Tinea capitis mimicking dissecting cellulitis in three children

Kerion Celsi in infants and children-A narrative review 2010-2023

Kerion Celsi is an inflammatory, deep fungal infection of the scalp. It is rare in neonates but gets more common in children about 3 years and older. It represents with swelling, boggy lesions, pain, alopecia and purulent secretions. Secondary bacterial infection is not unusual after maceration. Extracutaneous manifestations include regional lymphadenopathy, fever and very rare fungemia. Id-reactions can occur. Diagnosis is based on clinical suspicion, clinical examination and medical history. Diagnosis should be confirmed by microscopy, fungal culture and molecular procedures. The most common isolated fungal species are anthropophilic Trichophyton (T.) tonsurans and zoophilic Microsporum (M.) canis, while geophilic species and moulds rarely cause Kerion Celsi. Treatment is medical with systemic and topical antifungals supplemented by systemic antibiotics when necessary, while surgery needs to be avoided. Early and sufficient treatment prevents scarring alopecia. The most important differential diagnosis is bacterial skin and soft tissue infections.

Low-dose oral isotretinoin in a young female with dissecting cellulitis

Dissecting cellulitis (DC) is a chronic inflammatory primary neutrophilic scarring alopecia. It predominantly affects the vertex and occipital regions of Afro-descendent men. Female DC is uncommon, and little is known about this condition in childhood. This paper reports a pediatric female case of DC with an excellent therapeutic response to low-dose oral isotretinoin.

Tinea Capitis in Campania: A 5-Year Retrospective Study in Childhood and Adolescence (2013-2018)

Introduction

Tinea capitis is a dermatophytic infection of the scalp hair commonly affecting children in school age.

Methods

Here we report our data of a 5-year retrospective study, including all patients between 1 and 18 years old referred to our Mycological Laboratory for suspected tinea capitis.

Results

A total of 202 patients were included and positive tests for tinea capitis were found in 86/202 (42.57%) patients. Most of the patients, 126/202 (62.38%), had not applied any topical therapy or taken any systemic drug, whereas 76/202 (37.62%) had already treated the disease.

Discussion

We underline the importance of the differential diagnosis of scalp lesions, the possibility of the so-called "tinea incognita" in some cases, and the species isolated in fungal cultures. A high number of Trichophyton mentagrophytes were isolated (71/86; 82%) and this phenomenon may be due to a particular suspected clinical picture of tinea capitis that induced the dermatologist to ask for a more detailed exam.