10.5826/dpc.1304a203
text/xml
2160-9381
3170
en
Zoe Apalla
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Trichoscopy Unmasks Tinea Capitis in Elderly Individuals
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2023-10-31
2023-01-22
2023-10-31
2024-01-15
e2023203
Dermatol Pract Concept
Zoe Apalla
2023/10/31
10.5826/dpc.1304a203
e2023203
State Dermatology Department, Hippokratio General Hospital, Thessaloniki, Greece
2160-9381
en
e2023203
Pihet M, Le Govic Y. Reappraisal of Conventional Diagnosis for Dermatophytes. Mycopathologia 2017; 182(1-2): 169-180.
Trichoscopy Unmasks Tinea Capitis in Elderly Individuals
https://dpcj.org/index.php/dpc/article/download/3170/2371
                    Trichoscopy Unmasking Tinea Capitis
                            in Elderly Individuals
   Theodosia Gkentsidi1, Chryssoula Papageorgiou1, Konstantinos Lallas1, Aimilios Lallas1,
                                       Zoe Apalla2


1 First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
2 State Dermatology Department, Hippokratio General Hospital, Thessaloniki, Greece



Citation: Gkentsidi T, Papageorgiou C, Lallas K, Lallas A, Apalla Z. Trichoscopy Unmasking Tinea Capitis in Elderly Individuals.
Dermatol Pract Concept. 2023;13(4):e2023203. DOI: https://doi.org/10.5826/dpc.1304a203
Accepted: March1, 2023; Published: October 2023
Copyright: ©2023 Gkentsidi et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Zoe Apalla, MD, PhD, Hippokratio General Hospital, Thessaloniki, Greece, 124, Delfon street, 54643,
Thessaloniki, Greece. Tel. +306972916729, E-mail address: zoimd@yahoo.gr




Case Presentation                                                        Microscopic examination showed parasitism of the hair
                                                                         shafts (Figure 1C)[2]. As expected, the Morse-code sign was
A 84-year-old female presented with a 2-year history of gradual          not visible due to the white-colored hairs and M. Canis was
hair loss and alopecia. Previous diagnoses included psoriasis            identified in the culture. Complete response was achieved af-
and lichen planopilaris unsuccessfully treated with topical ste-         ter 1-month treatment with systemic itraconazole.
roids and systemic cyclosporine (current treatment), accord-
ingly. Clinical examination revealed erythematous and scaly
plaques on the scalp, with associated alopecia (­Figure 1A).
                                                                         Teaching Point
Zigzag, comma, pig-tail and broken hairs in trichoscopy
were highly suggestive of tinea capitis (Figure 1B)[1].                  Trichoscopy is essential in early recognition of tinea capitis.




Image Letter | Dermatol Pract Concept. 2023;13(4):e2023203                                                                            1
              Figure 1. (A) Clinical examination of the scalp revealed erythematous and scaly plaques on the scalp, with
              associated alopecia; (B) Dermoscopy reveals zigzag, comma, pig-tail and broken hairs; (C) Microscopic ex-
              amination showing parasitism of the hair shafts.




References                                                            2. Pihet M, Le Govic Y. Reappraisal of Conventional Diagnosis for
                                                                         Dermatophytes. Mycopathologia. 2017;182(1-2):169-180. DOI:
1. Rudnicka L, Rakowska A, Olszewska M. Trichoscopy: how it              10.1007/s11046-016-0071-y. PMID: 27718160.
   may help the clinician. Dermatol Clin. 2013;31(1):29-41. DOI:
   10.1016/j.det.2012.08.011. PMID: 23159174.




2                                                                           Image Letter | Dermatol Pract Concept. 2023;13(4):e2023203
