Question

Seven-year old male is brought by his mother to the physician because of a bald patch on his head which has been getting larger for the past three weeks. The child has been afebrile and feeling well throughout this time. The patient's mother has seen her son scratch the patch only occasionally, and the boy says that it only itches ""a little bit."" Past medical history includes asthma treated with albuterol. Physical examination reveals multiple non-erythematous, scaling, well-demarcated patches on the scalp. A microscopic examination of scrapings from one of the lesions prepared with KOH shows spores, but there is no fluorescence under ultraviolet light. A photograph of the lesion is shown. Which of the following is the most appropriate treatment for this patient's condition?

A. Clobetasol ointment
B. Mupirocin
C. Griseofulvin
D. Permethrin cream
E. Lindane shampoo

Answer 1

C. Griseofulvin

The most appropriate treatment for a seven-year-old male with a fungal infection of the scalp (tinea capitis) is C. Griseofulvin, which is an oral antifungal medication effective against this condition.

Step-by-step explanation:

The seven-year-old male with a bald patch on his head likely has a fungal infection of the scalp, commonly known as tinea capitis. The presence of spores in the microscopic examination of the scrapings prepared with KOH, and the lack of fluorescence under ultraviolet light suggest a fungal etiology. The most appropriate treatment for tinea capitis is an oral antifungal medication.

In this case, the correct answer is C. Griseofulvin. Griseofulvin works by inhibiting fungal cell mitosis, effectively preventing the fungus from reproducing which leads to the elimination of the infection.

Topical treatments like clobetasol ointment (a corticosteroid) and mupirocin (an antibiotic) are not effective against fungal infections and therefore would not be suitable. Permethrin cream and lindane shampoo are used to treat parasitic infections such as scabies and lice, respectively, and are not indicated for fungal infections.