Twenty-Nail Onychomycosis Associated with Tinea Capitis in a 12-Year-Old Boy: A Rare Paediatric Presentation

Abstract

Onychomycosis is uncommon in children and typically affects the toenails, while simultaneous involvement of all 20 nails in association with tinea capitis presenting as kerion is an unusual manifestation of dermatophytosis. Here is a report of a 12-year-old boy who presented with dystrophic changes involving all his fingernails and toenails with a scalp lesion clinically consistent with kerion. The aim of this report is to highlight the importance of careful examination of nails in children presenting with tinea capitis and the need for early recognision of nail disease, mycological confirmation and appropriate systemic antifungal therapy to prevent progression and complications, particularly scarring alopecia associated with kerion.