Abstract

Kerion celsi is generally known as an inflammatory form of tinea capitis and is the result of delayed type hypersensitivity reaction of the body to fungal agents. It causes a painful, inflamed, crusty mass on the scalp and is often associated with purulent drainage and regional lymphadenopathy. Kerion celsi is often reported in children between three to seven years of age and has a male predominance. This diagnosis should be kept in mind in patients with scalp scaling and alopecia, especially if they have pustular, crusted and nodular lesions and easily breaking hairs on the scalp. If untreated, alopecic scar tissue formation can develop on the scalp. Differential diagnosis with bacterial pyoderma or abscess is important and may avoid unnecessary and inappropriate surgical drainage. Although causative species show variations between regions, zoophilic dermatophytes such as Microsporum canis, Trichophyton verrucosum and Trichophyton interdigitale complex are usually isolated. Herein, we report a ten year-old boy who was referred to our clinic because of pyodermic skin lesion and abscess formation which did not respond to antibacterial treatment. He was diagnosed as kerion celsi related to Trichosporon asteroides and successfully treated with systemic fluconazole within eight weeks. To our knowledge this is the first case in the literature due to T. asteroides.