A Prospective Study on Trichoscopy as a Diagnostic and Monitoring Tool for Assessment of Therapeutic Response in Patients with Tinea Capitis

Abstract Introduction: Tinea capitis (TC) is a common scalp fungal infection, especially in children. Trichoscopy offers a quick, noninvasive way to examine hair and scalp details not visible to the naked eye. Aim: This study aims to use trichoscopy to diagnose TC, monitor treatment response, and track changes in its trichoscopic features over time. Materials and Methods: This observational, cross-sectional study was conducted from July 2023 to June 2024, involving 78 children with newly diagnosed TC. Diagnosis was confirmed by potassium hydroxide (KOH) and culture, and trichoscopic evaluation was done using a DermLite DL4. Treatment with terbinafine for black dot and griseofulvin for gray patch was adjusted by weight. Patients were monitored every 2 weeks for 8 weeks, with cure confirmed by KOH at the end. Statistical analysis was performed using SPSS. Results: The study included 78 children, with an average age of 7.14 ± 3.3 years, consisting of 34 males and 44 females (male: female ratio 1:1.27). The black dot type was most common, with Trichophyton rubrum as the primary pathogen. At baseline, trichoscopy showed comma hairs in 83.3%, black dots in 74.3%, and corkscrew hairs in 73%. Trichoscopic features improved by week 2, with most resolving by week 8, and all patients testing negative mycologically. Conclusion: Trichoscopy is an innovative, quick, and effective tool for diagnosing TC, guiding treatment, and evaluating response. The absence of dystrophic hairs suggests recovery, while persistent scaling may take longer to resolve and should not be seen as treatment failure alone.