Tinea Capitis — SCE Dermatology MCQ

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ModeratePaediatric DermatologyTinea CapitisSCE Dermatology

A 5-year-old boy presents with a single patch of alopecia on the occipital scalp. The patch has well-defined borders with broken hairs at the margins. Dermoscopy shows comma-shaped hairs and corkscrew hairs. What is the most likely diagnosis?

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Correct answer: D — Tinea capitis

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

E is correct. Comma and corkscrew hairs reflect fungal weakening and distortion of infected hair shafts and are characteristic trichoscopic clues to tinea capitis; mycological sampling is still required, and scalp-hair infection needs systemic rather than topical-only antifungal treatment. A more often shows yellow dots, exclamation-mark hairs and tapered hairs. B produces hairs broken at varied lengths, flame hairs or coiled hairs and a history or distribution suggesting manipulation. C causes diffuse shedding of club hairs without a focal scaly patch. D follows a traction distribution and may show fringe sign or later scarring rather than fungal hair-shaft morphology.

Reference: BAD tinea capitis information: https://www.bad.org.uk/pils/tinea-capitis