Tinea capitis in adults.

BACKGROUND

Tinea capitis is caused by dermatophyte fungi that utilize keratin as a nutrient source.  Scalp erythema, scaling, andcrusting are typical signs of this disease.  Although most commonly seen in prepubescent children, tinea capitis can occur in adults.

RESULTS

Endothrix tinea capitis owing to Trichophyton tonsurans commonly produces generalized scaling and localized perifollicular inflammation reminiscent of lichen planopilaris. Ectothrix tinea capitis owing to Microsporum sp. produces well- demarcated erythematous plaques suggestive of psoriasis. H&E stained biopsy specimens, KOH preparations or fungal cultures will confirm the diagnosis.

CONCLUSION

Because of a low index of suspicion for tinea capitis in adults with scaling and alopecia, diagnosis and appropriate treatment are often delayed. Resistance to treatment for seborrheic dermatitis or psoriasis should prompt a KOH, fungal culture orbiopsy to confirm the diagnosis of tinea capitis and initiate systemic antifungal agents.