Trichoscopic Features of Tinea Capitis in Iraqi Pediatric Patients: A Cross-Sectional Observational Study
DOI:
https://doi.org/10.66344/jpad.v36i3.3509Keywords:
Tinea capitis, Dermoscopy, Alopecia, Pediatric dermatologyAbstract
Background Tinea capitis (TC) is a common pediatric dermatophyte infection. Trichoscopy serves as a rapid, non-invasive alternative diagnostic tool, yet data correlating specific trichoscopic patterns with distinct clinical variants in the Middle Eastern population are scarce.
Objective To evaluate the trichoscopic features of TC in an Iraqi pediatric cohort and to correlate these findings with clinical variants.
Methods This observational cross-sectional study included 100 pediatric patients with clinically suspected TC and positive 10% potassium hydroxide mounts. Trichoscopic evaluation was performed using polarized and non-polarized dermoscopy (Dermlite DL4).
Results Grey patch was the most common variant (61%), followed by kerion (18%), pustular (13%), and black dot (8%). The most frequent overall trichoscopic findings were perifollicular scaling (94%) and broken hairs (94%). Perifollicular scaling differed across variants (P=0.012), most frequent in black dots (100%) and grey patch (98.4%). Black dots variant was associated with black dots, comma hairs, and corkscrew hairs (P<0.001, P=0.010, P<0.001). Kerion was associated with erythema and hemorrhagic crusts (both P<0.001) and the pustular variant was linked to follicular pustules (P<0.001). Additionally, loss of follicular ostia was observed in 20% of cases, predominantly within the inflammatory variants.
Conclusion Trichoscopy demonstrates distinct patterns corresponding to different clinical variants of TC. A diagnosis can be reliably supported by identifying a combination of perifollicular scaling with any form of dystrophic or broken hair. We advocate for routine integration of trichoscopy in the initial evaluation of pediatric hair loss to expedite diagnosis and guide management.
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