When Faced with the Eyebrows’ Density Depletion within Children, do not Hesitate to use the Dermoscope

Image Article

Tinea Capitis are frequent dermatophytes affecting mainly children. They are mainly found on the scalp, their localization on the eyebrows remains. Trichoscopy finds its place in the clinical diagnosis and follow-up of Tinea Capitis [1]. We demonstrate through an original case of trichophytic Tinea Capitis of the eyebrows the usefulness of trichoscopy in the diagnostic rectification.

This case concerns an 8-year-old child, followed for spinulosic psoriasis under topical dermocorticoids, in whom a rarefaction of the density of the head of the eyebrows was noticed during his routine consultation, which was mistakenly taken by the mother as being an eyebrow involvement of his psoriasis. Dermatological examination found partial depilation of the heads of both eyebrows without the presence of crusts or scales (Figure 1). The traction sign was positive. In addition, the patient did not report any functional signs, especially no itching. Trichoscopic examination revealed short broken hairs, corkscrew hairs, zigzag hairs, comma hairs and @ hairs (Figure 2). These different dermosocpic aspects made us evoke a Tinea Capitis of the eyebrows in the child. Mycological sampling confirmed the diagnosis with the presence of trichophyton. The child was treated with oral griseofulvin 20mg/Kg/day for 6 weeks with good improvement. In fact, the trichoscopic signs of Tinea Capitis have completely regressed (Figure 3).

The eyebrow location of Tinea Capitis seems to be exceptional, even in children, and can be confused with other hair diseases. Trichoscopy is a good tool for the clinical diagnosis of ringworm, helping the clinician to speed up the therapeutic management. Trichoscopy is considered positive when at least one specific sign is found on at least 2 hairs Image Article [2]. Among those described in the literature are: comma hair, corkscrew hair, zigzag hair, morse hair, whitish sheath. Mycological confirmation is mandatory before starting an oral antimycotic treatment [2, 3].

Click to enlarge

Click to enlarge

Click to enlarge

Consent

The examination of the patient was conducted according to the principles of the Declaration of Helsinki. The authors certify that they have obtained all appropriate patient consent forms, in which the patients gave their consent for images and other clinical information to be included in the journal. The patients understand that their names and initials will not be published and due effort will be made to conceal their identity, but that anonymity cannot be guaranteed.