearance with thick crusted areas.

Differential diagnosis (DDx)

Differential diagnosis of Tinea capitis includes seborrheic dermatitis, dandruff, scalp psoriasis, atopic dermatitis, scalp impetigo, and alopecia areata The finding of large areas of alopecia that have early pustule formation favors a diagnosis of Tinea capitis over alopecia areata.

Investigation

KOH preparation and looking for the fungal elements from skin scraping, nail or hair.

Treatment

Tinea capitis should be treated with systemic therapy. Griseofulvin in a dose of 10-20 mg per kg for six weeks to 8weeks is the first-line treatment of Tinea capitis. Ketoconazole 2-4mg per kg for ten days, itraconazole and terbinafine (Lamisil) are good alternatives.

Griseofulvin should be taken after fatty meal. Topical treatment can be added to decrease the transmission and accelerate resolution.

Whitefield ointment is preferred in the absence of secondary bacterial infection. Other family members should also be examined and treated.

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Superficial fungal infection of the skin : Dermatophytes and Tinea Capitis 2018-12-23T07:31:00-08:00 Rating: 4.5 Diposkan Oleh: David Maharoni