Which presentation is most classically associated with tinea capitis due to hair fracture?

• A. Kerion involves inflammation and may progress to scarring alopecia with cervical lymphadenopathy.
• B. Favus is characterized by boggy inflammatory nodules with crusting.
• C. Black dot tinea capitis is the classical presentation due to a hair fracture.
• D. Diffuse erythematous scaly plaque with widespread involvement.

Answer: (C)

In tinea capitis, the fungus invades the hair shaft. The classic form occurs when the infection weakens the hair at the follicular opening, causing hairs to break off right at the scalp. The resulting short, broken hairs leave visible dark stubs on the surface—these are the characteristic “black dots.” This presentation is the best-known example of tinea capitis centered on hair fracture.

Other forms—such as kerion, a boggy inflamed mass with lymph node involvement, and favus, with crusted scutula—are distinct patterns and not defined primarily by hair breaking at the surface. The key idea here is that the hair fracture pattern produces the black dot appearance on the scalp.