Importance of dermoscopy in diagnosis of tinea capitis: An evidence-based case report

Abstract

Diagnosis of tinea capitis requires direct microscopy with potassium hydroxide (KOH) staining and culture examination as the gold standard. Dermoscopy for the diagnosis of tinea capitis needs to be appraised through evidence-based case report method. A 22 years old woman came with systemic lupus erythematosus which was treated with methylprednisolone and azathioprine for a year. She had wide patchy alopecia, dry scaling, dull gray hair and minimal inflammation. KOH 20% showed septate hyphae and spores surrounding her hair shafts. Dermoscopy examination showed “comma hairs”, “corkscrew”, “perifollicular scaling” and “broken hairs”. Three articles from Pubmed and Gale fulfilled the inclusion and exclusion criteria. Articles were critically appraised and concluded that comma hairs sensitivity rate varies between 60-66% and specificity of 100%, while corkscrew had sensitivity rate varies 20-80% and specificity of 83-100%. Combination of dermoscopy with clinical performance and direct microscopic examinations amplify definitive diagnosis. Further investigations are needed to validate the role of dermoscopy as a diagnostic tool per se for tinea capitis.