Tinea capitis mimicking folliculitis decalvans.

Area of Science:

• Dermatology
• Mycology
• Infectious Diseases

Background:

• Tinea capitis is a fungal infection of the scalp, more common in children.
• Microsporum canis is a common dermatophyte, typically causing infections in animals.

Observation:

• An adult patient presented with diffuse alopecia and follicular pustules, clinically resembling folliculitis decalvans.
• Scalp examination revealed severe hair loss, erythema, pustules, and crusting, particularly on the frontal and vertex areas.
• Videodermoscopy showed visible follicular openings, pustular lesions, and characteristic comma hairs.

Findings:

• The patient was diagnosed with tinea capitis due to Microsporum canis.
• Treatment with oral fluconazole (150 mg weekly for 8 weeks) combined with ketoconazole shampoo successfully resolved the inflammatory lesions.
• Complete hair regrowth was observed post-treatment.

Implications:

• This case highlights the importance of considering tinea capitis in adults presenting with alopecia and pustular scalp conditions.
• It underscores the efficacy of systemic fluconazole and topical antifungals in treating severe tinea capitis.
• Early and accurate diagnosis is crucial for preventing permanent hair loss and ensuring successful treatment outcomes.