Tinea Capitis Caused by Microsporum ferrugineum in an Infant during the First Year of Life
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Tinea capitis is a dermatophyte infection that affects the scalp hair follicles and is most commonly observed in children but uncommonly recognized during infancy. This study aimed to investigate a 2-month-old girl with a well-demarcated gray-patch alopecic plaque accompanied by fine scaling and broken, dull, and occasionally bent ("bamboo-like") hairs. Wood's lamp examination showed bright blue-green fluorescence along the infected hair shafts, while the trichoscopy findings showed comma and corkscrew hairs. A potassium hydroxide preparation confirmed an ectothrix pattern, and a fungal culture indicated the presence of Microsporum ferrugineum. The patient was orally administered griseofulvin with adjunctive topical ketoconazole, achieving a significant clinical improvement by Week 6. This case emphasizes the value of layered diagnostics (Wood's lamp examination, trichoscopy, KOH, and fungal culture) to establish an etiologic diagnosis in very young infants and to distinguish Microsporum—infections typically gray-patch with bright fluorescence—from other dermatophytes. Since topical agents do not reach the deep portion of hair follicles, systemic therapy is essential; griseofulvin remains the preferred first-line agent for treating ectothrix infections due to Microsporum. Household or pet exposure should be assessed to identify potential sources and prevent recurrence.
Abstract
Tinea capitis is a dermatophyte infection that affects the scalp hair follicles and is most commonly observed in children but uncommonly recognized during infancy. This study aimed to investigate a 2-month-old girl with a well-demarcated gray-patch alopecic plaque accompanied by fine scaling and broken, dull, and occasionally bent ("bamboo-like") hairs. Wood's lamp examination showed bright blue-green fluorescence along the infected hair shafts, while the trichoscopy findings showed comma and corkscrew hairs. A potassium hydroxide preparation confirmed an ectothrix pattern, and a fungal culture indicated the presence of Microsporum ferrugineum. The patient was orally administered griseofulvin with adjunctive topical ketoconazole, achieving a significant clinical improvement by Week 6. This case emphasizes the value of layered diagnostics (Wood's lamp examination, trichoscopy, KOH, and fungal culture) to establish an etiologic diagnosis in very young infants and to distinguish Microsporum—infections typically gray-patch with bright fluorescence—from other dermatophytes. Since topical agents do not reach the deep portion of hair follicles, systemic therapy is essential; griseofulvin remains the preferred first-line agent for treating ectothrix infections due to Microsporum. Household or pet exposure should be assessed to identify potential sources and prevent recurrence.