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Diagnosis of fungal scalp infection

Authoring team

diagnosis

Diagnosis of tinea capitis should be established by clinical inspection as well as laboratory diagnostic tests whenever possible.

  • clinical diagnostic aids
    • Wood's lamp
      • ectothrix Microsporum species demonstrate bright green fluorescence of infected hairs under Wood's lamp examination
        • may help in differentiating from nonfluorescent Trichophyton infection (exception: T. schoenleinii can fluoresce dull green)
      • value is limited due to the current predominance of nonfluorescing species of Trichophyton

    • dermoscopy
      • black dot hair stubs may be visualized more clearly
      • 'comma-shaped' hairs have been described in white children with ectothrix infection whereas corkscrew hairs have been reported in Afro-Caribbean children with tinea capitis (1,2)

  • laboratory diagnosis
    • suspected tinea capitis lesions should be sampled by plucking hairs, using a blunt scalpel to remove hair and scalp scale, or by taking scalp brushings
    • microscopic examination
      • microscopy should be carried out on all scalp scrapings and plucked hairs, by mounting in 10-30% potassium hydroxide with or without calcofluor, and examination by light or fluorescence microscopy
      • presence of hyphae and/or arthroconidia should be reported.
    • culture
      • all specimens should be cultured on Sabouraud agar with at least one agar plate containing cycloheximide to inhibit nondermatophyte mould growth
      • any dermatophytes growing should be identified and reported (1,2)

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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