Black Dot Type Capitis Tinea Resembles Bacterial Folliculitis

The document from December 2020 reported a case of a 50-year-old male with end stage renal disease (ESRD) who presented with itchy papules, pustules, patch alopecia, and hair loss for 6 months. The patient was initially treated with ketoconazole shampoo for 3 weeks without any improvement. Further examinations including Gram stain, culture, and Wood’s lamp showed no bacteria or fluorescence. However, Potassium hydroxide (KOH) 10% from scalp scrapings and KOH 20% from hair revealed fungal elements, leading to a diagnosis of black dot tinea capitis, a superficial fungal infection of the scalp and hair. The patient was then treated with griseofulvin tablet 500 mg twice a day for 8 weeks, cetirizine tablet 10 mg once daily, and ketoconazole shampoo 2% three times a week, which resulted in improvement in clinical features and microscopic evaluation.