Alireza Firooz, Azin Ayatollahi, Farnaz Valizade, Mansour Nassiri Kashani, Zaghrabeigom Moosavi, Mahsa Fattahi,
Volume 13, Issue 2 (8-2022)
Abstract
Background: Tinea capitis is the term used for scalp infections caused by dermatophyte fungi. Tinea capitis is common in children and is less common in adults.
Case Report: The case was a 9-year-old girl with itchy patches of alopecia on the. The patient had a cat as a pet. On examination, the patch of hair loss was itchy and the hair shaft was broken and scales were mild. In the examination with Wood's lamp and direct microscopic examination, the ectothrix infection was deagnised. According to the dermatologist's opinion, a terbinafine 50 mg was prescribed daily. However, no significant improvement was observed despite 4 weeks of terbinafine. As a result, the dose of terbinafine treatment was changed from 50 mg to 250 mg per day. After 6 weeks of treatment, the clinical manifestations of the patient improved significantly.
Conclusion: After ringworm is confirmed microscopically, choosing the most appropriate antifungal treatment depends on determining the fungal species by culture. Therefore, when choosing empiric antifungal agent therapy, a dose of 250 mg terbinafine may be a good choice for children.
Mahsa Fattahi,
Volume 16, Issue 3 (11-2025)
Abstract
Background: Chronic granulomatous disease (CGD) is a rare primary immunodeficiency caused by defects in the NADPH oxidase complex, predisposing patients to severe bacterial and fungal infections. Dermatophytosis with severe inflammatory presentations such as tinea capitis is uncommon but challenging to manage in these patients.
Case presentation: We report a 9-year-old Iranian girl with autosomal recessive CGD who presented with refractory inflammatory scalp lesions. Mycological examination confirmed tinea capitis caused by Microsporum canis. Antifungal susceptibility testing showed reduced susceptibility to itraconazole, while susceptibility to terbinafine and fluconazole was preserved. Due to limited access to terbinafine, the patient received alternative management including antibacterial and anti-tuberculosis therapy, leading to clinical improvement.
Conclusion: This case highlights the diagnostic and therapeutic challenges of dermatophytosis in CGD patients and emphasizes the importance of accurate mycological diagnosis, antifungal susceptibility testing, and individualized multidisciplinary management, particularly in resource-limited settings.
