Wednesday, June 16

1st medical dilemma

which is which?*

Tinea capitis grey patch vs localized Alopecia areata are my first medical dilemma.The medical crossroad to consider which is which.It needs high level of understanding of both diseases.As both look the same, a patch of hairless and circumscribe lesion. 

It confused me a little, because the initial lesion is almost the same and the exclamation site is very hard and almost impossible to find.Also the diagnostic scales of the tinea capitis often get wash away by shampoo (mothers always clean her offspring before seeing a dermatologist).

Without the characteristic scales, patch of tinea capitis will look like patch of alopecia areata!.The solution is, tell the mother to come back or re-inspection after 3 days and tell her also do not wash her offspring hair.

Then the sign and scales of tinea capitis will return the diagnosis is surely tinea capitis and if it does not return, it is the same like before then the diagnosis will be alopecia areata.

Albeit that this is only a dermatological case, a misdiagnosis will be an eternal error because the treatment of both disease are totally contraindicated to each other.As for tinea is antifungal and for alopecia is corticosteroid.

Corticosteroid treatment in tinea capitis will flare the infection causing diffuse tinea capitis.My lecture advice is "Do not jump into a diagnosis like you jump from a bus here in egypt, but slowly arrive at the station and take all the steps necessary then after that you'll arrive at the diagnosis in no time at all".

thank you Dr!,
*Alpecia right and tinea capitis left

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