Acne Keloidalis : a novel presentation of Tinea capitis

Journal 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 soft Lymphadenopathy (-) 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 corneum Potato 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 * Bacterial skin flora * Sebum * Normal fungal * Cosmetics * 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 patients disease th/ oral antifungal

Tinea was the trigger of Ag

a rare cause for AK