Chapter 30: Tinea Capitus (Ringworm) In Children

Question 1

Tinea Capitus

Answer 1

Fungal Infection

• affects the scalp
• characterized by scaly, pruritic (itchy) patches
• can be associated with breakage of the hair
• seen in ages between 1 and 10 years

Question 2

How is Tinea Capitus Spread?

Answer 2

• person to person
• animal to person
• inanimate objects such as clothing, furniture, or bed linen of another infected person

Question 3

Signs and Symptoms

Answer 3

• pruritic (itchy) rash with round, scaly, pink to red lesions, often with central clearing, creating a circular lesion
• on the head, hair loss may occur in the area of the rash

Question 4

Diagnosis

Answer 4

• visual inspection using a Wood’s lamp that discloses yellowish gold fluorescent coloration
• a potassium hydroxide preparation of scrapings, demonstrating groups of thick-walled spores and myriad short thick angular hyphae resembling sphagetti

Question 5

Prevention

Answer 5

• have family pets checked if they experience areas of fur loss, excessive itching, or self-grooming
• encourage good hand washing
• have children and adolescence in sports activities bathe as soon as they are home from practice or games to remove fungal spores that may be on the skin
• do not share fomites (objects that can carry infection) like bath and hand towels, combs and brushes, hats, helmets, and intimate apparel

Question 6

Nursing Care

Answer 6

• everyone in the family needs to be treated
• do not share brushes or bath towels
• the affected area of hair growth may take 6 to 12 months to grow or may not grow back at all
• provide emotional support and suggest hairstyles to help conceal tinea capitis

Question 7

Medical Care

Answer 7

antifungal medications
-griseofulvin (Fulvicin or Grisactin); oral
-fluconazole (Diflucan); oral or topical shampoo
-miconazole (Monistat); buccal tablet or topical
-terbinafine (Lamisil); oral or topical
>treatment usually in the form of skin creams, lotions, or ointments
>widespread, or affects hair or nails, oral form is prescribed
-must be taken for at least 6 weeks to be effective

Question 8

Education/ Discharge

Answer 8

• checked periodically throughout treatment to be sure a proper response is noted
• stress importance of completing the recommended treatment even after lesions appear to be cleared

Question 9

Safety Alert when using Griseofulvin

Answer 9

baseline liver enzymes are evaluated and rechecked every 6 weeks
-alternate treatment if abnormal