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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Tinea capitis comprising of tinea favosa and kerion is mostly seen in school-aged children&#46; The incidence of unusual findings of tinea capitis caused by anthropophilic dermatophytes&#44; such as <span class="elsevierStyleItalic">Trichophyton violaceum</span>&#44; has grown in recent years&#46; These fungi tend to cause scarce inflammatory reactions&#44; presented with insignificant findings under the naked eyes are easily overlooked&#46; The diagnosis of less symptomatic and atypical cases of tinea capitis is based on the results of direct microscopic examination with conventional 10&#37; KOH smear and mycological cultures of skin scrapings and hair debris&#46; The absence of a rapid and reliable confirmatory test&#44; coupled with a nonspecific presentation&#44; can lead to delayed diagnosis or misdiagnosis&#46; It has been reported that comma and corkscrew hairs are two specific dermoscopic patterns of tinea capitis&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1&#44;2</span></a> Calcium fluorescent microscopy can definitely confirm a diagnosis&#46; Here&#44; we report a case of tinea capitis timely diagnosed with dermoscopy and calcium fluorescent microscopy as highly efficient and precise diagnostic tools&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">An 8-year-old Chinese girl weighing 21<span class="elsevierStyleHsp" style=""></span>kg presented to the dermatology clinic with a history of pruritus on the scalp for more than one year&#46; Her past medical history was unremarkable&#46; She had a history of taming a cat and a dog at home&#46; Dermatological examination revealed a small bean-sized patch hair loss and scattered &#8220;black spots&#8221; on the top of the head &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Numerous short&#44; highly convoluted&#44; coiled&#44; and twisted corkscrew hairs were observed under polarized dermoscopy &#40;JD801D&#59; JEDA&#44; China&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Calcium fluorescent &#40;Fungal Fluorescence Detection Kit&#44; Jiangsu Lifetime Biological Technology Co&#46;&#44; Ltd&#46;&#41; microscopy of the scale in corkscrew hair revealed extremely high numbers of spores &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; The lush purple colony developed after inoculating the scales in SDA medium at 28<span class="elsevierStyleHsp" style=""></span>&#176;C for 30 days &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; Calcium fluorescent microscopic examination showed separate branches of mycelium with irregular protrusions&#44; and thick-walled spores of varying sizes after the colony were cultured in PDA medium at 25<span class="elsevierStyleHsp" style=""></span>&#176;C for 14 days &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46; The girl was diagnosed with an unusual case of tinea capitis caused by <span class="elsevierStyleItalic">T&#46; violaceum</span> confirmed by dermoscopy&#44; calcium fluorescent microscopic examination and culture&#46; She received systemic treatment with itraconazole &#40;Xian-Janssen Pharmaceutical Ltd&#46;&#41;&#44; 100<span class="elsevierStyleHsp" style=""></span>mg per day with full fatty milk&#44; combined with topical application of 1&#37; naftifine 0&#46;25&#37; ketoconazole cream &#40;Chongqing Huapont Pharmaceutical Co&#46;&#44; Ltd&#46;&#41; followed after daily hair wash with 2&#37; ketoconazole shampoo &#40;Triatop&#44; Xian-Janssen Pharmaceutical Ltd&#46;&#41;&#46; The patient showed drastic improvement after 8 weeks of treatment with the disappearance of corkscrew hairs&#46; Therefore&#44; no recurrence was observed after one year of follow-up &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0015" class="elsevierStylePara elsevierViewall">The previous study speculated the formation of corkscrew hairs as a result of a combination of internal damage due to unsymmetrical hair degradation by <span class="elsevierStyleItalic">T&#46; violaceum</span> and external resistance due to scales covering the hair&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Dermoscopy is a diagnostic tool for the identification of fine structures and colors that cannot be observed with the naked eye&#46; It can facilitate the diagnosis of tinea capitis as a rapid&#44; noninvasive&#44; reliable&#44; and an inexpensive method&#46; Calcium fluorescent microscopy is easy to operate and timely that accurately identifies the fungal infections by specific staining of the fungal cell wall&#46; Thus&#44; it can significantly improve its positive rate&#44; on special populations&#44; of children&#44; who can receive early and effective treatment after the rapid diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Financial support</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Authors&#8217; contributions</span><p id="par0025" class="elsevierStylePara elsevierViewall">Hui Xiao&#58; Statistic analysis&#59; approval of the final version of the manuscript&#59; conception and planning of the study&#59; elaboration and writing of the manuscript&#59; obtaining&#44; analysis&#44; and interpretation of the data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Sushmita Pradhan&#58; Statistic analysis&#59; approval of the final version of the manuscript&#59; conception and planning of the study&#59; elaboration and writing of the manuscript&#59; obtaining&#44; analysis&#44; and interpretation of the data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Xin Ran&#58; Elaboration and writing of the manuscript&#59; obtaining&#44; analysis&#44; and interpretation of the data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the manuscript&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Yuping Ran&#58; Statistic analysis&#59; approval of the final version of the manuscript&#59; conception and planning of the study&#59; elaboration and writing of the manuscript&#59; obtaining&#44; analysis&#44; and interpretation of the data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tinea capitis comprising of tinea favosa and kerion is mostly seen in school-aged children&#46; Some tinea capitis often presented with insignificant findings under the naked eyes are easily overlooked&#46; The authors describe an unusual case of tinea capitis caused by <span class="elsevierStyleItalic">Trichophyton violaceum</span>&#46; The patient was an 8-year-old girl&#44; with a history of pruritus on the scalp for more than one year&#46; A diagnosis of tinea capitis was confirmed by clinical examination aided by dermoscopy&#44; calcium fluorescent microscopy and culture&#46; Comma and corkscrew hairs are two specific dermoscopic patterns of tinea capitis&#46; The patient was treated with systemic itraconazole&#44; topical application with 1&#37; naftifine 0&#46;25&#37; ketoconazole cream followed after daily hair wash with 2&#37; ketoconazole shampoo for 8 weeks&#46;</p></span>"
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Case Report
Tinea capitis: dermoscopy and calcium fluorescent microscopy as highly efficient and precise diagnostic tools
Hui Xiao, Sushmita Pradhan, Xin Ran, Yuping Ran
Corresponding author
ranyuping@vip.sina.com

Corresponding author.
Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Tinea capitis comprising of tinea favosa and kerion is mostly seen in school-aged children&#46; The incidence of unusual findings of tinea capitis caused by anthropophilic dermatophytes&#44; such as <span class="elsevierStyleItalic">Trichophyton violaceum</span>&#44; has grown in recent years&#46; These fungi tend to cause scarce inflammatory reactions&#44; presented with insignificant findings under the naked eyes are easily overlooked&#46; The diagnosis of less symptomatic and atypical cases of tinea capitis is based on the results of direct microscopic examination with conventional 10&#37; KOH smear and mycological cultures of skin scrapings and hair debris&#46; The absence of a rapid and reliable confirmatory test&#44; coupled with a nonspecific presentation&#44; can lead to delayed diagnosis or misdiagnosis&#46; It has been reported that comma and corkscrew hairs are two specific dermoscopic patterns of tinea capitis&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1&#44;2</span></a> Calcium fluorescent microscopy can definitely confirm a diagnosis&#46; Here&#44; we report a case of tinea capitis timely diagnosed with dermoscopy and calcium fluorescent microscopy as highly efficient and precise diagnostic tools&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">An 8-year-old Chinese girl weighing 21<span class="elsevierStyleHsp" style=""></span>kg presented to the dermatology clinic with a history of pruritus on the scalp for more than one year&#46; Her past medical history was unremarkable&#46; She had a history of taming a cat and a dog at home&#46; Dermatological examination revealed a small bean-sized patch hair loss and scattered &#8220;black spots&#8221; on the top of the head &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Numerous short&#44; highly convoluted&#44; coiled&#44; and twisted corkscrew hairs were observed under polarized dermoscopy &#40;JD801D&#59; JEDA&#44; China&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Calcium fluorescent &#40;Fungal Fluorescence Detection Kit&#44; Jiangsu Lifetime Biological Technology Co&#46;&#44; Ltd&#46;&#41; microscopy of the scale in corkscrew hair revealed extremely high numbers of spores &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; The lush purple colony developed after inoculating the scales in SDA medium at 28<span class="elsevierStyleHsp" style=""></span>&#176;C for 30 days &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; Calcium fluorescent microscopic examination showed separate branches of mycelium with irregular protrusions&#44; and thick-walled spores of varying sizes after the colony were cultured in PDA medium at 25<span class="elsevierStyleHsp" style=""></span>&#176;C for 14 days &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46; The girl was diagnosed with an unusual case of tinea capitis caused by <span class="elsevierStyleItalic">T&#46; violaceum</span> confirmed by dermoscopy&#44; calcium fluorescent microscopic examination and culture&#46; She received systemic treatment with itraconazole &#40;Xian-Janssen Pharmaceutical Ltd&#46;&#41;&#44; 100<span class="elsevierStyleHsp" style=""></span>mg per day with full fatty milk&#44; combined with topical application of 1&#37; naftifine 0&#46;25&#37; ketoconazole cream &#40;Chongqing Huapont Pharmaceutical Co&#46;&#44; Ltd&#46;&#41; followed after daily hair wash with 2&#37; ketoconazole shampoo &#40;Triatop&#44; Xian-Janssen Pharmaceutical Ltd&#46;&#41;&#46; The patient showed drastic improvement after 8 weeks of treatment with the disappearance of corkscrew hairs&#46; Therefore&#44; no recurrence was observed after one year of follow-up &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0015" class="elsevierStylePara elsevierViewall">The previous study speculated the formation of corkscrew hairs as a result of a combination of internal damage due to unsymmetrical hair degradation by <span class="elsevierStyleItalic">T&#46; violaceum</span> and external resistance due to scales covering the hair&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Dermoscopy is a diagnostic tool for the identification of fine structures and colors that cannot be observed with the naked eye&#46; It can facilitate the diagnosis of tinea capitis as a rapid&#44; noninvasive&#44; reliable&#44; and an inexpensive method&#46; Calcium fluorescent microscopy is easy to operate and timely that accurately identifies the fungal infections by specific staining of the fungal cell wall&#46; Thus&#44; it can significantly improve its positive rate&#44; on special populations&#44; of children&#44; who can receive early and effective treatment after the rapid diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Financial support</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Authors&#8217; contributions</span><p id="par0025" class="elsevierStylePara elsevierViewall">Hui Xiao&#58; Statistic analysis&#59; approval of the final version of the manuscript&#59; conception and planning of the study&#59; elaboration and writing of the manuscript&#59; obtaining&#44; analysis&#44; and interpretation of the data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Sushmita Pradhan&#58; Statistic analysis&#59; approval of the final version of the manuscript&#59; conception and planning of the study&#59; elaboration and writing of the manuscript&#59; obtaining&#44; analysis&#44; and interpretation of the data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Xin Ran&#58; Elaboration and writing of the manuscript&#59; obtaining&#44; analysis&#44; and interpretation of the data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the manuscript&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Yuping Ran&#58; Statistic analysis&#59; approval of the final version of the manuscript&#59; conception and planning of the study&#59; elaboration and writing of the manuscript&#59; obtaining&#44; analysis&#44; and interpretation of the data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tinea capitis comprising of tinea favosa and kerion is mostly seen in school-aged children&#46; Some tinea capitis often presented with insignificant findings under the naked eyes are easily overlooked&#46; The authors describe an unusual case of tinea capitis caused by <span class="elsevierStyleItalic">Trichophyton violaceum</span>&#46; The patient was an 8-year-old girl&#44; with a history of pruritus on the scalp for more than one year&#46; A diagnosis of tinea capitis was confirmed by clinical examination aided by dermoscopy&#44; calcium fluorescent microscopy and culture&#46; Comma and corkscrew hairs are two specific dermoscopic patterns of tinea capitis&#46; The patient was treated with systemic itraconazole&#44; topical application with 1&#37; naftifine 0&#46;25&#37; ketoconazole cream followed after daily hair wash with 2&#37; ketoconazole shampoo for 8 weeks&#46;</p></span>"
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Article information
ISSN: 03650596
Original language: English
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Idiomas
Anais Brasileiros de Dermatologia
en pt
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