Grey-Patch-Tinea B35.0

Grey-patch tinea (also tinea capitis of the grey-patch type) is a special, only slightly inflammatory clinical form of scalp dermatophytosis(microsporia). In this form of tinea, the hairs break off just above the scalp surface, resulting in a "stubble field" type appearance. Circumscribed foci of alopecia with a gray, scaly skin surface are the primary manifestation.

Typically caused by ectothrix dermatophytes (the fungal spores are located on the outside of the hair shaft - ectothrix), especially:

• Microsporum canis (zoophilic pathogen, most common pathogen in Europe), inflammatory component
• In anthrophilic pathogens such as Microsporum audouinii, T violaceum and M.ferrugineum, hardly inflammatory.

Especially for children.

Characteristic:

• round or oval hairless areas
• gray, fine scaling ("asbestos-like")
• broken hairs a few millimeters above the scalp
• hardly any inflammation
• no pain, no itching or only slight itching

The affected area appears "ashen", hence the name "gray patch".

Wood light: apple-green fluorescence in Microsporum infections

(classic for gray-patch tinea)

Light microscopic findings:

• Fungal spores surround the outside of the hair shaft
• Destruction of the hair cuticle
• Hair breakage just above the scalp

S.under microsporia:

systemically necessary (e.g. griseofulvin, terbinafine - depending on age)

additionally antifungal shampoos (e.g. ketoconazole)

1. Leung AKC et al. (2020) Tinea Capitis: An Updated Review. Recent Pat Inflamm Allergy Drug Discov 14:58-68.