Morse code‐like hairs in tinea capitis disappear after successful treatment

Souissi, A.; Lagha, Imene Ben; Toukabri, Nourchène; Mama, M.; Mokni, M.

doi:10.1111/ijd.14224

Cited by 13 publications

(10 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 In contrast to the previous study, short broken hair, erythema, telangiectasia, and hemorrhage disappeared at 6 weeks (Table 4). [3][4][5][6][7][8][9] Certain features like black dot and short broken hair showed constant declining trend and persisted in few cases, because of slower clinical cure response (relatively resistant to treatment) and may require longer treatment or could be indicative of the transition of other dystrophic hair to these hair morphologies. Previous trichoscopic study pertaining to tinea capitis did not include CASS evaluation and no attempts to quantify the trichoscopic features (as in our study by TAHC) were made.…”

Section: Discussionmentioning

confidence: 99%

Trichoscopy as a monitoring tool in assessing treatment response in 98 children with tinea capitis: A prospective clinical study

Kumar

Pandhi

Bhattacharya

et al. 2021

Dermatologic Therapy

View full text Add to dashboard Cite

Tinea capitis (TC) is the most common dermatophyte infection in children. Fungal culture the gold standard diagnostic method takes several weeks and has poor yields.Trichoscopy helps in rapid diagnosis and could work as a monitoring tool during antifungal therapy. Our main objective is to document the evolution of trichoscopic features with treatment and their correlation with clinical parameters in patients of TC. Forty-six and 52 children with clinically diagnosed TC that was confirmed by potassium hydroxide microscopy, received griseofulvin and terbinafine, respectively. Recruited children were subjected to clinical and trichoscopic assessment by calculation of CASS (clinical assessment severity score) and counting of TAHC (Total Altered hair count; negative and positive), respectively, at baseline and follow-up at 2, 4, and 6 weeks. McNemar, Wilcoxon singed ranked test and Spearman-rho correlation of various parameters was evaluated. Follow-up trichoscopy revealed significant (p < 0.009) disappearance of negative TAHC like black dot (second week onward), corkscrew, horseshoe and zigzag hair at 4 weeks and short broken hair, erythema telangiectasia hemorrhage (ETH) resolved at 6 weeks. Positive TAHC (regrowing hair)shows significant increase at 6 weeks (p < 0.001). CASS and negative TAHC showed significant difference at 4 weeks (p < 0.001) by analyzing boxplot graph. Therefore, trichoscopic resolution occurred before the clinical cure. Terbinafine subjects showed a higher clinical cure rate at 4 weeks (p = 0.02) as compared to griseofulvin. To conclude, trichoscopy is a good monitoring tool that could document the disappearance of almost all dystrophic hair at 4 to 6 weeks and is a more sensitive tool than microscopic examination. Regrowing hair and perifollicular scaling are markers of recovery.

show abstract

Section: Discussionmentioning

confidence: 99%

Trichoscopy as a monitoring tool in assessing treatment response in 98 children with tinea capitis: A prospective clinical study

Kumar

Pandhi

Bhattacharya

et al. 2021

Dermatologic Therapy

View full text Add to dashboard Cite

show abstract

“…The role of trichoscopy in monitoring tinea capitis therapy has also been described in the literature [19,33,36]. The trichoscopic marker of treatment efficacy is the disappearance of dystrophic hairs (comma hairs, corkscrew hairs, zigzag hairs, Morse code-like hairs, broken hairs and black dots), 4-12 weeks after therapy initiation [19,33,36].…”

Section: Discussionmentioning

confidence: 99%

“…Morse code-like hairs are formed due to the accumulation of spores around the hair shaft that cause a transverse perforation of the hair shaft. They were only described in patients with ectothrix-type fungal infection with an incidence rate between 12% and 56% (mean value: 22%) [9,22,[36][37][38][39][40].…”

Section: Morse Code-like Hairsmentioning

confidence: 99%

See 1 more Smart Citation

Trichoscopy of Tinea Capitis: A Systematic Review

Waśkiel‐Burnat

Rakowska

Sikora

et al. 2020

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

Introduction: An increased incidence of tinea capitis has been observed over the last few decades. Trichoscopy is a non-invasive, in-office method helpful in establishing the correct diagnosis in patients with hair loss and inflammatory hair disorders. The objective was to review and analyze current data on the trichoscopy of tinea capitis. Methods: A systematic review of the literature was conducted using the PubMed, EBSCO and Scopus databases. The search terms included 'tinea capitis' combined with 'trichoscopy', 'dermatoscopy', 'dermoscopy', 'videodermatoscopy' or 'videodermoscopy'. Results: Of 326 articles, 37 were considered eligible for the quantitative analysis. The most characteristic (with a high predictive value) trichoscopic findings of tinea capitis included comma hairs (51%), corkscrew hairs (32%), Morse code-like hairs (22%), zigzag hairs (21%), bent hairs (27%), block hairs (10%) and i-hairs (10%). Other common, but not characteristic, trichoscopic features were broken hairs (57%), black dots (34%), perifollicular scaling (59%) and diffuse scaling (89%). Morse code-like hairs, zigzag hairs, bent hairs and diffuse scaling were only observed in Microsporum tinea capitis (8/ 29, 28%; 6/29, 21%; 4/29, 14% and 4/29, 14%, respectively). In Trichophyton tinea capitis, corkscrew hairs were more commonly detected compared to Microsporum tinea capitis (21/38, 55% vs 3/29, 10%). Conclusion: The presence of characteristic trichoscopic features of tinea capitis is sufficient to establish the initial diagnosis and introduce treatment before culture results are available. Trichoscopy may be useful in distinguishing between Microsporum and Trichophyton tinea capitis.

show abstract

“…Common dermoscopic findings may involve broken hairs, scales, black dots, perifollicular erythema, comma hairs, empty follicles and pustules [ 11 ]. In ectothrix infection caused by M.canis , Morse code-like hairs (AKA barcode-like hairs) [ 19 , 20 ] and white sheaths [ 21 , 22 ] are typical characteristics under the dermoscope. For a definitive diagnosis, mycological examinations are very important.…”

Section: Discussionmentioning

confidence: 99%

Tinea Capitis by Microsporum canis in an Elderly Female with Extensive Dermatophyte Infection

et al. 2021

View full text Add to dashboard Cite

Tinea capitis is a type of dermatophyte infection primarily affecting children. We report a case of an elderly woman with well-controlled diabetes mellitus presenting with a six-month history of erythema with yellow crusts on her scalp and extensive erythematous patches with scales on the body skin. She adopted a stray cat before the disease onset. Dermoscopic findings and manifestation under the Wood’s lamp favoured the diagnosis of tinea capitis. Further microscopic examinations of her scalp, including direct KOH and fluorescence stain examination, fungal culture and polymerase chain reaction sequencing identification confirmed the diagnosis of tinea capitis caused by Microsporum canis. Treatment with oral terbinafine was effective. Adult tinea capitis is often misdiagnosed due to its rarity and atypical presentation. However, in some regions, the incidence of tinea capitis in immunocompetent adults is rising which requires the awareness of clinicians. A thorough history (including the animal contacting history), physical examination and further mycological examinations are required for diagnosis. Trichophyton violaceum is the most common dermatophyte species in most regions while adult tinea capitis caused by Microsporum canis is less common. Terbinafine, griseofulvin and itroconazole have been reported to be effective drugs for the treatment of tinea capitis, and terbinafine can be considered as systemic treatment in elderly patients with comorbidities to reduce the drug–drug interaction.

show abstract

Morse code‐like hairs in tinea capitis disappear after successful treatment

Cited by 13 publications

References 10 publications

Trichoscopy as a monitoring tool in assessing treatment response in 98 children with tinea capitis: A prospective clinical study

Trichoscopy as a monitoring tool in assessing treatment response in 98 children with tinea capitis: A prospective clinical study

Trichoscopy of Tinea Capitis: A Systematic Review

Tinea Capitis by Microsporum canis in an Elderly Female with Extensive Dermatophyte Infection

Contact Info

Product

Resources

About