Kerion Celsi in pediatrics: Case report and diagnostic considerations

Abstract

Introduction: Kerion Celsi is a severe inflammatory form of tinea capitis, presenting with painful plaques, suppuration, and localized alopecia, often mimicking bacterial scalp infections. Objective: To describe the clinical course of a school-aged child with kerion Celsi treated with topical terbinafine. Methodology: A descriptive pediatric case report with serial photographic follow-up over six weeks is presented, for which informed consent was obtained from the legal guardian. Result: A previously healthy 5-year-old boy developed a progressive inflammatory scalp lesion with erythema, scaling, crusting, and localized alopecia. Topical terbinafine was administered for six weeks, leading to gradual improvement and clinical resolution, leaving mild residual alopecia. Discussion: Kerion reflects an intense hypersensitivity reaction to dermatophytes. Early recognition is essential to prevent misdiagnosis, unnecessary intravenous antibiotic use, and long-term complications such as scarring alopecia. Conclusion: This report highlights the importance of considering kerion as part of the differential diagnosis of inflammatory scalp lesions, particularly in children, either through the use of dermatoscopy or on clinical suspicion in cases of suppurative lesions that do not respond to antibiotics, with the aim of preventing complications such as permanent scarring alopecia.