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Clinical and Mycological Features of Pediatric Tinea Capitis Caused by Microsporum canis

Jisu Kim,Seung Hee Cho,In Young Yoo,Ji Hyun Lee
10.17966/JMI.2026.31.2.88 Epub 2026 June 30

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Abstract



Keywords



Dermatophytosis Microsporum canis Tinea capitis



A 7-year-old girl presented with a 1-week history of patchy alopecia on the scalp. She had been in close contact with cats during her travel 6 weeks earlier. Examination revealed three scaly, erythematous patches on the frontal, vertex, and occipital scalp (Fig. 1A-C). Further examination using potassium hydroxide (KOH) microscopy showed septate hyphae with ectothrix spores that surrounded the hair shafts. Fungal culture on Sabouraud's dextrose agar produced whitish-yellow cotton-like colonies at 7 days (Fig. 1D), with macroconidia that exhibited variably thick echinulate walls of 5-15 cells with curved knob-like ends (Fig. 1E). Polymerase chain reaction (PCR) identified Microsporum canis within 4 days (Fig. 1F). The patient was given an 8-week treatment with oral itraconazole (100 mg/day; i.e., 4.1 mg/kg/day) and topical isoconazole, resulting in clinical improvement.

Figure 1. (A) Localized scaly skin-colored patch having broken hairs on the occiput (B, C) Scaly erythematous patches with broken hairs on the frontal and vertex scalp (D) Fungal culture on Sabouraud's dextrose agar that showed whitish-light yellow cottony colonies (E) Lactophenol cotton blue staining demonstrating fusiform macroconidia having thick or thin echinulate walls, containing 5–15 cells (original magnification ×1,000) (F) The alignment of internal transcribed spacer sequences that were obtained from the clinical isolate, showing 100% sequence identity with Microsporum canis

Tinea capitis predominantly affects children, and it is clinically significant due to the risk of permanent hair loss in the case of delayed diagnosis1. This condition is most com- monly caused by species of Trichophyton and Microsporum; Microsporum canis, transmitted by animals such as cats and dogs, is a predominant cause in Korea2. Diagnosis of the condition is primarily based on clinical findings, supported by KOH microscopy and fungal culture, where the latter allows for definitive species identification. Recent evidence indicates that dermatophyte PCR is a rapid and highly sensitive tool for the baseline diagnosis of pediatric tinea capitis, enabling early species-level identification and timely initiation of appropriate systemic therapy3.

This case demonstrates that a comprehensive diagnostic approach using microscopy, fungal culture, and PCR enables early and accurate species-level diagnosis, thereby preventing complications such as scarring alopecia.



References


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