Ringworm is an infectious disease caused by a wide range of
parasitic fungal elements which localize and proliferate at different
levels of the body: scalp, nails, hands, feet, crotch and armpits. When
the fungal infections characteristic to ringworm are localized in the
region of the scalp, the disease is referred to as ringworm of the
scalp. Ringworm of the scalp is a very common type of ringworm among
children, predominantly affecting the very young. However, in rare cases
ringworm of the scalp can also be acquired by people belonging to other
categories of age.
Ringworm of the scalp comprises three
subtypes, each of them having distinctive features and requiring
specific medical intervention. The most common form of ringworm of the
scalp is responsible for causing more than 95 percent of the overall
reported annual cases of ringworm. This type of ringworm of the scalp
generally occurs in very young children, disappearing before the age of
puberty even in the absence of the specific medical treatment. Being
very contagious, this form of ringworm of the scalp is easily
transmissible from one individual to another. Due to this fact, the
affected persons should avoid entering in contact with other people
until the disease is appropriately cured. Afflicted children should be
instructed by their parents to restrict from physical contact with their
playmates, teachers and other people they normally interact with. Under
special circumstances, the young patients may even require to remain
indoors until the disease ameliorates and loses its infectious
character.
This common type of ringworm of the scalp is highly
resistant to regular treatments, rarely being successfully cured with
local antifungal medications. At first, the disease is manifested
through the occurrence of multiple patches with diameters of
approximately 1 cm. As the infectious progresses, the patches begin to
grow in size, eventually involving the entire surface of the scalp.
Also, the patches characteristic to this type of ringworm have a grayish
aspect, mostly due to scaling of the superficial layers of the scalp.
The affected patients rarely present symptoms such as irritation,
itching and inflammation of the scalp, the disease triggering no other
noticeable physical manifestations. However, this form of ringworm may
sometimes lead to atrophy of the hair, causing visible damage to the
hair follicles found on the affected regions of the scalp. Thus,
temporary baldness can also be considered a symptom characteristic to
this very common form of ringworm of the scalp.
The second type of
ringworm of the scalp is referred to as kerion. This form of fungal
infection is very different from the previously described type of
ringworm, producing soft, moist excrescences at the superficial level of
the scalp. Despite the fact that kerion is commonly diagnosed in
children, the disease can also occur in adults. This type of ringworm of
the scalp is rare, being responsible for causing less than 3 percent of
all ringworm of the scalp cases. Although kerion is not considered to
be highly contagious, the afflicted persons should avoid entering in
contact with other people until the disease becomes non-infectious.
Kerion is manifested through the following symptoms: the occurrence of
various swellings (soft prominences that are filled with fluid),
tenderness and inflammation of the scalp, inflammation of the lymph
nodes.
Similar to the previously described type of ringworm,
kerion also involves deterioration of the hair. In the affected regions
of the scalp, the hairs become very fragile and may eventually detach
from their follicles. Kerion often involves temporary or permanent
baldness associated with scarring. However, this type of ringworm of the
scalp is easier to treat, most patients responding well to local
treatments with antifungal creams, ointments and lotions. Even in the
absence of treatment, kerion generally clears up in 3-4 weeks, depending
on the seriousness of the infection.
The third and last type is
also a very rare form of ringworm of the scalp. Although it is not
considered to be very serious, the disease is responsible for causing
few noticeable symptoms, thus being more difficult to detect during
medical examinations. This form of ringworm of the scalp causes the
occurrence of tiny black spots which are sometimes spread over the
entire surface of the scalp. The infection causes no inflammation or
redness, and it rarely involves deterioration of the hair or scarring.
This type of ringworm of the scalp is considered to be contagious and
thus temporary isolation is recommended to all affected patients.
However, the disorder can be easily overcome with local treatments
consisting of specific antifungal agents. With appropriate treatment,
this form of ringworm can be completely cured in several weeks or less.