Diagnosis and management of scalp ringworm

Scalp ringworm, or tinea capitis, largely disappeared in Great Britain after oral griseofulvin was introduced in the late 1950s.1 Over the past few years, however, dermatology departments in London, Bristol, and Birmingham have seen a large increase in cases, with rates of positive scalp isolates up to 20 times higher than previous baseline rates.2^–4 A community point prevalence study from London suggested a disease prevalence of about 2.5% with a carriage rate of between 12% and 47% among schoolchildren.5 AfroCaribbean children seem to be particularly vulnerable to infection.3 Scalp ringworm is also increasing in Europe and North America. 6 7 We discuss the current epidemic, illustrate the clinical presentations of the disease, and describe the methods for diagnosis and management.