Tinea Capitis Kerion

Tinea capitis otherwise known as scalp ringworm is a dermatophyte infection of the scalp. With certain dermatophyte infections like Tinea Capitis kerions are occasionally formed.  A kerion is a large, boggy, inflammatory scalp mass caused by a severe inflammatory reaction to the dermatophyte. A kerion may have pustules and crusting and can be mistaken for an abscess. A kerion may also cause scarring and hair loss.

Tinea capitis symptoms and signs vary by the area affected for example the skin, hair, nails etc.  Organism virulence and host susceptibility and hypersensitivity determine severity.  Most often, there is little or no inflammation; asymptomatic or mildly itching lesions with a scaling, slightly raised border fade and recur sporadically. Occasionally, inflammation is more severe and shows up as sudden vesicular or bullous disease. This is normally of the foot. It may also occur as an inflamed boggy lesion of the scalp called a kerion.

Tinea capitis causes the gradual appearance of round patches of dry scale, alopecia, or both. T. tonsurans infection causes what is called black dot ringworm.  With this infection the hair shafts break at the scalp surface.  M. audouinii infection causes patch ringworm.  The hair shafts break above the surface, leaving short stubs with this particular type of infection. Tinea capitis is less likely to appear as drawn out scaling, like dandruff, or in a spreading pustular patte

What is the most probable explanation for the higher occurrence of Tinea Capitis in the African-American population is that the higher prevalence is more likely due to infection and re-infection within families, communities, and schools. Ringworm of the scalp is most commonly caused by the fungus Trichophyton tonsurans.  Trichophyton tonsurans is the most common cause in the US, followed by Microsporum canis and M. audouinii. This fungus is easily passed from one person to another. It is also the cause of more than 90 out of every 100 cases of ringworm of the scalp found in both North and Central America.

Children are far more susceptible to the fungal infection and more likely than adults to develop a tinea capitis infection.  It is not unheard of that even after exposure to fungi causing ringworm adults do not develop an infection.   Adults can be carriers for ringworm, as well as children, but is less likely that the children carry the infection but show no symptoms.  Carriers can pass ringworm on to others but do not have symptoms of the disease.