Tinea capitis (Video 5:03 minutes)

When it comes to tinea capitis, there’s a downside to loving your pet. Dermatologist Ted Rosen takes you through the differential and details effective diagnostic strategies.

A brief summary of the topics Dr Rosen addresses in this podcast:

Variable presentations of tinea
Hair loss with broken off hairs close to scalp
Inflammatory tinea (fungus usually from an animal or from the dirt)

Fast facts about tinea
3% -14% of all children grades K-8 are affected with tinea capitis
Trichophyton tonsurans is the most common fungus
Microsporum canis if pet is present in the home
Trichophyton violaceum is possible
African Americans affected more often than whites
Family members are often the vector
Think fomites!

Diagnosis
• KOH of plucked hairs
• Woods pamp for M canis
• Culture: swab, toothbrush, pluck

Therapy
• Terbinafine (best for most common fungus)
• Griseofulvin (best alternative)

Pearls and pitfalls
• Ask about scaling or fur loss in cats and dogs in the house
• ID reaction
• Kerions (often negative cultures)
• Fluconazole when therapy fails

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