Inflammatory tinea capitis: non-healing plaque on the occiput of a 4-year-old child

Inflammatory tinea capitis is an uncommon condition in Singapore. In this case report we present a patient whom we managed for this condition.

A 4-year-old girl presented to us with multiple pustules over the occipital scalp for 6 weeks, associated with painful cervical lymphadenopathy. Her condition did not respond to topical and oral antibiotics.

The patient was diagnosed with kerion (inflammatory tinea capitis) and fungal culture of plucked hairs from the kerion grew Microsporum species of dermatophyte. She was treated with a course of oral griseofulvin and topical selenium sulfide shampoo. She was advised to bring her pet cats to the veterinarian for screening, as well as not to share combs with her other siblings.

Her condition improved with the antifungal therapy, and there was no residual alopecia.

Physicians should consider tinea capitis when they encounter a patient with scalp folliculitis or scarring alopecia in the appropriate clinical context.