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Surgical treatment of tinea capitis in childhood
E Thoma-Greber1, S Zenker, M Röcken
1Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, Frauenlobstrasse 8-11, D-80337 Münich, Germany.
Abstract:
Fungal infections of the scalp can cause kerion, pus-filled swellings, that may look like bacterial abscesses. We report on two children who underwent incision and drainage of their kerions under local and general anesthesia. This treatment was inappropriate: it carried the risk associated with general anesthesia and surgery without providing the therapeutic chance linked to adequate antimicrobial chemotherapy. We recommend that children who are present at emergency departments with pus-filled swellings on the scalp should be referred to a dermatology unit where appropriate clinical and laboratory investigations and antifungal treatment can be provided, if considered adequate.
Insights
Scalp fungal infections can cause kerion, pus-filled swellings mimicking bacterial abscesses. Incision and drainage is inappropriate; referral to dermatology for antifungal treatment is recommended for effective management.
Area of Science:
- Dermatology
- Mycology
- Pediatric Infectious Diseases
Background:
- Fungal infections of the scalp can manifest as kerion, characterized by pus-filled swellings.
- These lesions may be misdiagnosed as bacterial abscesses, leading to inappropriate treatment.
- Prompt and accurate diagnosis is crucial for effective management of pediatric scalp conditions.
Observation:
- Two pediatric cases of kerion treated with incision and drainage under anesthesia are presented.
- This surgical approach was deemed inappropriate due to associated risks and lack of therapeutic benefit.
- The study highlights the potential for misdiagnosis and suboptimal treatment of fungal scalp infections.
Findings:
- Incision and drainage of kerions carries risks of general anesthesia and surgery without addressing the underlying fungal cause.
- Inadequate treatment can delay resolution and potentially lead to complications.
- Appropriate management requires accurate diagnosis and targeted antifungal chemotherapy.
Implications:
- Children presenting with pus-filled scalp swellings should be referred to dermatology for specialized evaluation.
- Dermatology units can provide necessary clinical and laboratory investigations for accurate diagnosis.
- Timely antifungal treatment is essential for effective management of pediatric kerion, preventing complications and ensuring better outcomes.