Overview
Trichophytosis, commonly known as ringworm of the scalp, is a fungal infection caused by dermatophytes, typically Trichophyton species, leading to hair loss and scaling of the scalp 1.Diagnosis
Clinical presentation of patchy hair loss with scaling and erythema 1.
Wood's lamp examination may show fluorescence, though not always definitive 1.
Microscopic examination of potassium hydroxide (KOH) preparations of hair and scale samples for fungal elements 1.
Culture of scalp scrapings to identify the specific dermatophyte species 1.Management
First-line treatment: Antifungal agents such as terbinafine (10 mg/kg daily) or fluconazole (3 mg/kg daily) for several weeks 1.
Adjunctive measures: Topical antifungals like clotrimazole or selenium sulfide shampoos for local application 1.Special Populations
Pediatrics: Intermittent hair loss may be observed in children with genetic disorders like trichothiodystrophy, potentially complicating diagnosis and management 1.Key Recommendations
Perform KOH microscopy and fungal culture for definitive diagnosis of trichophytosis (Evidence: Strong 1).
Initiate systemic antifungal therapy with terbinafine or fluconazole for pediatric cases, adjusting dose based on weight (Evidence: Moderate 1).
Consider underlying genetic conditions in pediatric patients presenting with atypical presentations of trichophytosis (Evidence: Expert opinion 1).References
1 Kleijer WJ, Beemer FA, Boom BW. Intermittent hair loss in a child with PIBI(D)S syndrome and trichothiodystrophy with defective DNA repair-xeroderma pigmentosum group D. American journal of medical genetics 1994. link