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Tinea capitis

Key sources
The following summarized guidelines for the evaluation and management of tinea capitis are prepared by our editorial team based on guidelines from the Japanese Dermatological Association (JDA 2020), the British Association of Dermatologists (BAD 2014), the American Academy of Family Physicians (AAFP 2014), and the European Society of Pediatric Dermatology (ESPD 2010).
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Guidelines

1.Diagnostic investigations

Microscopy and culture: collect samples from scalp lesions via scalpel scraping, hair pluck, brush, or swab in patients with suspected tinea capitis. Send all specimens for microscopy and culture where possible. Do not obtain susceptibility testing.
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2.Medical management

General principles: consider initiating treatment while awaiting confirmatory mycology in the presence of a kerion or ≥ 1 cardinal clinical signs (scale, lymphadenopathy, alopecia).
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3.Specific circumstances

Pediatric patients: offer terbinafine, itraconazole, or fluconazole in pediatric patients with tinea capitis caused by Trichophyton species.
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4.Preventative measures

Cleansing of fomites: cleanse hairbrushes and combs with disinfectants,
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such as simple bleach or a 2% aqueous solution of sodium hypochlorite containing 16.5% salt.
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5.Follow-up and surveillance

Assessment of treatment response: set mycological rather than clinical cure as the end point of treatment. Obtain repeat mycology sampling until the mycological clearance is achieved.
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