BLACK DOT TINEA CAPITIS IN A MAN

Abstract

A 52‐year‐old healthy man presented with scalp alopecia, which had progressed over a period of several weeks. The patient stated that he was unemployed and lived at home alone without pets. He recalled that a neighbor who routine‐ly cut his hair in her home also cut the hair of many local children, some of whom had recently had scalp ringworm.Physical examination revealed a patchy noncicatricial alopecia with numerous short hair stubs (i.e., black dots) in the frontal, parietal, and temporal areas of the scalp (Fig. 1). There was minimal scaling, but no pustulation, kerion forma‐tion, or adenopathy. Glabrous skin and nails were normal. Potassium hydroxide (KOH) preparation of a black dot hair showed multiple arthroconidia within the hair shaft, typical of endothrix hair invasion. Fungal culture on Sabouraud's media later revealed growth consistent with Trichophyton tonsurans. In addition, a culture mount showed abundant microconidia of variable size and shape with occasional macroconidia and chlamydospores, characteristic of T. ton‐surans (Figs. 2 and 3).The patient was subsequently treated with 500 mg of griseofulvin par day for 2 months. At the completion of therapy, there was healthy regrowth of hair.