ABSTRACT

Tinea capitis is a common dermatophyte infection of the scalp in children. Causative agents vary within different geographical areas as well as during decades. The main pathogens are usually Trichophyton and Microsporum species. There are three recognized pattern of hair shaft invasion; endothrix, ectothrix and favus. The latter, a pattern of hair loss caused by Trichophyton schoenleinii, is rarely seen. The clinical presentation varies depending on the type of hair invasion, the level of host resistance and the inflammatory response. Therefore, appearances vary from inflammatory to non inflammatory lesions and usually associated with patchy alopecia. If tinea capitis is suspected, the clinical diagnosis should be confirmed by mycological examination. This includes both direct microscopic examination and cultures. Wood’s light examination may be useful for certain ectothrix infections caused by Microsporum canis and Microsporum audinii however, it is not suitable for definitive diagnosis. The aim of treatment of tinea capitis is to achieve a clinical and mycological cure and requires an oral antifungal agent. Oral antifungal treatment is based on griseofulvin and the newer oral antifungal agents including terbinafine, itraconazole, and fluconazole. Adjunctive local treatment with topical antifungal lotion and shampoo is recommended to shortening the duration of the systemic treatment and to reduce the risk of infecting other people. The response to treatment needs to be monitored by repeated fungal tests. Examination of family members is a