Abstract
Tinea capitis (TC) is the most common dermatophyte scalp infection in children and an unusual dermatophytosis in adults. The clinical appearance of tinea capitis is highly variable and depends on the causative organism, type of hair invasion, and degree of the host inflammatory response. The commonly observed features are patchy hair loss with varying degrees of scaling and erythema. The clinical signs may be subtle and diagnosis may be challenging. We report the case of an adult patient with tinea capitis mimicking alopecia areata. The patient was initially diagnosed with alopecia areata and completed one month of treatment without clinical benefits. In view of no clinical signs of tinea capitis, a biopsy was performed. A scalp punch biopsy revealed an endothrix dermatophytosis. The patient’s medication was switched to 250 mg terbinafine daily for 8 weeks and 2% ketoconazole shampoo. The patient completed two months of therapy with maintenance of hair regrowth and resolution of symptoms and scales.
Highlights
Tinea capitis is a common scalp condition seen primarily in the pediatric population
We describe a case of endothrix tinea capitis mimicking alopecia areata
The patient was initially diagnosed with alopecia areata and completed one month of treatment with clobetasol cream, zinc capsule, and intramuscular triamcinolone without clinical benefits
Summary
Tinea capitis is a common scalp condition seen primarily in the pediatric population. It has been observed in postpubertal individuals, but is far less common, and can present bizarrely, often leading to misdiagnosis [1]. We describe a case of endothrix tinea capitis mimicking alopecia areata. The patient was initially diagnosed with alopecia areata and completed one month of treatment with clobetasol cream, zinc capsule, and intramuscular triamcinolone without clinical benefits. The patient’s medication was switched to 250 mg terbinafine daily for 8 weeks and 2% ketoconazole shampoo She completed two months of therapy with maintenance of hair regrowth and resolution of symptoms and scales She completed two months of therapy with maintenance of hair regrowth and resolution of symptoms and scales (Figs. 4 and 5)
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