Nodular Melanoma Presenting with Paraplegia: a Case Report

Background: Tinea capitis (TC), a fungal infection of the scalp, hair follicles and hair shafts, is common among the paediatric population especially under tropical conditions. The etiological factors vary between different regions of the world. Clinical presentation of tinea capitis varies widely from non-inflammatory to severe, painful inflammatory lesions. Aim: To look into the clinical manifestations, causative agents and the treatment pattern for tinea capitis in Penang Hospital. Methods: A retrospective study of all patients who were treated clinically for tinea capitis in Penang Hospital from January 2011 to June 2013. Results: There were a total of thirty nine patients treated for tinea capitis during this period. Tinea capitis was found to be most common in the 7-12 year age group (44%) with a male to female ratio of 2:1. Non-inflammatory type (54%) was more common then the inflammatory type. Twenty seven of them (69%) had positive fungal culture of their pluck hair roots. The most common dermatophyte detected was Microsporum canis (92%) followed by Trichophyton rubrum (4%) and Trichophyton metagraphyte (4%). Thirty-one (80%) of them were treated with griseofulvin at a dose of 10-15mg / kg /day. The rest were treated with itraconazole, terbinafine or fluconazole. All of them responded well to the treatment. In this cohort only one patient, has a second episode of infection a year later. He is a child who was concomitantly undergoing chemotherapy for acute lymphoblastic leukaemia. Conclusion: Tinea capitis is predominantly an infection of pre-adolescent children and M. canis was the most common dermatophyte isolated.