This pediatric case demonstrates the successful application of photodynamic therapy (PDT) in treating tinea capitis with minimal side effects, avoiding the risks associated with systemic antifungal medications. The patient showed no recurrence at 6-month follow-up, indicating excellent clinical outcomes and strong potential for broader application.

01. Basic Patient Information

• Gender: Female

• Age: 6 years old

• Chief Complaint: Scalp rash with pain and itching for one week

• 
  

02. Medical History

The patient presented with a one-week history of scalp rash accompanied by itching and pain. The lesion did not improve significantly after topical treatment with Triamcinolone and Econazole cream, and the affected area gradually enlarged, with associated hair loss.

03. Clinical Examination

• Physical Examination: Two patchy erythematous areas with papules and pustules measuring approximately 1.5–2 cm in diameter were observed on the right side of the scalp, accompanied by hair loss and broken hairs.

• Laboratory Test: Positive fungal microscopy

• 
  

04. Diagnosis

Diagnosis: Tinea Capitis

05. Treatment Plan

1. Pre-Treatment Preparation

The patient was comforted to reduce anxiety. Parents were instructed to help keep the child calm during application. The affected scalp area was shaved in preparation for treatment.

2. Lesion Preprocessing

After cleaning the lesion with sterile water, larger pustules were drained using a sterile needle. A disposable microneedling roller was gently rolled over the lesion area until mild pinpoint bleeding was observed, enhancing skin permeability.

3. Drug Application

The total drug dose was measured at 354 mg, using 3 vials of Ameluz (ALA). A 10% concentration solution was prepared with thermosensitive gel and applied evenly to the lesion. The area was then occluded:

• 1st session: 1.5 hours occlusion

• 2nd & 3rd sessions: 2 hours occlusion each

Treatment durations were adjusted based on patient tolerance.

4. Light Irradiation

The lesion was exposed to red light using a photodynamic therapy device, set at 80 mW/cm² for 20 minutes per session.

06. Case Images

[Images Placeholder – Clinical photos before, during, and after treatment]

07. Follow-Up and Prognosis

One week post-PDT, the patient’s lesion showed resolved erythema and pustules, with visible brown scabs and no adverse reactions.
At 6-month follow-up, the lesion had fully healed, with complete hair regrowth and no recurrence.
Both the patient and her family expressed high satisfaction with the treatment outcome.