Page 28 - LECTURE NOTES

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.

3.7.3. Tinea corporis

Tinea corporis is dermatophytosis of the glabrous skin of the trunk and extremities.

Lesions are round, scaly patches that have a well defined, enlarging border and a

relatively clear central portion. The active edge often contains follicular papules.
Itching is variable and not diagnostic

Tinea corporis can assume a giant size (Tinea incognito) when steroids are applied for

cosmetic reasons or as a result of miss diagnosis.

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