Favus B35.0

The term "favus" can already be found in Celsus. It is unclear whether this term refers to favus in the modern sense. According to M. Kaposi, the first reference to the contagious nature of the disease was made by the French dermatologist Mahon in 1829. It was not until 1839 that Schönlein's discovery clarified the fungal nature of the disease).

Rare special form of tinea capitis, with highly chronic inflammation of the scalp leading to scarring alopecia ( pseudopéladesis) with formation of characteristic shield-shaped, mycelium-containing crusts (scutula). Scutulae are present in around 95% of those affected.

Trichophyton schoenleinii, a fungus belonging to the dermatophytes. Transmission from person to person, low contact.

Favus is very rare in Central Europe and is occasionally introduced by people from endemic areas (China, Nigeria, Russia).

Occurs mainly in infants and young children. The peak incidence is in children between the ages of 6 and 10. Poor hygienic conditions and tight-fitting headgear promote infection. The duration of the disease is 6-10 years if untreated. With increasing age, the susceptibility of the skin to the favus decreases. Adults rarely become infected. The disease can last a lifetime.

Erythema initially covered with fine grayish-white scales, yellowish crusts develop in the hair follicles as the fungal colonies expand. Enlargement to the so-called scutulae (= bowl-shaped, 0.5 to 2.0 mm large, partially confluent yellow crusts, which are pierced in the center by 1 or 2 hairs) also known as favuscutulae. Exudation, impetiginization, penetrating smell of "mouse urine". This process leads to destruction of the hairs, which slowly fade and are destroyed (follicular scarring). The foci fluoresce gray-green in Wood light. After healing, scarring alopecia with individual tufts of hair in the atrophic areas (favus alopecia). Mandatory reporting!

In rarer cases, clinical pictures reminiscent of tinea amiantacea develop (Anane S et al. 2012).

1. Anane S et al (2012) Tinea capitis favosa misdiagnosed as tinea amiantacea. Med Mycol Case Rep 2:29-31.

2. Kaposi M (1976) Favus . In Virchow R (ed) Handburch der speciellen Pathologie und Therapie. Publisher F. Enke, Stuttgart pp.592-593.

3. Niczyporuk W et al (2004) Tinea capitis favosa in Poland. Mycoses 47:257-260.
4. Poppe H et al. (2013) Pitfall scarring alopecia: favus closely mimicking lichen planus. Mycoses 56:382-384.