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May 1989

Picture of the Month

Am J Dis Child. 1989;143(5):621-622. doi:10.1001/archpedi.1989.02150170123038

The statements listed below are best associated with which of the above figures:

  • "Black dot" hairs appear with this infection.

  • Exclamation mark-shaped hairs help identify this condition

  • Patients with this group of disorders have a complete and permanent absence of hair.

Denouement and Discussion  (a) Trichophyton tonsurans, an endothrix anthrophilic organism, is currently the most common dermatophyte infection causing tinea capitis in children. Occurring most frequently in black children, and equally distributed between males and females, the clinical manifestations of a T tonsurans infection are (1) seborrheic or dandrufflike dermatitis; (2) patchy or diffuse alopecia with or without "black dot" hairs (Fig 2); and/or (3) a kerion (a boggy, tender, edematous mass studded with suppurative, perifollicular pustules and nodules), which may be accompanied by fever, malaise, lymphadenopathy, leukocytosis, and a generalized id reaction or morbilliform rash. The black dot hairs are the remnant hair stubs that have

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