Tinea capitis is one of the most popular and common pediatric dermatophyte infections. The optimal treatment regimen varies according to the type of dermatophyte involved. This work aimed to study the trichoscopic signs concerning isolated organisms in a sample of Egyptian patients with tinea capitis and the possibility of using them as a guide for the selection of appropriate antifungals. This study was carried out on 60 subjects with tinea capitis. Patients were mycologically examined, both direct microscopy with KOH preparation and culture of the scraped hair materials on Sabouraud dextrose agar. The researchers used culture mounts for the identification of the organism. Trichoscopic examination of all patients was performed using the Dermlite DLIII dermoscope.

The result showed a significantly higher prevalence of comma and corkscrew hair in endothrix infection and T. violaceum‐infected cases. On the other hand, there was a considerably higher prevalence of zigzag, barcode hairs, and white sheaths in ectothrix infection and M. canis‐infected cases. While some trichoscopic findings are nonspecific, others were there to be more specific. Finding zigzag hairs and barcode hairs points to ectothrix infection (M. canis), and it is recommended to start treatment with griseofulvin. On the other hand, finding comma hairs and corkscrew hairs without zigzag hairs and barcode hairs points to endothrix infection.

Ref: https://onlinelibrary.wiley.com/doi/10.1111/ijd.15289