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Diagnosis of fungal scalp infection

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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