Scutula

Scutula
[[File:|250px|]]
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Yellow, cup-shaped crusts on the scalp
Complications	Hair loss, secondary infections
Onset
Duration
Types	N/A
Causes	Fungal infection (Trichophyton schoenleinii)
Risks	Poor hygiene, crowded living conditions
Diagnosis	Clinical examination, fungal culture
Differential diagnosis	N/A
Prevention	N/A
Treatment	Antifungal medications
Medication	N/A
Prognosis	Good with treatment
Frequency	Rare
Deaths	N/A

Scutula are characteristic lesions associated with a chronic fungal infection known as favus, primarily affecting the scalp. These lesions are typically yellow, cup-shaped crusts that adhere to the hair and scalp, and are caused by the dermatophyte fungus Trichophyton schoenleinii.

Pathophysiology

Scutula form as a result of the fungal invasion of the hair follicles and the subsequent immune response. The fungus produces keratinase enzymes that degrade the keratin in the hair and skin, leading to the formation of these distinctive crusts. The crusts are composed of fungal hyphae, skin cells, and inflammatory debris.

Clinical Presentation

Patients with scutula typically present with:

• Yellow, cup-shaped crusts on the scalp
• Hair loss in the affected areas
• Possible secondary bacterial infections
• Itching and discomfort

In severe cases, the infection can lead to scarring and permanent hair loss.

Diagnosis

Diagnosis of scutula is primarily clinical, based on the appearance of the lesions. However, confirmation can be obtained through:

• Microscopy: Examination of hair and scalp scrapings under a microscope to identify fungal elements.
• Fungal culture: Growing the fungus in a laboratory setting to confirm the species.

Treatment

The treatment of scutula involves the use of antifungal medications, which may include:

• Griseofulvin: An oral antifungal that is effective against dermatophyte infections.
• Terbinafine: Another oral antifungal that can be used for treatment.
• Topical antifungals: Such as ketoconazole or selenium sulfide shampoos, to reduce fungal load on the scalp.

Prognosis

With appropriate treatment, the prognosis for patients with scutula is generally good. However, if left untreated, the condition can lead to permanent hair loss and scarring.

Epidemiology

Scutula and favus are rare in developed countries but may be more common in areas with poor hygiene and crowded living conditions. The condition is more frequently seen in children and young adults.

Prevention

Preventive measures include maintaining good personal hygiene, avoiding sharing personal items such as combs and hats, and treating infected individuals promptly to prevent spread.

Also see

• Dermatophyte
• Tinea capitis
• Fungal skin infections
• Hair loss

Dermatology and Rheumatologic diseases A - Z

A | B | C | E | F | G | H | I | J | K | L | M | O | P | R | S | T | V

Glossary of dermatology