Which presentation corresponds to kerion in tinea capitis?

• A. Patches with central clearing
• B. Scattered vesicles
• C. Hair shaft fracture
• D. Inflammation with boggy mass and cervical lymphadenopathy

Answer: (D)

Kerion is the inflammatory form of tinea capitis, representing a robust immune reaction to the scalp fungus. It presents as a tender, boggy, inflamed mass on the scalp with purulent discharge and crusting, and it is often accompanied by scalp edema and alopecia. Regional lymph nodes in the neck commonly enlarge because of the spread of inflammatory mediators and organisms to the local lymphatics. This combination—the inflamed, boggy lesion with nearby lymphadenopathy—is the hallmark feature of kerion, setting it apart from other forms of tinea capitis that may show patches with central clearing, scattered vesicles, or hair shaft breakage without the dramatic inflammatory mass. In managing kerion, systemic antifungal therapy is typically required, sometimes with adjunctive anti-inflammatory treatment to reduce swelling and prevent scarring.