Tinea capitis

Last Updated: 2020-06-01

Author(s): Anzengruber F., Navarini A.

ICD11: 1F28.0

Herpes tonsurans, ringworm of the hair, ringworm of the scalp, scalp ringworm, and tinea tonsurans.

Fungal infection of the scalp.

Pathogen:

  • Microsporum canis (> 50%)
  • Trichophyton mentagrophytes (< 25%)
  • T. verrucosum (< 20%)
  • T. rubrum (approx. 10%)
  • Rarely: T. violaceum, tonsurans, soudanese, T. schoenleinii, M. audouinii
  • Depending on whether the fungus is located in the hair shaft or outside, it is called an ecto- or endotrix infection.
  • Depending on the depth of infiltration, a distinction can be made between tinea capitis superficialis and tinea capitis profunda.

Variable depending on pathogen: alopecia, deposits.

  • Pathogen detection by means of scaling, biopsy or hair removal.
  • Preparation of native potassium hydroxide solution: The obtained material is placed on a slide and dissolved with 20% potassium hydroxide solution. In case of a fungal infection, fungal threads can be seen microscopically.
  • Periodic acid ship staining (PAS): In the course of a dermatopathological examination the existence of fungal threads and spores (red) can be detected by means of PAS staining.
  • Fluorescence microscopy: Fluorescent dyes can be used to visualize the cell walls of fungi.
  • Wood light lamp: Shows fluorescence e.g. in favus, microspore, tinea inguinalis.
    Culture (gold standard): Cultural cultivation of fungi. Duration: Up to 4 weeks for dermatophytes, up to 2 weeks for moulds, approx. 3-4 days for yeasts.
  • Microculture: This allows a further differentiation between the different types of fungi.
  • Molecular diagnostics: PCR enables rapid multiplication. This method is very sensitive.

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