10 years girl itching scab and oozing lesions since 4 years. mainly occipital region diagnosis? treatment?

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SIR, Boggy Pus filled marked Information, along with loss/fall of hair area on Occipital region--- Might B a Case of KERION, caused by Dramatic Immune response to Dermatophyte Fungal/TINEA Infection, commonly found in KERION is Microsporum Canis--- TINEASIS may B transmitted by KERION to Other Family Members N Somtimes by PETS. D/D- - SEBORRHEIC DERMATITIS. - SCALP PSORIASIS. DX- Suspicion is raised due to Typical appearance of a Kerion, as well as Wood lamp examination; Other test including Laboratory Tests for Fungal Infection; N ALONG with a BACTERIAL Swab Should B considered as Secondary Infection with Bacteria is Common. Skin Biopsy to exclude PSORIASIS. Rx- 1stly, Oral N Topical Antibiotics must B needed to Control da Bacterial Infection, Along with, Oral Antifungals like Terbinafine, Griseofulvin or Itraconazole R Useful for at least 6 - 8Wks, As Bcoz, Topical Antifungals R Not Effective due to deep invasion of Fungus into Hair Follicles. - Topical Antifungals, Terbinafine, Luliconazole, or Amorolfin Cream/lotion. - Ketoconazole (+ ZPTO) Shampoo. - Personal Hygiene should be maintained, stictly. Thanks.

Valuable opinion sir g
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Good answers from CUROFIANS. It's KERION case. We can diagnosis the KERION by Cicatrical alopecia, lymphadenopathy and scales with secondary infection ...produce Boggy and pus filled inflammation with swelling...... Good presentation by Dr. Dhara. Here,I am adding few more points... The guidelines of treatment in the KERION are.... First should be treated by oral antifungals . Topicals are not at all useful, due to deep invasion of fungus. Before going to treatment, confirm the fungal elements in the lesion. By doing ... WOODS lamp examination KOH mounting... Culture sensitivity Remove the pus, debris and scabs superficially. Should not go deep or should not do surgical excision. Preferable oral antifungal in this case is Itraconazole...100 mg for 4 weeks. Short course of antibiotics are beneficial. Keratolytic antifungal shampoo is good choice in this cäse. Personal hygiene and good Nutrition will improve the health and respond to treatment well.

Thank you so much sir for sharing ur knowledge.keep guiding us
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Kerion . Result of the hosts response to a fungal ringworm infection of the hair follicles of the scalp that can be accompanied by secondary bacterial infection . Raised spongy lesion and typically occurs in children . Painful inflammatory reaction with deep suppurative infection on the scalp . Follicles may be discharging pus . Usually caused by dermatophyte such as trichophyton n microsporum . Treatment griseofulvin or terbinafine for a sustained duration of at least 6 to 8 weeks .

Thank you doctor
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Kerion Ketoconazole Shampoo Tab Terbenafine 250mg OD×8weeks Tab Levocetrizine5 mg BD×3weeks Tab Coamoxyclav 625mg TDS×7days Luliconazole lotion to apply locally Maintain personal hygiene

Thanks Dr Joseph Gupta & Dr Simmi Ansari
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Tinea capital - kerion type. Seb capital doesn't ooze or crust but form yellowish, greesy flakes attached to hair shafts all over scalp , not limited to occipital region.

Sir ,not seen from long time you ,you have not posted the link published as you said
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Dr Josh, Thanks for remembering especially about the link. I had a rude reply to that post ascribing as self advertisement. But the fact is that those interested may go through the article. Second intention is to share with my Curofy family. Unfortunately such news seem to be beyond tolerance of some Curofians. Any way U can type any of my article's name in Google search and read it as the article are open a cess type. My Best to you. wishes

Thanks so much,
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Most Probably it's a case of KERION, typically on Occipital region.

Thank you doctor
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SEBORRHIC DERMATITIS..

Tnx a lot Dr Amitabha Dasgupta
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Seborroic dermatitis

Kerion with seb dermatitis Need properly treatment

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