Tinea capitis inflamatoria por Trichophyton violaceum simulando dermatosis pustulosa erosiva

Abstract

Abstract—The differential diagnosis of erosive pustular dermatosis of the scalp and inflammatory tinea capitis may be difficult on clinical grounds. Fungal cultures may be negative in some cases of scalp ringworm infection. This fact, together with the lack of specific diagnostic features for erosive pustular dermatosis, makes sometimes repeated cultures and a trial of griseofulvine convenient to differentiate both conditions.We present a 75-year old woman with a 3-month history of exudative alopecia affecting the scalp, negative fungal cultures, and a non-specific inflammatory infiltrate. We suggested the diagnosis of erosive pustular dermatosis of the scalp. However, repeated cultures yielded the growth of Trichophyton violaceum. The patient was treated with oral griseofulvine, with a dramatic and complete clearing of the pustular changes. Tinea capitis due to T. violaceum is considered to be an uncommon condition in adults from developed areas. Nevertheless, current migratory streams may account for the re-emergence of antropophilic dermatophytes in developed regions.