Report of an outbreak of ringworm of the scalp due to M. audouini

Experience in Los Angeles County with an outbreak of ringworm of the scalp caused by M. audouini, and a review of the literature have led to the following conclusions:

DIAGNOSIS

The Wood's lamp is an indispensable piece of equipment in case finding. While M. audouini infection is often characteristic in appearance, there are frequent variations. Culturing on Sabouraud's medium (glucose-agar) is a requirement for positive diagnosis. Most surveys show an infection ratio of six or seven boys to one girl.

TREATMENT

X-ray epilation provides the best prospect for cure in the shortest time. Manual epilation can be employed but is less efficient and more disagreeable. Shaving the scalp every seven to ten days is helpful in preventing the spread of the infection but is not a satisfactory substitute for epilation. The most effective topical application is an ointment containing 5 per cent salicylanilide in carbowax 1500. All treatment should be conducted under trained supervision for constancy and thoroughness. Hormone therapy is in general to be discouraged.

CONTROL

With proper supervision of treatment and adequate protective covering of the scalp, there need be no loss of school time after treatment has been instituted. Enlistment of the barbers of the community in refusing to serve clients with obviously infected scalps, and properly sterilizing instruments is important. Cutting instruments can be satisfactorily sterilized in petroleum oil at 100 degrees C. without detriment to the instruments. Complete discipline must be maintained on school grounds with regard to exchange of headgear between children.

Radiation therapy of ringworm of the scalp

A recent epidemic of tinea capitis in children has revived a considerable interest in the methods of treatment of this disease. The most efficacious form of therapy for M. audouini infections is roentgen epilation. The various methods of x-ray treatment are briefly presented and compared. A modification of the four-point technique is shown to offer a simple yet safe method of curing ringworm of the scalp. Results with this method compare favorably with the best of those reported by the use of other methods. Cure was effected by this method in all of a group of 125 cases.

Congenital defect of the scalp; an infant with a bullous lesion at birth

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