Ringworm of the scalp tinea capitis is a fungal infection of the scalp and hair shafts. Ringworm of the scalp is particularly common in young children. Tinea capitis is the medical term for ringworm, a very common fungal infection, of the scalp. Tinea capitis is suspected if there is a combination of scale and bald patches. Gray patch refers to the scaling with lack of inflammation, as noted in this patient. Graypatch ringworm microsporosis is an ectothrix infection or prepubertal tinea capitis seen here in an african american male child. Trichoscopy as a diagnostic tool for tinea capitis. Twenty years ago, the most widespread etiologic agent was reported to be trichophyton violaceum, which was later succeeded by microsporum ferrugineum and trichophyton schoenleinii. Treatment includes antifungal drugs taken by mouth for all people and, for children, antifungal cream. Tinea capitis has the potential to cause significant problems. Ringworm is contagious and can be spread from person to person. Tinea capitis remains a common childhood infection in many parts of the. Apr 29, 2020 gray patch ringworm microsporosis is an ectothrix infection or prepubertal tinea capitis seen here in an african american male child. The fungus causes a rash to appear on the scalp that most often is circular and expands over time.
Treatment for ringworm of the scalp includes medications taken by mouth to kill the fungi, as well as medicated shampoos that may lessen the spread of infection. Tinea capitis, commonly known as ringworm of the scalp, is a fungal infection often seen in children. Tinea capitis caused by trichophyton rubrum we present a. Tinea capitis in general is much more prevalent in prepubescent children with spontaneous remissions that can occur at puberty, as surface lipids in the. Mar 08, 2003 tinea capitis requires systemic treatment because antifungal creams are unable to penetrate the hair shaft sufficiently to clear the infection. The classical presentations of scalp ringworm, however, are black dotin which hair shafts break at the scalp surfaceand gray patchin which hair shafts break above the surface, leaving short stubs. If a patient believes theyor their children may have tinea capitis, its a good idea to have any pets or farm animals. A study on tinea capitis in the pre school and school going children. Tinea capitis dallas fungal infection of the scalp plano, tx. Fungal folliculitis in children, caused by microsporum canis and m audouinii, which progresses from an erythematous papule at the hair follicles, extends peripherally. Doctors base the diagnosis on an examination of the scalp and samples taken from the scalp. Slightly erythematous, scaly scalp lesion page 2 of 2. Gray patch tinea capitis is rare in north america, as is tinea favus, which.
Fungal infections tinea, pityriasis causes, symptoms. The signs and symptoms of ringworm of the scalp may vary, but it usually appears as itchy, scaly, bald patches on the head. Tinea capitis causes hair loss, scaling, erythema, and impetigolike lesions. Gray patch refers to the scaling with lack of inflammation. Tinea corporis, tinea pedis, tinea cruris, tinea faciei, and tinea manuum infections are typically superficial, involving only the epidermis. When the fungus infects the scalp, it is called tinea capitis. All these cases were fluorescent under woods uv light and positive in cultures for m.
Scalp ringworm tinea capitis merck manuals consumer version. Tinea capitis is caused by species of either trichophyton or microsporum, with the most common etiologic agent varying geographically. Tinea corporis is also known with various other names, like ringworm 1, tinea circinata 2 or tinea glabrosa 1. Tinea capitis must be treated with systemic antifungal agents, since topicals cannot penetrate the hair shaft. Outbreak of tinea capitis and corporis in a primary school in. Gray patch ringworm microsporosis is an ectothrix infection or prepubertal tinea capitis seen here in an african american male child. This disease is a contagious infection with worldwide distribution and is occasionally associated with permanent alopecia. Most cases are caused by a fungus called tinea tonsurans. Microsporum audouinii an overview sciencedirect topics. Tinea capitis caused by species of microsporum and trichophyton is a contagious disease that is endemic in many countries. Tinea capitis must be treated with systemic antifungal agents because topical agents do not penetrate the hair shaft. Tinea capitis gray patch tinea capitis gray patch the lesion is a small, round, elevated patches, hyperkeratotic, scaling of the scalp, and dry and brittle hair. It occurs almost exclusively in children and some forms can be nearly epidemic. The rash is usually reddish or gray, and can include scaly patches of skin.
The organism microsporum, which was the most common fungus in the united states in the 1940s and 1950s but now is a rare cause of ringworm of the scalp, causes gray patch ringworm. Occasionally, dermatophyte infections penetrate the hair follicle and dermis causing a condition called majocchis granuloma. Tinea capitis can be classified by its clinical appearance into four specific presentations. The three clinical types of tinea capitis have been described. Tinea capitis scalp ringworm dermatologic disorders. Pdf outbreak of tinea capitis and corporis in a primary. Tinea capitis red book 2015 aap pointofcaresolutions. The classical treatment for tinea corporis includes the use of topical antifungals in the milder cases and oral medications in the. Symptoms of tinea capitis include a dry patch of scale, a patch of hair loss, or both on the scalp. All 27 children reported a contact with infected classmates, and 19 70% reported to have infected brothers and sisters at home. Hair within the patch area is brittle and easily breaks off near the scalp or pulls out. Tinea capitis is a dermatophytosis that mainly affects children, is contagious, and. Tinea capitis is a fungal infection of the scalp and hair that can arise from different genera of dermatophytes, e. The assessment and management of tinea capitis in children.
Tinea capitis scalp ringworm dermatologic disorders msd. Tinea capitis is the most common superficial mycosis in children. The most common was scaly, pruritic, single or multiple gray patchy figure 1a hair loss seen in 111 66. Dec 05, 2017 some causes of endothrix infection are tschoenleinii species gray patch ringworm microsporosis is an ectothrix or prepubertal tinea capitis seen here in african american male child. Scalp ringworm tinea capitis is a very common scalp infection among children throughout the world. It appears as bald patches with multiple black dots. The treatment of this infection usually requires the administration of appropriate oral antifungal agents. Scalp ringworm tinea capitis is a common mild infection of the scalp and hair that appears as scaly spots and patches of broken hair on the head. The most common type of tinea capitis in the united states, found most often in children. Tinea capitis is most common in people who are immunocompromised and children, particularly those under the age of 10. Classic presentation strongly suggests tinea capitis. Caused by a fungus, it is most commonly seen in children.
Affecting primarily pre pubertal children between 6 and 10 years, it is more common in males than females. Scalp ringworm tinea capitis skin disorders msd manual. Tinea capitis may cause a dry scaly rash that may be somewhat itchy, a patch of hair loss, or both. Those children receiving treatment should be allowed to return to. Occasionally, the lesion becomes boggy, waxy, purulent, and extremely tender and is associated with lymphadenopathy kerion. Feb 02, 2014 tinea capitis can occur in three distinctly different forms. One type of fungus causes black dot ringworm, in which hair shafts break at the scalp surface. Tinea capitis is a common dermatophyte infection of the scalp of children in western china, with the graypatch from being the most prevalent. Other clinical patterns of tinea capitis in children are also commonly.
It is the most common dermatophyte infection found in children under the age of 12, especially in african americans. Tinea capitis was the final diagnosis in 50 out of 80 children who had hyperkeratosis without alopecia 60%, 16 of 43 children with alopecia alone 37. Gray patch tinea capitis gptc it begins with an erythematous, scaling, welldemarcated patch on the scalp that spreads centrifugally for a few weeks or months, ceases to spread, and persists indefinitely, sometimes for years round grayish, scaly. Feb 21, 2020 gray patch ringworm microsporosis is an ectothrix infection or prepubertal tinea capitis seen here in an african american male child. Tinea capitis scalp ringworm etiology, pathophysiology, symptoms, signs. Symptoms and signs of ringworm on scalp tinea capitis. This form presents with minimal erythema and scale. Hairs in the involved areas assume a characteristic dull, grayish, discolored appearance. Tinea capitis can occur in three distinctly different forms. It can show up in a number of ways, but often as scaly patches of hair loss on the head. It is one of the most common skin problems seen in children. Tinea capitis causes the gradual appearance of round patches of dry scale, alopecia, or both.
The concept of carriers is controversial but describes patients whose symptoms and clinical. Despite the name, there are no worms involved in scalp ringworm, rather the rash forms a scaly, round patch that sometimes clears or improves in the middle, thus looking like a ring. Identifying and treating superficial fungal infections in. Another type of fungus causes gray patch ringworm, in which hair shafts break above the surface, leaving short stubs. Ringworm, scalp tinea capitis condition, treatments, and. Ringworm is a superficial fungal infection of the skin. Tinea capitis is the name used for infection of the scalp with a dermatophyte fungus. Fungi are microorganisms that can survive on dead tissue. Because spread is thought to occur through direct contact with. Apr 16, 2015 gray patch tinea capitis presents as circular patches of alopecia with prominent scaling.
When it affects the scalp, it is medically known as tinea capitis. Today, it is much less common in north and central america but continues to be the dominant cause of scalp ringworm in southern and eastern europe. Hence most cases of tinea capitis do not fluoresce. Acceptable treatments for tinea capitis, with shorter treatment. Twentyfive 93% of the 27 children with tinea capitis presented a gray patch as the main clinical feature. Some causes of endothrix infection are tschoenleinii species gray patch ringworm microsporosis is an ectothrix or prepubertal tinea capitis seen here in african american male child. Tinea capitis and tinea barbae are characterized by infection of terminal hairs. The fungus attacks hair shafts and follicles, making the hair in the area affected fragile and broken, leaving small areas of baldness alopecia. Sebum, the skin oil stimulated by teenage hormones, has a negative impact on the ability of fungi to penetrate the hair shaft, thus preventing tinea capitis infection in teenagers and adults. A clinicoepidemiological study of scalp hair loss in. Tinea capitis is the most frequent manifestation of dermatophyte infection in children, especially in the lower socioeconomic strata. Gray patch tinea capitis painless patchy alopecia but bald patches are covered with fine graywhite scales with broken hair shafts kerion extremely painful and inflammatory presentation, the kerion looks like a large bump on the scalp with alopecia, may be boggy and purulent when pressed with pus coming out of the hair follicles may.
Ringworm of the scalp, a highly contagious infection, is most common in toddlers and schoolage children. Tinea capitis less commonly manifests as diffuse scaling, like dandruff, or in a. Although common in children, tinea capitis is less frequently seen in adults. Tinea capitis caused by trichophyton rubrum occurs in less than 1 percent of all cases8,9. Doctors notes on ringworm on scalp pictures, symptoms, home remedies, treatment, and cure. Ringworm on the scalp can also cause what is sometimes called black dota patch of hair loss with black dots on the scalp caused by hairs that are broken off just below the surface of the skin. Tinea capitis requires systemic treatment because antifungal creams are unable to penetrate the hair shaft sufficiently to clear the infection. An imidazole or ciclopirox cream can be applied to the scalp to prevent spread, especially to other children, until tinea capitis is cured. Trichophytan usa, microsporum europe age most affected by tinea capitis. Changes in frequency of agents of tinea capitis in school. Clinicomycological profile of tinea capitis and its.
Fungal organisms known as dermatophytes superficially. How is ectothrix infection in tinea capitis scalp ringworm. It is not caused by a worm, but by a fungus and is named for the ringlike or circular appearance of the infection on the skin. Outbreak of tinea capitis and corporis in a primary school. Posterior cervical lymphadenopathy absent in alopecia hubbard 1999 arch pediatr adolesc med 153 11. Dec 18, 2018 when the fungus infects the scalp, it is called tinea capitis. Diagnosis and management of tinea infections american family. Scalp ringworm may be passed among humans by direct contact with infected people or with contaminated objects such as combs, pillows, and.