griseofulvin and Cellulitis

Tinea capitis is a common scalp dermatosis with several clinical patterns. Only two patients with a presentation of tinea capitis mimicking dissecting cellulitis have been described in the English literature.. We report a patient with tinea capitis mimicking dissecting cellulitis who did not respond to griseofulvin therapy at 16 mg/kg/day but eventually cleared after a protracted course of higher dose griseofulvin.. recognition of a dissecting cellulitis-like pattern of tinea capitis will increase clinical suspicion and avoid inappropriate management of a recalcitrant "dissecting cellulitis" in favor of prompt antifungal therapy of appropriate dosage and duration for patients with this unusual variant of tinea capitis.

Topics: Antifungal Agents; Cellulitis; Child; Diagnosis, Differential; Griseofulvin; Humans; Male; Tinea Capitis

A 4-year-old girl had redness and swelling of the left upper eyelid of 1 week's duration. She had been treated with topical fusidic add and oral flucloxacillin without resolution. Ophthalmic examination showed a diffuse, erythematous, tender lesion affecting the entire upper eyelid. There was a central area of skin ulceration with marked bleeding and discharge. Also found were small vesicles under the left eyebrow. The child's mother had noticed a scaly rash on her own forearm. Examination under anesthesia was carried out to assess the globe and to obtain samples for microbiology investigation. Microbiology scrapings showed fungal hyphae of the Dermatophyte group. Treatment with Griseofulvin was commenced, and complete resolution of the lesion occurred. To our knowledge there is only one similar case reported in the literature describing ring-worm as a cause of preseptal cellulitis. This case highlights the importance of considering alternative diagnoses when standard antibiotic treatment has failed.

Topics: Antifungal Agents; Cellulitis; Child, Preschool; Diagnosis, Differential; Eye Infections, Fungal; Female; Griseofulvin; Humans; Tinea