A boy with multiple patches of alopecia and an affected cat.

Abstract

A 7-year-old boy presented with itching, scaling, and areas of hair loss in the left parietal area on the scalp of 6 weeks duration (Figures 1 and 2). His past health was unremarkable. Family members were not affected. Physical examination revealed patches of fine scaling, patchy hair loss with broken hair shafts, and a black dot appearance in the left parietal area. The hair in the affected area was of irregular length. The hair-pull test was negative. [The test is conducted at more than three locations on the scalp and is used for monitoring alopecia areata, acute cases of telogen effluvium, anagen effluvium, and loose anagen syndrome. The results are considered positive if more than 10% of hairs in a pulled bundle are removed]. There was no cervical, occipital, or postauricular lymphadenopathy. The rest of the physical examination was unremarkable. A clinical diagnosis of noninflammatory tinea capitis was made based on the history of an affected cat at home and findings of multiple patches of alopecia with fine, white, adherent scaling of the scalp. The diagnosis was confirmed by potassium hydroxide wet-mount examination of scalp scrapings of the active border of an alopecic lesion, which showed septate hyphae and fungal spores. Culture of scalp wounds yielded Microsporum canis.