Tinea capitis mimicking dissecting cellulitis of the scalp: a histopathologic pitfall when evaluating alopecia in the post‐pubertal patient

Miletta, Nathanial R; Schwartz, Carmen; Sperling, Leonard C.

doi:10.1111/cup.12270

Cited by 13 publications

(17 citation statements)

References 16 publications

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“…Unlike tinea capitis, dissecting cellulitis usually occurs in African American adults as a deep lesion. It is important to perform cultures and swabs to confirm fungal infections in cases of atypical presentation …”

Section: Differential Diagnosismentioning

confidence: 99%

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The kerion: an angry tinea capitis

2016

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Tinea capitis has a high incidence with a global changing pathogen distribution, making this condition a public health concern around the world. As the infection is initially asymptomatic, it is easily spread. Moreover, it is present in many fomites, including hairbrushes, pillows, and bedding. Prompt recognition and treatment is necessary for kerion, an inflammatory subtype characterized by tender boggy plaques with purulent drainage. Kerion is usually associated with infection by zoophilic dermatophytes, although other sources have been described. Treatment for this severe form of dermatophytic infection can be challenging. In addition to the use of topical treatments, oral administration of griseofulvin, terbinafine, itraconazole, or fluconazole is often required. Griseofulvin, the first-line treatment, may not completely eradicate pathogen colonization of the host and may contribute to reinfection and prevalence of infective but asymptomatic carriers. This review highlights new agents that are being evaluated for the treatment of kerion and typical tinea capitis, enhanced diagnostic criteria, and a grading system for kerion evaluation.

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Section: Differential Diagnosismentioning

confidence: 99%

“…It is important to perform cultures and swabs to confirm fungal infections in cases of atypical presentation. 30…”

Section: Differential Diagnosismentioning

confidence: 99%

The kerion: an angry tinea capitis

2016

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“…erinacei causes well-circumscribed, severe suppurative inflammation with follicular pustules known as kerion (Arenas et al 2006;Menelaos 2006;Nenoff et al 2014;Sidwell et al 2014). Kerion also resembles a suppurative, moist and painful boggy lesion as the result of advanced disease caused by the dermatophyte organism (Miletta et al 2014). In dogs, a retrospective study of T. mentagrophytes infection has been reported.…”

Section: Discussionmentioning

confidence: 99%

Dermatophytosis caused by Trichophyton mentagrophytes var. erinacei in a dog: a case report

Kurtdede¹,

Haydardedeoğlu²,

Alihosseini³

et al. 2014

Vet. Med. - Czech

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Trichophyton mentagrophytes var. erinacei is rarely isolated from dogs with dermatophytosis. It is a zoophilic dermatophyte transmitted by hedgehogs and, in contrast to other dermatophyte species, is characterised by a severe suppurative and inflammatory response known as kerion. A 5-year-old male mongrel dog was referred to the Veterinary Teaching Hospital with a 2-week history of a localised pruritic and suppurative alopecic lesion on the scrotum. Routine blood tests, peripheral blood smears, multiple skin scrapings and bacteriological culture did not reveal any abnormalities. However, Trichophyton mentagrophytes var. erinacei was isolated from a fungal culture. The presence of hedgehogs around the daily walking areas of the dog suggested the possibility of direct or indirect contact of the dog with hedgehogs. Fungicidal treatment was implemented with oral itraconazole (5 mg/kg once daily) and topical application of clotrimazole (twice daily) for a month. The scrotal lesion healed completely and hair grew back within a month. No recurrence occurred during a 4 month follow-up. T. mentagrophytes var. erinacei should be included in the differential diagnosis of suppurative scrotal skin lesions of dogs, which have come into possible contact with hedgehogs.

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“…Noninflammatory presentations include scaly alopecic patches, alopecic patches with black dots, and a seborrheic variant with diffuse scaling and subtle hair loss. A hypersensitivity reaction to the dermatophyte infection causes inflammatory subtypes of tinea capitis such as kerion and favus . Kerion presents as an inflammatory plaque with crusting, pustules, and drainage, whereas favus presents with thick yellow crusts .…”

Section: Introductionmentioning

confidence: 99%

Tinea capitis mimicking dissecting cellulitis in three children

Shastry

Ciliberto

Davis

2017

Pediatric Dermatology

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Tinea capitis mimicking dissecting cellulitis is a rare presentation, and there is a paucity of information regarding this presentation in the literature. Three children 10-14 years of age who presented with an unusual clinical manifestation of tinea capitis that clinically resembled dissecting cellulitis are reported. The patients were treated with systemic antifungals for 3-4 months. Treatment success was measured according to repeat fungal cultures and clinical assessment of hair regrowth at follow-up visits. All three patients had resolution of infection, with negative repeat fungal cultures and complete hair regrowth without scarring. These cases highlight a rare inflammatory subtype of tinea capitis that can be easily misdiagnosed and therefore improperly treated, prolonging the duration of infection.

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Tinea capitis mimicking dissecting cellulitis of the scalp: a histopathologic pitfall when evaluating alopecia in the post‐pubertal patient

Cited by 13 publications

References 16 publications

The kerion: an angry tinea capitis

The kerion: an angry tinea capitis

Dermatophytosis caused by Trichophyton mentagrophytes var. erinacei in a dog: a case report

Tinea capitis mimicking dissecting cellulitis in three children

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