Tinea capitis is a superficial fungal infection of the scalp and hair, which can be classified into three types based on the causative pathogen and clinical manifestations: favus, white ringworm, and black dot ringworm. Tinea capitis commonly affects children, is highly contagious, and easily spreads in environments such as nurseries, kindergartens, elementary schools, and households. It is primarily transmitted through contaminated hairdressing tools, but can also be contracted by contact with infected animals like cats and dogs.

bubble_chart Clinical Manifestations

1. Favus: commonly known as "bald sore" or "favus head"
   1. Common in children, but adults can also be infected;
   2. The typical skin lesion is a disk-shaped yellow scab the size of a soybean, with hair penetrating the center, forming atrophic scars after healing;
   3. Affected hair is uneven, dry, and lacks luster, leading to permanent baldness.
2. White Ringworm
   1. Mainly seen in children
   2. The typical skin lesion is an initially large scaly mother patch, surrounded by smaller satellite-like daughter patches, which self-heal after puberty without leaving scars;
   3. Affected hair has a white sheath around it and often breaks off 2-3mm from the scalp.
3. Black Dot Ringworm
   1. Common in children, but adults can also be infected;
   2. The typical skin lesion consists of multiple scattered small scaly patches, which may leave small scars after healing;
   3. Affected hair breaks off just as it emerges from the scalp, leaving black dot-like remnants.

bubble_chart Diagnosis

1. Tinea capitis is mainly seen in children, while favus and black dot ringworm can affect both children and adults;
2. the typical skin lesion manifestations of various types of tinea capitis;
3. the characteristics of affected hair in different types of tinea capitis;
4. direct microscopic examination and culture of affected hair showing positive fungal results;
   1. Favus: microscopic examination reveals intrapilar hyphae, arthrospores in scutula, or Deer Horn hyphae, with culture showing Trichophyton schoenleinii;
   2. White ringworm: microscopic examination shows intrapilar hyphae and external round spores, with culture yielding Microsporum canis or Microsporum ferrugineum;
   3. Black dot ringworm: microscopic examination reveals intrapilar chain-like spores, with culture showing Trichophyton violaceum or Trichophyton tonsurans.
5. Wood's lamp examination.
   1. Favus: dark green fluorescence;
   2. White ringworm: bright green fluorescence;
   3. Black dot ringworm: no fluorescence.

bubble_chart Treatment Measures

Treatment Principles

1. Oral antifungal medication (griseofulvin is the first choice);
2. Topical antifungal preparations;
3. Wash hair twice daily for 8 weeks;
4. Shave the head once weekly for 8 weeks;
5. Disinfect the patient's daily utensils or contact items.

1. The preferred method is griseofulvin combination therapy, which involves oral griseofulvin combined with topical antifungal preparations;
2. For those who fail or are allergic to griseofulvin, terbinafine can be taken as an alternative;
3. Common antifungal preparations include 2.5% iodine tincture, 5–10% sulfur ointment, compound benzoic acid ointment, and imidazole creams.

bubble_chart Cure Criteria

1. Cure: Skin lesions subside, fungal direct microscopy and culture, once a week, negative for three consecutive times, negative under filtered ultraviolet lamp examination;
2. Improvement: Partial subsidence of skin lesions, fungal examination negative or positive, filtered ultraviolet lamp examination negative or positive;
3. No cure: No improvement in skin lesions, fungal examination positive, filtered ultraviolet lamp examination positive.