Diagnosis and Treatment ofTinea Capitis

By:

Aimie Farhanah Binti Zakaria – C111 11 834

Siti Fatimah Binti Othman – C111 11 881

Ahmad Yani Sukarso – C111 11 152

Advisor:

dr. Rani

Supervisor:

dr. Asnawi Madjid, Sp.KK

2

Definition

• Dermatophyte scalp, eyebrows, & eyelashes

• Attack hair shafts and follicles• = Ringworm of the scalp.

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

3

Epidemiology

• >> Children (3-14 years of age)

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Etiology

Pathogenesis

Reference: William D. James, T.G.B., Dirk M. Elston, Andrews' Diseases of the Skin Clinical Dermatology, W. Daniel, Editor 2010, Saunders Elsevier: United Kingdom. p. 287-290

Pathogenesis

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

7

Clinical Features

1. Gray patch

2. Black dot

3. Kerion

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

8

1. Gray Patch

• Erythematous, scaling, well-demarcated patch spreads centrifugally

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

9

2. “Black dot”• Asymptomatic,

erythematous, scaling patch on the scalp enlarges.

• Overlying scale and "black dots" follicular openings

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

10

3. Kerion

• Inflammatory type• Painful, boggy mass

hair lose and broken off.

• Kerion scarring and permanent alopecia

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Diagnosis

• Clinical features• Microscopic examination• Wood’s Lamp examination

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Wood’s Lamp Examination

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Laboratory Test

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Culture

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Microscopic Morphology Features

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Microscopic Morphology Features

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Microscopic Morphology Features

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Microscopic Morphology Features

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Microscopic Morphology Features

DIFFERENTIAL DIAGNOSIS

1. SEBORRHOIC DERMATITIS

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

2. PSORIASIS

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

DIFFERENTIAL DIAGNOSIS

3. ALOPECIA AREATA

DIFFERENTIAL DIAGNOSIS

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

TREATMENT

• MEDICAMENTOUS– TOPICAL– SYSTEMIC

• NON-MEDICAMENTOUS

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

MEDICAMENTOUS

• TOPICAL TREATMENT – Povidone-iodine shampoo– Ketoconazole 2% shampoo– Selenium-sulphide 1%

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

• Systemic treatment – Anti mitotic :

• Griseofulvin (1st line therapy)• Terbinafine • Azole drugs: ketoconazole, itraconazole,

fluconazole

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

NON-MEDICAMENTOUS

• EDUCATIONAL• SCREENING• ERADICATION OF POTENTIAL

SOURCE

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

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COMPLICATION

• Severe hair loss. • Scarring alopecia “bald areas”• Psychological impact

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

PROGNOSIS

• Bonam: under proper treatment

Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.

Wassalamu’alaikum wr. wb.and

Thank You