RT Book, Section
A1 Usatine, Richard P.
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114875378
T1 Fungal Overview
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114875378
RD 2024/04/25
AB An  otherwise  healthy  7-year-old  boy  is  seen  in  a  homeless  shelter  with  a  2-month  history  of  patchy  hair  loss  (Figure  120-1).  Various  anti-dandruff  shampoos  had  not  helped.  On  physical  exam,  there  are  moderate  areas  of  patchy  alopecia  with  significant  scaling  of  the  scalp.  Posterior  cervical  adenopathy  could  be  seen  and  palpated  on  the  left  side.  There  was  no  fluorescence  with  a  Wood’s  lamp  indicating  that  this  fungal  infection  was  most  likely  Trichophyton  tonsurans.  The  pediatrician  easily  identified  this  as  tinea  capitis  but  decided  to  confirm  the  diagnosis  with  a  KOH  preparation.  Some  of  the  scale  was  scraped  from  the  scalp  using  two  microscope  slides  (one  to  scrape  and  another  to  catch  the  scale).  KOH  was  added  and  a  coverslip  placed.  Branching  hyphae  were  seen  under  the  microscope.  The  child  was  treated  with  oral  griseofulvin  at  20  mg  per  kilogram  per  day.  At  the  4-week  follow-up  there  was  significant  improvement,  no  reported  side  effects  of  the  griseofulvin,  and  the  treatment  was  continued  for  an  additional  4  weeks.