Case history
Case history #1
A 3-year-old boy presents with a 3-week history of a circular scalp area of hair loss and flaky skin. The scalp lesion is not itchy, but has not resolved with an antidandruff shampoo. There are no other skin lesions present. He attends daycare and is provided with a sleep mat, which is not exclusively for his use, for an afternoon nap.
Case history #2
A 15-year-old boy presents with a month-long history of itching and scaling in the groin region. Physical exam reveals hyperpigmentation of skin on both upper medial thighs and inguinal areas with scaling and secondary excoriation. There is sparing of the scrotum and penis; also noted is some maceration between the fourth and fifth toe of his right foot that causes burning and itching. He competes as a member of his school swim team.
Other presentations
A characteristic feature of dermatophyte infections is an inflammatory pattern at the edge of the skin lesion, with scaling and redness or, occasionally, blister formation. The lesions can be located, in addition to the scalp, on the trunk, face, palmar area of the hands, groin (but sparing the scrotum and penis), and the fingernails and toenails.
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