Tinea Infections by Dr Turek

Articles:

Tinea Corporis and Tinea Capitis:

http://pedsinreview.aappublications.org/content/28/5/164.full?sid=cccdadf7-6d4f-4570-90e8-b596c5f61cf1

Superficial Fungal Infections:

http://pedsinreview.aappublications.org/content/33/4/e22.full?sid=cccdadf7-6d4f-4570-90e8-b596c5f61cf1

An 11 yo boy is found to have an area of alopecia. He complains of pruritis and you notice some overlying scale as well as posterior cervical lymphadenopathy on exam. You diagnose tinea capitis.

1. What would you be worried about if this same child presented with a painful, boggy, pus-filled lesion in the area of the alopecia? What is concerning about this stage of tinea capitis?
2. As opposed to other forms of tinea, why does tinea capitis require systemic therapy? What is considered first-line treatment and how long should you treat this child? To improve its absorption, what is the best way to take this medication?
3. What side effect has been associated with this medication? When should you send this patient to Gorman laboratory for blood work?
4. Several days after starting treatment, this child returns to clinic with the development of an intensely pruritic erythematous papular rash on his trunk and upper extremities. The patient’s mother is concerned about an allergy and wants to stop the medication. What is the most likely cause of this rash? What would you recommend they do for it?
5. This child is an avid wrestler on his school team. Can he return to school? What about wrestling practice?