Kerion

Excerpt

A 6-y-old boy in good health presented with a single, mildly painful, pus-filled lump over the scalp, for 2 mo. Past treatments included multiple oral antibiotics and topical antibiotic-corticosteroid creams, without improvement. Cutaneous examination revealed a large 3 × 4 cm sized tender erythematous boggy swelling over the frontal scalp with significant loss of hair and yellowish-brown to hemorrhagic crusts (Fig. 1). Removal of crusts revealed seropurulent discharge. Nails and mucosae were normal. Pre-auricular lymph nodes were enlarged but non-tender. A 10% KOH preparation from lesional hair follicles showed fungal hyphae and fungal culture confirmed Trichophyton verrucosum as the cause. Bacterial culture yielded growth of Staphylococcus epidermidis. A diagnosis of Kerion was made. Treatment with oral terbinafine 125 mg daily for 4 wk and prednisolone 0.5 mg/kg/d for 2 wk resulted in marked improvement with some regrowth of hairs (Fig. 2).

…