The Role Of Dermoscopy In The Diagnosis And Treatment Of Tinea Capitis

Objective: Observing the dermoscopic features and changes of tinea capitis before and after treatment is to evaluate the role of dermoscopy in the diagnosis and treatment.Methods: We collected clinical data of tinea capitis in the Affiliated Hospital of North Sichuan Medical College from 2015.6 to 2016.1. Clinical images of each lesion were taken by digital camera. Dermoscopic images of each lesion were shot with digital dermoscopic system. In 8 weeks, all the patients were followed up with dermoscopy once every 2 weeks, and we also observe the variation each time. The frequency of each pattern was analyzed statistically with SPSS17.0.Results: 1. The results showed that the incidence of tinea capitis between male and female is 1.7:1. The average onset age is 6 years old, most of the patients(48.8%) are preschool children. Data showed 27(65.9%)cases of white ringworm, 5(12.2%) cases of black-dot ringworm, 9(22.0%) cases of kerion. The Positive rate of fungus microscope examination is 85.4%, The Positive rate of culture is 87.8%. 2. Dermoscopic features’ incidence of tinea capitis before treatment arranging from high to low are broken hairs(97.6%),black dots(95.1), sugarcane hairs(63.4%), hook hairs(51.2%), zigzag hairs(26.8%), pustule(22.0%), comma hairs(14.6%), corkscrew hairs(9.8%). 3. We have found sugarcane hairs, zigzag hairs in white ringworm; comma hairs, corkscrew hairs, and zigzag hairs in black-dot ringworm; sugarcane hairs, comma hairs and zigzag hairs in kerion. 4. The fungus microscope examination find out hyphae have a positive correlation relationship with Sugarcane hairs(r= 0.327, P < 0.05). The fungus microscope examination find out hyphae have a negative correlation relationship with comma hairs(r=–0.518,P<0.05). The fungus microscope examination findout hyphae had negative correlation relationship with corkscrew hairs(r=–0.411,P<0.05). Correlation relationship between other dermoscopic features and microscope examination results has no statistical significance(P > 0.05). 5. All the dermoscopic features declined after treatment. The fungus microscope examination turns negative when the dermoscopic features disappear.Conclusion: 1.We can make diagnosis of tinea capitis by dermoscopy. Sugarcane hairs, comma hairs, corkscrew hairs and zigzag hairs are characteristic dermoscopic features of tinea capitis. Sugarcane hairs, zigzag hairs can be seen in white ringworm. Comma hairs, corkscrew hairs and zigzag hairs can be seen in black-dot ringworm. Sugarcane hairs, comma hairs and zigzag hairs can be seen in kerion. 2. Under the guidance of dermoscopy to select sample, positive rate of microscope examination can be improved. 3. Dermoscopy can facilitate the observation of curative effection, which is more convenient than fungus microscope examination and culture.