We read with interest the article by Hubbard.1 We agree that lymphadenopathy is a useful clinical clue in diagnosing tinea capitis in patients with alopecia, pruritus, and scale and have emphasized the importance of such an evaluation in our teaching program for years. Hubbard's recommendation that empiric therapy be instituted in highly suspicious cases also seems reasonable and is also common practice at our institution. However, we do not agree with the suggestion by both Hubbard and Dr DeAngelis in her editorial comment that evaluating culture findings of such cases may be omitted. We believe that the design of Hubbard's study does not allow such a generalization to the pediatric population, and flaws in the study unfortunately weaken the validity of such a conclusion.
Fallon Friedlander S, Williams JV, Cunningham BB, Eichenfield LF. The Case for Not Omitting Evaluation of Culture Findings for Diagnosing Tinea Capitis. Arch Pediatr Adolesc Med. 2000;154(6):637-638. doi: