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Kerion mimicking erosive pustular dermatosis in elderly patients

Charles Chia1, Mark V Dahl

  • 1Department of Dermatology, Mayo Clinic, Scottsdale, Arizona 85259, USA.

Cutis
|March 22, 2013
PubMed

Insights

Fungal kerion infections can mimic erosive pustular dermatosis in elderly patients. Repeated diagnostic tests may be needed to confirm fungal infections and guide effective terbinafine hydrochloride treatment.

Area of Science:

  • Dermatology
  • Mycology
  • Infectious Diseases

Background:

  • Erosive pustular dermatosis of the scalp typically affects elderly individuals.
  • Fungal kerion infections are often considered less likely in this demographic.
  • Distinguishing between these conditions is clinically challenging.

Observation:

  • Three elderly patients presented with pustular scalp eruptions resembling erosive pustular dermatosis.
  • Initial cultures and biopsies did not identify fungal kerion infections.
  • Subsequent diagnostic procedures revealed fungal infections in all three cases.

Findings:

  • Cultures isolated *Trichophyton* species in one patient and *Microsporum* species in two patients.
  • The correct diagnosis of fungal kerion was established after initial exclusions.
  • All patients responded successfully to oral terbinafine hydrochloride treatment.

Implications:

  • Fungal kerion should be considered in the differential diagnosis of elderly patients with pustular scalp dermatoses.
  • Repeated cultures and biopsies of various sample types (hair, scale, skin) may be necessary for accurate diagnosis.
  • Prompt diagnosis and treatment with oral antifungals like terbinafine hydrochloride are crucial for successful outcomes.

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