TINEA CAPITIS AND PITYRIASIS VERSICOLOR

Desi Anna Rahmi

Nurul Nadia

Pembimbing : Fitria Salim

INTRODUCTION

Tinea capitis is a worldwide public health problem and requires identification of the specific causative fungal agent.

Etiologic: -Host preference and natural habitat-Classified of agents : Anthropophilic, Zoophilic, Geophilic

Variety of tinea capitis’s :Black dot, gray patch, kerion, favus.

CASE REPORT

IDENTITY OF PATIENTName : Mrs. DSex : FemaleRegistration number : 0-94-10-76Age : 23 years old Address : Kp. LaksanaPhone number : 0852 7502 4401Examination date : February27th 2013

ANAMNESEChief complaint:

Itching and dandruff in the head since 8 months ago.

White patches on the back since 2 weeks ago.

Present illness history:Patient came to the hospital with chief complaint of itching and dandruff in the head since 8 months ago. Initially, complaint perceived little, but gradually became too much and itching increased. The complaints was not diminished even though she washed her hair. The patient admitted has been scratched her head until became the wound, and the crusts appeared on it. The wound was becoming increasingly widespread. Patients also complained her hair falled off and broke easily. Patient also complained of white patches on the back since two weeks ago. The white patches were becoming increasingly large. It was also itching.

Drug history:

Selsun shampoo

Past medical story:Never

experienced these

complaints before.Family

history:No history of

the same disease

Social history

•go in the morning and return home late in the afternoon.

•lives in the urban area

•has a cat.

PHYSICAL EXAMINATIONDermatological status:

Regio capitis :

erythematous plaques without central healing, with scales on it, yellowish crusts, multiple, polycyclic configuration, distributed regional.

V

Regio posterior thoracalis : hypopigmentation patches, well demarcated, with regular border, multiple, plaque, distributed regional.

Differential Diagnosis1. Tinea capitis2. Seborrheic dermatitis3. Pediculosis capitis

1. Pityriasis Versicolor2. Pityriasis Alba3. Vitiligo

Diagnosis

Tinea capitis + Pityriasis Versicolor

Planning Diagnosis

•a/r capitis : negative•a/r thoracalis: negative

KOH 10 %

•a/r capitis: greenish.•a/r thoracalis: golden yellow.

Wood lamp test

Treatment

Systemic

•Antifungal : •Griseofulvin 500 mg single dose for 6-8 weeks

Topical

•Antifungal :•ketoconazole cream 2% (morning – night)

•Selenium sulfide 1% (shampoo)

Education

•Give explanation to patient about the disease.•Apply the cream until 2 cm out of the lessions.•Apply the cream and drug in a routine manner.•Keep body clean.•Do not share use of clothes and towel.•Do not scratch the wound•avoid the scalp and the back is too moist or avoid excessive sweating•Control1 week later.

Quo ad vitam: dubia ad bonam

Quo ad functionam:dubia ad bonam

Quo ad sanactionam:

dubia ad bonam

Prognosis

DISCUSSION

Tinea capitis and pityriasis versicolor are worldwide in its distribution, but it will be more common in tropical and temperate climates. High temperature, humidity, use of oils and hyperhidrosis are the main factors responsible for the occurrence of these disease

The patients admitted often got sweating. Patient is being studied at university. Often goes in the morning and returns home late in the afternoon

The patient has a cat. This habit can suppose the infection. The identity of the pathogen may also be important to identify a zoonotic reservoir of infection (a cat or dog for M. Canis infections, cattle for Trichophyton verrucusum, rats for granular zoophilic Trichophyton metagrophytes).