Family medical history is significant for eczema and asthma in the mother. The patient has no significant past medical history, but did have "cradle cap" when he was an infant. The patient has also developed a small area of hair loss which the mother feels is related to the patient scratching. The patient denies pain, but reports that his scalp is itchy at night. She reports that for the past week the son has had, “white flakes,” in his hair despite daily baths. Which of the following is the best initial diagnostic test?Ī mother arrives to your clinic with her 5-year-old son afraid that he caught lice from a recent preschool outbreak. Physical exam is negative except for scalp findings shown in Figure A. Vital signs include a temperature of 99☏ (37☌), blood pressure of 122/76 mmHg, a pulse of 88/min, and an oxygen saturation of 99% on room air. The patient reports fatigue, but denies headache, shortness of breath, chest pain, polyuria, hematuria, or other rashes. The patient's past medical history is significant for bipolar I disorder, for which she takes lithium, and acne, for which she uses topical salicylic acid. She admits to feeling tired lately and gained 5 lbs in the last 2 months, but admits she has been staying up late to study for exams. She has begun ritualistically and repetitively combing her to the left 3 times every time she feels any "flakes." The patient reports that in the past she chemically treated her hair, but stopped when she noticed the scalp scaling had developed into an area of balding. Her symptoms then developed into a scaling patch at the top of her head.
#TINEA CAPITIS SCALP OTC SKIN#
Staphylococcal Scalded Skin Syndrome (SSSS)Ī 21-year-old female is being evaluated for worsening "flaky scalp." She does not remember exactly when it started, but reports it has been at least a couple months.