A 4-year-old boy presents with a boggy, tender, boggy-edged swelling on the scalp studded with pustules and overlying hair loss. Pus extrudes from multiple follicular openings. Wood's lamp shows green fluorescence of affected hairs. Which statement about management is correct?

• A Incision and drainage followed by topical mupirocin is curative
• B Oral griseofulvin for 6 to 8 weeks is the mainstay of treatment ✓
• C Topical ketoconazole shampoo alone for 2 weeks suffices
• D Systemic corticosteroids must be avoided under all circumstances

Explanation

This is a kerion, an intensely inflammatory form of tinea capitis, classically due to Microsporum canis or Trichophyton species. The fungus invades the hair shaft, so topical agents cannot eradicate it; systemic therapy such as griseofulvin for 6 to 8 weeks is required. Incision and drainage is specifically contraindicated because it worsens inflammation and scarring. Short courses of adjunctive prednisolone may reduce discomfort but are not mandatory.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.