Tinea Capitis

Tinea capitis is the name used for infection of the scalp with a dermatophyte fungus. Although common in children, tinea capitis is less frequently seen in adults.

Hair can be infected with Trichophyton (abbreviated as "T".) and Microsporum ("M".) fungi.

Clinical features of tinea capitis.

Tinea capitis is most prevalent between 3 and 7 years of age. It is slightly more common in boys than girls.

Tinea capitis may present in several ways.

• • like dandruff but usually with moth-eaten hair loss.
• • the hairs are broken off at the scalp surface, which is scaly.
• • Smooth areas of hair loss.
• • very inflamed mass, like an abscess.
• • yellow crusts and matted hair.
• • Carrier state no symptoms and only mild scaling.

Untreated may result in permanent scarring (bald areas).

Diagnosis:

• • Suspected if there is a combination of scale and bald patches.
• •Wood's light fluorescence.
• •The diagnosis is confirmed by microscopy and culture of skin scrapings and hair pulled out by the roots.

Treatment:

• • Oral antifungal medicines - Griseofulvin, terbinafine and itraconazole.
• • Topical – antibiotics and antifungals.

Treatment of carriers:

Necessary to prevent spread of infection. Antifungal shampoo twice weekly for four weeks may be sufficient but if cultures remain positive, oral treatment is recommended.

Suitable shampoos include:

• • 2.5% selenium sulfide.
• • 1% to 2% zinc pyrithione.
• • Povidone-iodine.
• • 2% Ketoconazole.

Folliculitis:

What is folliculitis?:

Skin condition in which there is inflamed hair follicle. The result is a tender red spot, often with a surface pustule.

Folliculitis may be superficial or deep. It can affect anywhere there are hairs, including chest, back, buttocks, arms and legs. Acne and its variants are also types of folliculitis.

Causes:

Folliculitis can be due to infection, occlusion (blockage), irritation and various skin diseases.

Diagnosis:

To determine if folliculitis is due to an infection, swabs should be taken from the pustules for cytology and culture in the laboratory.

Bacteria:

Bacterial folliculitis may result in a painful boil.

Treatment:

Treatment for bacterial folliculitis :

• • Hygiene.
• • Antiseptic cleanser.
• • Antibiotic 0- topical and/or oral.

Yeasts:

Also known as Malassezia folliculitis, itchy acne-like condition usually affecting the upper trunk of a young adult.

Treatment for Yeast:

Also known as Malassezia folliculitis, itchy acne-like condition usually affecting the upper trunk of a young adult.

• • Avoiding moisturisers
• • Topical or oral antifungal medication.

Fungi

Ringworm of the scalp (tinea capitis) usually results in scaling and hair loss, but sometimes results in folliculitis.

Viral Infections

Folliculitis may caused by herpes simplex virus (HSV).

This tends to be tender.

Herpes zoster may also present as folliculitis with painful pustules and crusted spots within a dermatome.

Treatment for HSV and herpes zoster:

Severe recurrent attacks may be treated with antiviral agents.

Folliculitis due to irritation from regrowing hairs

Folliculitis may arise as hairs regrow after shaving, waxing, electrolysis or plucking.

Swabs taken from the pustules are sterile.

Beard area irritant folliculitis is known as pseudofolliculitis barbae.

Treatment:

• • Stopping hair removal.
• • Recurrent irritant folliculitis, - Use a gentle hair removal method.

Folliculitis due to contact reactions

Occlusion leading to follicullitis

Paraffin-based ointments, moisturisers, and adhesive plasters may all result in a sterile folliculitis.

Treatment:

Use oil-free product, as it is less likely to cause occlusion.

Chemicals leading to follicullitis

Coal tar, cutting oils and other chemicals may cause an irritant folliculitis.

Treatment:

Avoid contact with the causative product.

Folliculitis due to drugs

Folliculitis may be due to drugs, particularly corticosteroids, androgens, ACTH, lithium, isoniazid , phenytoin and B-complex vitamins.

Folliculitis due to inflammatory skin diseases

Certain uncommon inflammatory skin diseases may cause permanent hair loss and scarring because of deep seated sterile folliculitis. These include:

• • Lichen planus.
• • Discoid lupus erythematosus.
• • Folliculitis decalvans.
• • Folliculitis keloidalis.

Treatment:

Treat the underlying condition and its severity.

Acne variants leading to folliculitis.

Acne and acne-like or acneform disorders are also forms of folliculitis.

Treatment of the Acne variants:

• •Topical therapy – Retinoid.
• •Oral antibiotics.
• •Antiandrogenic therapy (women).