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Tinea Capitis — SCE Dermatology MCQ

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HardPaediatric DermatologyTinea CapitisSCE Dermatology

A child has a painful boggy kerion with broken hairs and cervical nodes after guinea-pig contact. There is no spreading cellulitis. What is the best immediate treatment principle?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Start systemic antifungal treatment, send mycology and avoid incising the kerion

Explanation lettering: E = shown as A · D = shown as B · A = shown as C · C = shown as D · B = shown as E

E is correct. Kerion is an intense inflammatory response to tinea capitis and needs prompt systemic antifungal therapy to reduce the risk of permanent scarring alopecia. Hair and scale should be sent for mycology, but severe typical disease is not left untreated while awaiting culture. Adjunctive shampoo reduces carriage but cannot penetrate infected hair sufficiently to cure. Incision can worsen tissue injury and scarring; antibiotics are added only when bacterial superinfection is clinically supported. Zoophilic Microsporum infection may influence the eventual systemic agent once species information is available.

Reference: BAD guideline for tinea capitis: https://doi.org/10.1111/bjd.13196