Tinea Capitis
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Diagnosis and Treatment ofTinea Capitis
By:
Aimie Farhanah Binti Zakaria – C111 11 834
Siti Fatimah Binti Othman – C111 11 881
Ahmad Yani Sukarso – C111 11 152
Advisor:
dr. Rani
Supervisor:
dr. Asnawi Madjid, Sp.KK
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Definition
• Dermatophyte scalp, eyebrows, & eyelashes
• Attack hair shafts and follicles• = Ringworm of the scalp.
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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Epidemiology
• >> Children (3-14 years of age)
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
Etiology
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Pathogenesis
Reference: William D. James, T.G.B., Dirk M. Elston, Andrews' Diseases of the Skin Clinical Dermatology, W. Daniel, Editor 2010, Saunders Elsevier: United Kingdom. p. 287-290
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Pathogenesis
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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Clinical Features
1. Gray patch
2. Black dot
3. Kerion
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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1. Gray Patch
• Erythematous, scaling, well-demarcated patch spreads centrifugally
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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2. “Black dot”• Asymptomatic,
erythematous, scaling patch on the scalp enlarges.
• Overlying scale and "black dots" follicular openings
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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3. Kerion
• Inflammatory type• Painful, boggy mass
hair lose and broken off.
• Kerion scarring and permanent alopecia
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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Diagnosis
• Clinical features• Microscopic examination• Wood’s Lamp examination
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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Wood’s Lamp Examination
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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Laboratory Test
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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Culture
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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Microscopic Morphology Features
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
Microscopic Morphology Features
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Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
Microscopic Morphology Features
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Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
Microscopic Morphology Features
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Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
Microscopic Morphology Features
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DIFFERENTIAL DIAGNOSIS
1. SEBORRHOIC DERMATITIS
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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2. PSORIASIS
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
DIFFERENTIAL DIAGNOSIS
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3. ALOPECIA AREATA
DIFFERENTIAL DIAGNOSIS
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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TREATMENT
• MEDICAMENTOUS– TOPICAL– SYSTEMIC
• NON-MEDICAMENTOUS
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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MEDICAMENTOUS
• TOPICAL TREATMENT – Povidone-iodine shampoo– Ketoconazole 2% shampoo– Selenium-sulphide 1%
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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• Systemic treatment – Anti mitotic :
• Griseofulvin (1st line therapy)• Terbinafine • Azole drugs: ketoconazole, itraconazole,
fluconazole
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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NON-MEDICAMENTOUS
• EDUCATIONAL• SCREENING• ERADICATION OF POTENTIAL
SOURCE
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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COMPLICATION
• Severe hair loss. • Scarring alopecia “bald areas”• Psychological impact
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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PROGNOSIS
• Bonam: under proper treatment
Reference: Schieke SM, Garg A. Superficial Fungal Infection. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. New York: Mc Graw Hill; 2012. p. 2277-2286, 2293-2295.
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Wassalamu’alaikum wr. wb.and
Thank You