Corkscrew Hair: A New Dermoscopic Sign for Diagnosis of Tinea Capitis in Black Children

T inea capitis (TC) is the most common dermatophytosis of childhood and has an increasing incidence worldwide. The presence of Microsporum canis, the most prevalent causative organism in Europe, is usually easy to diagnose: it classically presents with a patch of alopecia, a scaly plaque, and a positive finding under Wood lamp examination. An increase in anthropophilic organisms is widely reported, mostly among immigrant populations and associated with a noninflammatory TC, which may present with little alopecia or scale and a negative finding under Wood lamp examination. Diagnosis in black patients, where subtle erythema of the scalp is more difficult to appreciate, often presents a diagnostic challenge. The absence of a rapid, reliable, confirmatory test, coupled with a nonspecific presentation, means that patients often wait several weeks for a fungal culture result before commencing appropriate systemic therapy. Slowinska et al have described dermoscopic findings in 2 white children with Microsporum canis. Herein, we report the dermoscopic features of TC among black children, a potentially diagnostically challenging population, in an attempt to identify specific patterns that may be used for a rapid and reliable diagnosis.