Acne Keloidalis :

a novel presentation

ofTinea capitisJournal American Academy of Dermatology

Vol. 56 No. 4 April 2007

CASE REPORT

• A 60 y.o African American men with a 3 y history of enlarging papules & nodules on the vertex & posterior

surface of her scalp PE : the small papules were firm &

the larger nodules were softLymphadenopathy (-)History of acne & hirsutism (-)

• History of acne & hirsutism (-)• Medical history : NIDDM, choles

& hypertension• Unsuccessfully th/ : oral

Cephalexin,intralesionaltriamsinalon, topical cortikosteroids

• A biopsy of 3 protuberant papules :a mixed inflammatory infiltrate Fibrosis surrounded the hair shafts

• PAS stain : 1 biopsy specimen clusters of spores within a hair shaft &hyphae in the stratum corneumPotato dextrose agar isolated :Trichophyton tonsurans (+)Micros : teardrop shaped microconidia,septated hyphae

• Th/ Griseofulvin tab 500 microsized,complete resolution after 2 m

DISCUSSION

• < puberty / > 50 y.o is extremly rare• In late AK, a granolomatous

inflammation typically occurs & eventual fibrosis

• The cause of AK is unknown :* tight collared shirts* football helmets not proven* hygiene practices etiologies* habitual picking

Intrafollicular Ag : * Demodex * Normal fungal * Bacterial skin flora * Cosmetics * Sebum * Desquamated keratinocytes

Chronic Inflammatory &

Degenerating epithelial components

CONCLUSSION• Our patient presented with a rare

clinical manifestation of Tinea capitis

spores hyphae fungal culture

chronicity of the patient’s diseaseth/ oral antifungal

Tinea was the trigger of Ag

a rare cause for AK