Clinical Pearl of the Month – Identify and Treat Tinea Capitis

Gerard Kiernan, MD, FAAFP, FHMClinical Pearls, Family Medicine, Internal Medicine, Nurse Practitioner, Nursing RN/PN, Pediatric Medicine, Physician Assistant

Tinea Capitis Case

A 10-Year-Old Boy with an Itchy Scalp and Patches of Hair Loss

Identify and Treat Tinea Capitis Pearls of Wisdom Q&A Case

Tinea capitis is a dermatological condition most common in children. It is caused by a fungal infection of the hair and scalp caused by dermatophyte fungi.  Let's take a look at this tinea capitis case and see if you can correctly treat it. 

Patient Case:

A 10-year-old boy presents with an itchy scalp and patches of hair loss. He has no chronic conditions and uses no medications regularly and is up to date on his immunizations. He lives with both parents, a younger sister, and the family dog. No other family members have had similar scalp issues. His parents had tried topical hydrocortisone on the patches with no effect

On examination, he has patchy alopecia with black dots in the areas of alopecia. There are erythema and moderate scale in the patches as well. He has some cervical lymphadenopathy. The remainder of the physical examination is normal. Under fluorescent light, the patches of alopecia fluoresce greenish-yellow.


Which is the most appropriate treatment for tinea capitis in this patient case?

Answer Options:

Oral terbinafine

Topical terbinafine

Topical miconazole

Oral griseofulvin

See the Answer:

About the Author:

Gerard Kiernan, MD, FAAFP, FHM is a Dartmouth-Hitchcock Clinic hospitalist in Keene, NH. He attended the University of Rochester School of Medicine and Dentistry, followed by a Family Medicine residency at the University of Wisconsin, Madison, where he was a chief resident. Dr. Kiernan is a Lean Six Sigma Greenbelt and has led hospital medicine quality improvement efforts. He is a fellow of both the American Academy of Family Physicians and the Society of Hospital Medicine. He has achieved the Recognition of Focused Practice in Hospital Medicine offered through the AAFP and ABIM via their joint examination pathway.

About Clinical Pearl of the Month:

Med-Challenger's Clinical Pearl Blog Series is a recurring segment of Med-Challenger's popular Medical Education BlogSubscribe for more free pearls of wisdom. Opt-out anytime.

About Med-Challenger:

Med-Challenger provides online medical education products and services to physicians, nurses, and other medical specialists as well as medical training programs and healthcare groups world-wide via its web-based medical education library and world-class assessment platform at

tinea capitis case

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