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Three cases of easy to be misdiagnosed tinea of vellus hair

Summary

This case report describes three patients (ages 2-24) who had skin infections caused by a fungus called Microsporum canis that initially was misdiagnosed as eczema or other simple skin conditions. The infections involved fine vellus hair and required prolonged combined treatment with both oral and topical antifungal medications to fully resolve. The key lesson is that proper fungal testing and extended treatment similar to scalp ringworm protocols are necessary for treating these easily-missed infections.

Background

Tinea of vellus hair is caused by dermatophyte infection of fine hair, with fungal microscopy revealing mycelium and/or spores inside and outside the hair. Different dermatophytes cause different types of lesions, leading to underdiagnosis or misdiagnosis in clinical practice.

Objective

To report three cases of tinea of vellus hair caused by Microsporum canis that were initially misdiagnosed as tinea simplex or eczema, highlighting the importance of proper diagnostic methods and treatment protocols.

Results

Case 1: 24-year-old male with bilateral upper extremity erythema showed normal skin after 9 weeks of combined oral and topical treatment. Case 2: 5-year-old female with nasal rash completely resolved after 6 weeks of treatment. Case 3: 2-year-old male with facial rash showed improvement after 2 weeks of treatment and remained under follow-up.

Conclusion

Tinea of vellus hair requires combination therapy with both oral and topical antifungal medications for extended treatment periods. The diagnosis should be confirmed with dermatoscopy and fungal culture, and treatment protocols similar to tinea capitis are recommended due to persistent fungal elements within hair.
  • Published in:Medical Mycology,
  • Study Type:Case Report,
  • Source: 10.1093/mmy/myac072.P229, PMC9515941
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