Tinea Capitis Favus-Like Appearance: Problem of Diagnosis
ABSTRACT: Tinea capitis (TC)
is an infection of scalp, hair follicles, and the surrounding skin, caused by
dermatophyte fungi. Favus, a chronic inflammatory tinea capitis typically seen
in Trichophyton schoenleinii infection. Favus is characterized by ‘scutula’.
Favus may result in cicatricial alopecia. Purpose: To understand the clinical
manifestation and management of tinea capitis. Case: A girl, 8 year-old, 18 kg,
with thick crust located at the center of the head since 3 months, became
spreading overtime. There were itchy sensation, no fever, no pain. There was
history of an itchy red patch on her neck which diminished with topical
antifungal. Dermatological examination revealed multiple thick brown-yellow crust
sharply marginated, there were erosion and alopecia area beneath the crust.
There were no sign of inflammation, no pustule, no enlargement of cervical and
occipital lymphnodes on palpation. Discussion: Wood’s light examination showed no
fluorescence and potassium hydroxide (KOH) showed no spores. Result of fungal
culture was no colony growth. Patient was given griseofulvin 20 mg/kg body
weight/day, wet dressing, and ketoconazole 2% shampoo twice weekly. Good
clinical result shown after 10 weeks. Conclusion: Diagnosis of TC established
based on history taking, clinical findings, Wood’s light examination, KOH
preparation, fungal culture. A negative culture may arise because antifungal
treatment had been used prior to collection of the specimen. Griseofulvin still
became the drug of choice for tinea capitis even there are new generations of
antifungal.
Key words: diagnosis,
favus-like, griseofulvin, tinea capitis
Penulis: Dwi Ratna Adisty,
Linda Astari
Kode Jurnal: jpkedokterandd170518
