Tinea capitis: a painful scalp lesion

Test your knowledge in our picture quiz By: Adam Duckworth, Ingrid Salvary Published: 20 January 2010 DOI: 10.1136/sbmj.b4938 Cite this as: Student BMJ 2009;17:b4938 A 9 year old girl presents to the emergency department with a painful lesion on her scalp. It was initially a small, erythematous, scaly, pruritic eruption but gradually increased in size over the previous six weeks despite several courses of antibiotics from her general practitioner. Physical examination showed a girl in good health, with a 15 cm by 15 cm extremely tender, boggy inflammatory mass on the crown of her head accompanied by localised alopecia (hair loss) and cervical lymphadenopathy (fig 1 1 ). She is apyrexial with a white cell count 16.5×10[9]/l and C reactive protein 28 mg/l.