Internal Medicine

0521779407-20 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:22

1430 Tics Tinea Capitis

■Nicotine gum or patch may provide days of relief

■Botulinum toxin may help simple tics

follow-up

■Depends on cause & treatment

complications and prognosis

■Neuroleptic treatment can cause tardive dyskinesia

■Prognosis depends on cause

TINEA CAPITIS

BONI E. ELEWSKI, MD and JEFFREY P. CALLEN, MD

history & physical

History

■Prepubertal children and those of African or Hispanic descent

■Rare in Adults – except in immunocompromised patients

■Adults exposed to young children – i.e. teachers

■Exposure to cats or dogs

Signs & Symptoms

■Hair loss, scale, crusting, pustules or abscesses in the scalp

■Black dots – broken hairs

■Posterior cervical and postauricular lymphadenopathy

■Scarring alopecia in end stage infections

tests

Laboratory

■KOH – spore within or without hair shaft

■Fungal culture of a dermatophyte

■Trichophyton tonsuransmost common in U.S.

■Woods light – yellow fluorescent in Microsporum canis

differential diagnosis

■Alopecia areata

■Trichotillomania (hair pulling tics)

■Seborrheic dermatitis/psoriasis

■Folliculitis

management

Oral Antifungal Drugs

■Oral antifungal drugs required