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Acne Keloidalis :
a novel presentation
ofTinea capitisJournal American Academy of Dermatology
Vol. 56 No. 4 April 2007
CASE REPORT
• A 60 y.o African American men with a 3 y history of enlarging papules & nodules on the vertex & posterior
surface of her scalp PE : the small papules were firm &
the larger nodules were softLymphadenopathy (-)History of acne & hirsutism (-)
• History of acne & hirsutism (-)• Medical history : NIDDM, choles
& hypertension• Unsuccessfully th/ : oral
Cephalexin,intralesionaltriamsinalon, topical cortikosteroids
• A biopsy of 3 protuberant papules :a mixed inflammatory infiltrate Fibrosis surrounded the hair shafts
• PAS stain : 1 biopsy specimen clusters of spores within a hair shaft &hyphae in the stratum corneumPotato dextrose agar isolated :Trichophyton tonsurans (+)Micros : teardrop shaped microconidia,septated hyphae
• Th/ Griseofulvin tab 500 microsized,complete resolution after 2 m
DISCUSSION
• < puberty / > 50 y.o is extremly rare• In late AK, a granolomatous
inflammation typically occurs & eventual fibrosis
• The cause of AK is unknown :* tight collared shirts* football helmets not proven* hygiene practices etiologies* habitual picking
Intrafollicular Ag : * Demodex * Normal fungal * Bacterial skin flora * Cosmetics * Sebum * Desquamated keratinocytes
Chronic Inflammatory &
Degenerating epithelial components
CONCLUSSION• Our patient presented with a rare
clinical manifestation of Tinea capitis
spores hyphae fungal culture
chronicity of the patient’s diseaseth/ oral antifungal
Tinea was the trigger of Ag
a rare cause for AK