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| Ringworm of the scalp (tinea capitis) |
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Reviewed by Professor James Ferguson, consultant dermatologist
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What is ringworm of the scalp?
Ringworm of the scalp is a type of fungal infection. The most
common species of fungi affecting humans are Microsporum canis
and Tricophyton verrucosum.
The majority of UK cases are due to another type of fungus,
namely, Tricophyton tonsurans. The medical term for
ringworm of the scalp is tinea capitis.
How is it caught?
In most cases, the disease is transferred by way of contact with
animals (eg dogs, cats, cows, hamsters and guinea pigs).
Most mammals have a skin fungus with which they live in peaceful
coexistence, without any symptoms for the animal, but the fungus can be
transferred to humans.
Ringworm is most common among farming populations whose
lifestyle involves frequent contact with animals. Children are particularly at
risk; between children the infection can be highly contagious.
What are the signs of ringworm of the scalp?
There are two common types of symptoms.
One or more sections of the scalp will show hair loss or give a
stubbly appearance. The skin will be slightly scaly but with little or no
irritation. In addition to these symptoms, ringworm may be present on the face
or other parts of the body.
Alternatively, a 6 to 9cm wide lesion will appear that may
develop into a large rash.
In severe cases, a kerion (a swollen mass discharging pus) will
appear on the scalp. The kerion may become inflamed and fill with fluid or pus,
and may also be quite painful.
Severe alopecia (baldness) may develop and at this stage the
scalp will often become infected further with Staphylococci bacteria. The lymph
nodes of the neck can also become swollen and tender. In rare cases, there may
also be a fever.
Who is at special risk?
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Children in close contact with animals.
Good advice
It is difficult to avoid the fungi that cause ringworm as they
are everywhere in our surroundings. However, a good preventive measure is to
minimise direct contact with animals showing symptoms of ringworm, such as
scaly, patchy skin.
How does the doctor diagnose ringworm?
Many other skin diseases can have similar symptoms but require
very different treatment. It is therefore important for the doctor to perform
several tests and not to rely only on a visual diagnosis.
A scraping of the fungi can be taken for
microscopic checks
and cultivation to identify it. Some fungi will appear fluorescent (glow in the
dark) under ultraviolet light. This could be done by a GP or by a dermatologist
(a skin specialist).
Future prospects
Treatment should be started as soon as possible to avoid the
fungal infection spreading further and to avoid infection of other healthy
people.
If a kerion forms, bacteria build up in the hair follicles and
cause tumour-like swellings that ooze pus, which can lead to permanent baldness
in some areas of the scalp.
How is ringworm affecting the scalp treated?
The most common treatment is an
antifungal medicine taken by mouth.
If a large kerion has formed, the antifungal treatment may be supplemented with
corticosteroids for a short period of
time.
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Based on a text by Dr Flemming Andersen and Dr Ulla Søderberg, consultant dermatologist
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Last updated 06.07.2005
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