Kerion in Infant/Neonate
A kerion will occur in a patient who has an intact immune response and develops an intense inflammatory response to the organisms. It is almost exclusively seen in children, but on rare occasions, it may be seen in adolescents and young adults. As in tinea capitis, this disease is more common in patients of African descent. It is more common in males than females and in those with short hair. Other risk factors include diabetes, anemia, immunosuppression, underlying malignancy, and organ transplantation. It is seen less frequently in HIV-infected patients; this may be due to increased colonization with Malassezia, which may inhibit dermatophyte colonization.
Fever, pain, occipital lymphadenopathy, and secondary bacterial infection may be associated. The intensity of the inflammation depends on the host immune response. If left untreated, scarring and permanent alopecia can develop. Patients with kerion may develop immunological dermatophytid reactions, which may be localized or generalized. The "ear sign" is a dermatophytid reaction that presents as erythematous plaques and papules on the helix, antihelix, and retroauricular region.
Kerions can be distinguished from cellulitis based on their location and the presence of other signs of a fungal infection, such as scaling.
B35.0 – Tinea barbae and tinea capitis
19087001 – Kerion
Differential Diagnosis & Pitfalls
- Pustules, tenderness, and inflammation often mimic a bacterial infection or abscess.
- Kerion formation may mimic acne keloidalis nuchae and folliculitis decalvans.
- Seborrheic dermatitis
- Contact dermatitis
- Dissecting cellulitis of the scalp
- Nonbullous impetigo
- Pemphigus foliaceus or vulgaris
- Cicatricial pemphigoid