Symptoms of tinea capitis can vary significantly depending on the fungal species involved, the type of hair invasion, and the host’s inflammatory response. Common symptoms include:
Non-inflammatory Variants:
Gray Patch: Fine scaling of the scalp and patches of alopecia (hair loss) that appear gray due to spores coating the affected hairs. Erythema (redness) is usually minimal with anthropophilic species but can be marked with zoophilic or geophilic species.
Black Dot: Fine scaling with patches of alopecia, characterized by black dots where the hair shafts have broken off.
Diffuse Scale: Resembles generalized dandruff; alopecia is subtle or absent.
Inflammatory Variants:
- Diffuse Pustular: Patchy alopecia with associated pustules or folliculitis. Secondary infection with bacteria or other fungi may occur.
- Kerion:A severe inflammatory reaction resulting from a delayed immune response to the fungus. This manifests as a painful, erythematous, boggy plaque with associated alopecia and scattered pustules. It is usually caused by a zoophilic species and may result in permanent alopecia.
- Favus: A chronic inflammatory infection characterized by matted hair and the formation of yellow, crusted cup-shaped lesions (scutula) around the base of the hairs. Scutula contain hyphae and keratin debris and may coalesce to form a large mass.
