I will continue the previous explanation about Tinea Capitis.

The next one is about the clinical

features that can be found in the history taking, the physical examination, and also the additional
examination to diagnose tinea capitis.

The first one is anamnesis:

- So the present complaints in tinea capitis can be:….

- We also have to ask about the duration of the symptoms, the risk factors that may be
related to patient’s current condition, the previous occurrence of the disease, and also
patient’s past treatments.
- We also have to look for the history of immunocompromised conditions.
- And we also have to pay attention to patient;s occupation and also the exposure from
patient’s environment.

The next one is Physical Examination:

The clinical manifestatins can be varied by the etiology and depended on the hair invasion.

There are four common clinical types of Tinae Capitis that can be seen, such as: Grey patch (scalling
with patchy hair loss), black dot ringworm, kerion, and tinea favosa.

1…

And then for the additional examination to confirm the diagnosis of Tinea Capitis, we can perform:

1. Wood lamp examination

2. Mycological Analysis using Potassium Hydroxide
3. ..

The differential diagnosis of Tinea Capitis include:

1) Seborrhoeic Dermatitis
In seborrhoeic dermatitis, the symptoms appear gradually and usually the first signs are flaky
skin and scalp.

2) Alopesia Areata
3) Psoriasis
4) Discoid Lupus Eritromathosa
5)

Both psoriasis and ringworm (tinea capitis) can cause red, scaly patches to appear on the scalp. Both
can also lead to intense itching.

How to differentiate them?

Psoriasis Tinea Capitis

Psoriasis is an autoimmune condition, so it’s
not contagious. And certain factors such as
stress or alcohol can trigger a flare. Psoriasis is
also a chronic residive condition, so it tends to
happen repetitively. And there may be a family
member who has the same condition with
patient.
Psoriasis plaques may spread, appearing on one
It is caused by fungal infection, so it’s
contagious. We may find that the pasient do
direct or indirect contact with another person
who has the same condition or maybe with
infected animals.
In tinea capitis the lesions are limited to appear
 area of the body and then another. And unlike only on the scalp and have common clinical
tinea capitis, psoriasis plaques can change in types, such as grey patch, black dot, and kerion.
color and texture. They are often red at first
and then may become grey and scaly, or crack
and bleed. There is a specific sign called Auspitz
sign in Psoriasis, which is a pin point bleeding
when we ngopek the scale.
No hyphae and fungal spores in KOH In KOH examination, we can find the hyphae
ezamination. and arthrospore.

And then for the treatment of Tinea Capitis:

Tinea capitis requires systemic treatment because antifungal creams are unable to penetrate the
hair shaft sufficiently to clear the infection.

For the oral antifungal therapy in Microsporum infection, we can use Griseofulvin with the dosage

And we can also use itraconazole and terbinafine for the alternatives.

Fpr the oral antifungal therapy in iTrichophyton infection, we can use Terbinafin with the dosage
being adjusted with patient’s weight and given for about 2 – 4 weeks.

We can also ude griseofulvin, itraconazole, and fluconaxole for the alternatoves.

For the topical anti fungal therapy, the use of topical antifungal treatment alone is not
recommended because it may contribute to the creation of carriers and presumed capable of
transmitting infection.

But we can combine it with the systemic treatment. The topical therapy includes washing hair or
scalp with antifungal shampoo such as: