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Resistant ringworm?
Angie80538 posted:
Our household got ringworm from an infected shelter cat at Christmas. My hubby, two older sons and myself were put on Terbinafine oral and topical prescription lamisil... we were all cured. My 4yr old however got it on his leg, arm and scalp. He was put on Griseofulvin and the topical creme. All sores went away except the scalp. The medication seemed to stop it's progression on his scalp but would come back as soon as he goes off the medication. The last time, he had three little hairs that fluoresced under a blacklight. But there were no other signs of ringworm so his doctor took him off meds. 6 days later, he got three spots on his head right where those hairs had fluoresced. I took him in and she looked under the blacklight and sure enough you could see the ring and everything. So, she put him on griseofulvin again. After one month on that his head still fluoresced so she sent him to a dermatologist who 'doesn't believe in using a black light at all' and he took a hair sample. (we aren't sure he got an infected hair or not because he refused to use a blacklight). It came back negative for ringworm. He said if it comes back that they will do a scalp biopsy to see if they can figure it out. We don't want to see if it comes back! This poor little guy has had this going on 8 months. He has been on griseofulvin for about 4 of them, terbinafine for 1 month. He has four days left of terbinafine and the spots where the ringworm was still fluoresce. But it is the hair shafts themselves that fluoresce from the scalp and all the way down the shaft. But it is spotty on the shaft, not completely fluorescing. I looked up 'piedra' and it said that you can see visible spots on the hair. He is a dusty blonde so I would think we could see something if it was there but we don't. His hair grew back patchy and you can just tell that as soon as we stop the meds, it is going to come back. He takes a shower every night. I even enrolled him in swim classes all summer hoping that the chlorine would kill whatever was on his poor lil head!

Is there any other condition that could cause the hair shafts to fluoresce?? I am afraid to shave his head again because I worry that that may be what caused his last bout because the hairs fluoresced and I worry that I caused it to go into his scalp by shaving his head.

I am just at such a loss. He is four and we are scared to hug him, let him sleep in our bed, be around other kids - because we are worried he will give it to someone. Any suggestions would be very welcomed!! Thank you!
Mohiba K Tareen, MD responded:
Dear Angie,

This is really such a terrible stress on you, your family and your poor little son.

Your son needs a hair pull and culture with sensitivity. That definitively will test if indeed any fungus is remaining, the type of the fungus, and which medicine is best for treating that particular fungus.

At this point, I would see a pediatric dermatologist. A peds derm does a full dermatology residency, followed by a fellowship in treating resistant and complex pediatric dermatology cases.

If you live in NYC, I can give you the names of a few great peds derms at Columbia

Please keep us posted and I hope this helps.

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Mohiba K Tareen, MD is a board certified dermatologist who has an innovative practice in Roseville, Minnesota. Tareen Dermatology ( www.TareenDermato...More

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