A Descriptive Review of Kerion and Non-inflammatory Tinea Capitis / 대한피부과학회지

ABSTRACT

BACKGROUND: Tinea capitis manifests either as a non-inflammatory or inflammatory type including kerion, which may cause permanent alopecia. In addition to antifungals, systemic corticosteroids (prednisolone at 1~2 mg/kg/day) have been used to reduce inflammation in patients with kerion. OBJECTIVE: We studied the clinical and laboratory features, treatments, and prognosis of tinea capitis. METHODS: We performed a retrospective review of 12 cases of kerion and 12 cases of non-inflammatory tinea capitis (median age, 8 years; range, 3 months~80 years) diagnosed using a potassium hydroxide mount at the National Health Insurance Service Ilsan Hospital between November 2011 and April 2018. RESULTS: Fungal cultures showed Microsporum species in 6 cases and Trichophyton species in 1 case. The duration of diseases and extent of lesions were greater in the kerion group than in the non-inflammatory tinea capitis group (p<0.05). Sixteen patients were treated with systemic antifungals. In the kerion group, 10 patients were treated with systemic antifungals (6 with itraconazole [median, 26 days; range, 21~58 days] and 4 with terbinafine [median, 24.5 days; range, 13~31 days]). The median intervals between the onset of treatment and scalp clearing (in 10 cases), the onset of new hair growth (in 9 cases), and complete regrowth of hair (in 7 cases) were 27 (range, 13~77), 33 (range, 19~63), and 89 (range, 42~180) days, respectively, in the kerion group. The median dosage of prednisolone used in patients with kerion was 0.26 mg/kg/day (range, 0.15~0.42) with good clinical response. CONCLUSION: The patients with kerion responded well to antifungal treatments. A lower dose of prednisolone was adequate when systemic corticosteroids were required for the treatment of kerion.