title: The kerion: an angry tinea capitis.
abstract: Tinea capitis has a high incidence with a global changing pathogen distribution, making this condition a public health concern around the world. As the infection is initially asymptomatic, it is easily spread. Moreover, it is present in many fomites, including hairbrushes, pillows, and bedding. Prompt recognition and treatment is necessary for kerion, an inflammatory subtype characterized by tender boggy plaques with purulent drainage. Kerion is usually associated with infection by zoophilic dermatophytes, although other sources have been described. Treatment for this severe form of dermatophytic infection can be challenging. In addition to the use of topical treatments, oral administration of griseofulvin, terbinafine, itraconazole, or fluconazole is often required. Griseofulvin, the first-line treatment, may not completely eradicate pathogen colonization of the host and may contribute to reinfection and prevalence of infective but asymptomatic carriers. This review highlights new agents that are being evaluated for the treatment of kerion and typical tinea capitis, enhanced diagnostic criteria, and a grading system for kerion evaluation.
authors.affiliation: Dermatology, Pathology, Pediatrics, and Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: John
authors.affiliation: Dermatology, Pathology, Pediatrics, and Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA.|Rutgers University School of Public Affairs and Administration, Newark, NJ, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schwartz
authors.affiliation: Dermatology, Pathology, Pediatrics, and Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA.
authors.forename: Camila K
authors.initials: CK
authors.lastname: Janniger
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D006801:Humans; D014006:Tinea Capitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000935:Antifungal Agents