Patient is a 2 year old female who was noticed to have a scaly round patch on the left side of her scalp. She was prescribed several shampoos and was given steroid creams to put on the area but mother noticed that this seem to be persistent for 1 year now and not getting any better. She was then prescribed some Nizoral shampoo which she can buy over the counter and told to follow-up in 1 month. On follow-up apparently the lesion seem to have gotten a lot better but still persistent. Otherwise, she has been a healthy young girl with no other problems. She was them prescribed some Griseofulvin to follow-up in 2 months.
She has "ringworm of the scalp" known as tinea capitis. This is from a group of fungi which invades the layer of the skin, hair and nails. This can be transmitted from animals such as cats or dogs directly or indirectly. This can also be transferred from person to person. The treatment takes a long time because this is a slow growing microorganism. The first line of treatment is Griseofulvin by mouth with Nizoral shampoo twice a week. If we encounter resistance Ketoconazole is another alternative for treatment. Most patients respond well to the medications.
We usually tell parents to make sure child does not share combs, towels with any one, because this can be contagious.