A prospective clinical and trichoscopic study of tinea capitis in children during treatment.

Tinea capitis (TC) is the most common dermatophyte infection in children. Fungal culture; although a gold standard of diagnosis, requires time for the final results which can favor horizontal transmission. Trichoscopy helps in rapid diagnosis and could work as a monitoring tool during antifungal therapy. The objective of this study is to provide a clinico-trichoscopic evaluation and follow-up of children presenting with TC during treatment with either griseofulvin or terbinafine. One hundred and twenty children clinically diagnosed with TC confirmed by potassium hydroxide microscopy, were divided into two groups and given either oral ultramicrosize griseofulvin (60, Group A) or terbinafine (60, Group B). Following initiation of the antifungal therapy, trichoscopic features within Groups A and B were noted at 0, 2, 4, 6, and 8 weeks. However, variation in the baseline trichoscopic features between the two groups was not statistically significant (p = 0.855). A significant reduction of corkscrew and broken hairs as well as perifollicular scales, scalp erythema, and crust was significantly observed from 2 weeks onward irrespective of the antifungal drug prescribed. Despite the paucity of data evaluating trichoscopic features in patients with TC, this tool can serve as a rapid diagnostic and monitoring tool during antifungal treatment. Trichoscopic signs of TC resolution occur before clinical improvement and can guide for treatment adjustment during the course of therapy.