Question

A male child was brought with a mild painful swelling on his scalp since the last 3 months, as shown in the image below. History reveals that there is a pet dog in the child’s house. What is the diagnosis?

• A. Folliculitis
• B. Abscess
• C. Kerion
• D. Scabies

Answer 1

The Correct Option is C

The given case describes a male child experiencing a mildly painful scalp swelling persisting for 3 months, with a notable household exposure to a pet dog. Considering these details, we need to assess the symptoms alongside the given options:

• Folliculitis: An infection and inflammation of one or more hair follicles characterized by small, white-headed pimples or pustules. Less likely given the prolonged duration and pet exposure.
• Abscess: A painful, swollen lump filled with pus. It usually develops due to an infection; however, pet exposure is not typically a contributing factor.
• Kerion: A severe inflammatory reaction to a fungal infection often associated with scalp dermatophytes, particularly in children. Notably, animals, such as dogs, can transmit these fungi, leading to this condition. The description of a moist, boggy scalp lesion aligns with this diagnosis.
• Scabies: A condition caused by mites, leading to intense itching and a rash, not typically presenting as a localized scalp swelling.

Given the factors of prolonged swelling, pain, and potential zoonotic exposure due to the presence of a pet dog, the diagnosis aligns with Kerion. Kerion represents an exaggerated inflammatory response to tinea capitis (scalp ringworm). It is pertinent to proceed with antifungal treatment and potentially systemic therapy if indicated.