Tinea amiantacea


Tinea amiantacea

Description, Causes and Risk Factors:

Alternative Name: Pityriasis amiantacea.

ICD-10: L44.8

Tinea amiantacea is an eczematous condition of the scalp resulting in hair loss in which thick tenaciously adherent scale infiltrates and surrounds the base of a group of scalp hairs.

Tinea amiantacea affects the scalp as shiny asbestos-like (amiantacea) thick scales attached in layers to the hair shaft. The scales surround and bind down tufts of hair. The condition can be localized or covering over the entire scalp. Temporary alopecia and scarring alopecia may occur due to repeated removal of hairs attached to the scale. It is a rare disease with a female predilection.

Tinea amiantaceais frequently found to affect only a small part of the scalp. But there are some cases wherein the condition of tinea amiantacea has involved the entire scalp. It has also been seen to be present in the skin behind the ears of young girls, as a localized condition of tinea amiantacea but it may also extend to the scalp area. It may also be seen extending from an infection of lichen simplex in the scalp.

Its definite cause has not yet been found although it is associated with various underlying primary dermatoses, such as psoriasis, atopic dermatitis, seborrheic dermatitis, tinea capitis, pyoderma, pediculosis, alopecia areata, lichen simplex chronicus and lichen planus.

Tinea amiantacea can easily be misdiagnosed due its close resemblance to other scalp diseases such as psoriasis, seborrheic dermatitis or lichen planus. However in tinea amiantacea the scales are attached to both the hair shaft and the scalp. Tinea amiantacea may be present with other inflammatory conditions such as atopic dermatitis or seborrheic dermatitis and sebaceous scales and alopecia can occur.

Tinea amiantacea

Symptoms:

When afflicted with the condition tinea amiantacea, the skin of the scalp is found to be densely covered with scales, more specifically the ends of the hair where the follicles are found. The scales produced by tinea amiantacea are found to be arranged like shingles on a roof. Some may describe it like asbestos flakes, which gives it its name. The skin of the scalp commonly appears normal, under the scales, but it can also appear reddish and scaly.

Areas afflicted with tinea amiantacea may experience hair loss although hair may grow afterwards following extensive and continuous treatment of the infection. It is often caused by difficulty in combing the hair strands and separating them from each other since they are found to be clumped together with the scales caused by this condition.

Diagnosis:

Skin and hair samples for mycology (the branch of botany that studies fungi and fungus-caused diseases) and bacterial culture may be useful. Skin biopsy is rarely necessary.

Treatment:

The treatment of tinea amiantacea, like any other scalp infection, is quite messy and even smells bad, which makes it rather unpopular with those afflicted with it. Unfortunately, there is no other way but to go through this treatment for several weeks, at least, to get rid of the infection.

There are studies that concentrate on finding an effective cure for tinea amiantacea but at present, shampoos that contain either coal tar or ketoconazole may be used. Application depends on the degree of the infection. Sometimes, it may need to stay on the scalp for an extended period of time, just to make sure that the medication has penetrated the skin of the scalp. This is often seen in more severe cases. Steroids and lotions may help with the itch but does not remove the scales and there is a possibility of aggravating the inflammation even more.

The bacteria staphylococci are present in the majority of cases. Treatment with systemic antibiotics and coal tar shampoo can completely clear the condition when Staphylococcus Aureus bacteria are found. Fungal infections such as tinea capitis are known to mimic the symptoms of the condition and can be cleared with antifungal treatment.

Preventive Measures:

    Avoid demanding physical activities that can raise body temperature and worsen itching.

  • Avoid hot baths or showers to prevent the itching from worsening. Oatmeal baths may also sooth the itching.

  • Exposure to sunlight or treatment with artificial ultraviolet light (by a doctor) may speed up the healing process. But be careful to avoid sunburn.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

9 Comments

  1. Carol

    I have had a condition of the scalp which closely resembles that described here. I have had this condition since 2012. I at first thought I had a bug infestation on my scalp because I felt the sensation of crawling. I have not seen a doctor because my friend and my daughter told me I was imagining it. I shave my head regularly to manage the condition and wear a wig. It’s so embarrassing to me to not have any hair this is why I haven’t seen a dr. I’m 2012 I contracted HA-MRSA after surgery on my broken wrist, I was hospitalized for 16days. What should I do because my condition isn’t improving?

    Reply
    • editor-m

      Thank you for shring your story. We strongly recommend you to get rid of your embarrassment because your health is much important, visit your doctor and have physical examination.

      Reply
    • dawn gotte

      Hi Carol,
      I have had this condition for about a year now. It was misdiagnosed at first but I finally found a Dr. diagnoses it correctly. I have tried many treatments that haven’t worked and my latest is Salicylic Acid Shampoo 6% I use every other day and a liquid treatment I use once daily. I have only used it twice and I hope it works. It looks as if it is starting to break it up and I am keeping my fingers crossed. I have it on my entire scalp and it has thinned my hair out allot, it is a very embarrassing, irritating, itchy situation that I don’t wish on anyone. I recommend seeing a dermatologist ASAP and maybe you can tell them my situation, who knows if it will help? Good news is that your hair should grow back! Let me know if you need any more help and good luck!

      Reply
  2. Victoria

    Hi,

    I’m a 29 year old female. Last September (2016) I moved from Virginia to Florida and developed a really nasty ring worm infection on my arm. Not long after I started developing a really sticky and wet mucus type infection on my scalp. I went to the emergency room and was prescribed a very expensive medication I could not afford under my insurance. I then went to a patients first walk in clicic and was given a cheaper anti-fungal medication. This helped clear up the sticky wetness I was experiencing but I was still losing hair from my scalp. Due to an insurance lapse I was unable to see a doctor for several months in which I had several outbreaks of ringworm showing up in other places along my body. I was finally able to see another patients first office who referred me to a local dermatologist back in February of 2017. I had informed him of the previous ringworm skininfections that occurred in other areas of my body and he told me I had Pityriasis amiantacea and prescribed an oil and topical solution to use along with a steady regime of T-Gel shampoo. Within less than a week all of my scales were gone. However, I had not have anymore ringworm “flare up” but my scalp still develops the asbestos like scales despite my continued use of T-Gel. At my follow up I explained this to my doctor but he insisted that I continue the T-Gel and wouldn’t listen to my complaints of continued hair loss and scale reformation stating my hair was still thick enough not to worry about resulting hair loss. He wouldn’t even look at the resulting hair loss I have. What should I do now? I have a follow up appointment at the end of June and have no clue how to approach this situation to him.

    Reply
    • marko r

      Pityriasis amiantacea is damaging the skin of the scalp and therefore the hair. Unfortunately it becomes too thin and thick and the damaged skin fails to grow new hair. The best option for you is to take care of your scalp. The scales you are still developing show that you haven’t treated the pityriasis aminacea completelely (T-gel is not enough) and until then nothing can be done to restore your hair.
      You should definitely see a dermatologist and follow his recommendations to treat the pityriasis aminacea. And when your will be healthy he may also prescribe you something to help restore your hair.

      Reply
  3. Niki A

    Our 7 year old has been seeing a dermatologist for over a year now. He diagnosed her with the fungal infection on her scalp and treated her with varying meds including ketoconazole (both shampoo and ointment), lamasil by mouth, and griseofulvin by mouth. When no improvement was seen we decided to seek a second opinion. This poor little girls has had to withstand me (mom) coating her hair in oils and scraping the scales from Her scalp (per dr order). I have seen her scalp bleed and hear her cry many times due to this infection. Upon seeking the second opinion, the new dermatologist diagnosed her with pityriasus amiantacea. We just began treatment and are very excited to find the above information. Thank you for sharing. This helps us to be more positive that we are now On the right path of treatment. Best wishes to everyone.

    Reply
  4. Taryn

    Please help. I’ve had this condition for over a year now & finally got diagnosed but was so discouraged when the dermatologist told me the treatment is the shampoo & ointment that she wants me to keep on my head until I wash my hair again with the damaging shampoo. I do not understand. The scales will grow back & this treatment will result in a lot more hair loss. Can someome please explain why anyone would choose to lose what hair they have, do the treatment and then have less hair or possibly even none after the treatment, and then the scales grow back anyway? How is this any form of a “treatment”? I know emotionally I cannot handle becoming bald & I’m pretty sure my husband of less than 6 mos. cannot either. Am I missing something? And what about uv treatment? Can a patient use that for treatment instead even if it doesn’t completely clear up all of the scales? Please help!!!

    Reply
    • maisteri

      The treatment of tinea amiantacea should include both topical (coal tar shampoo, topical steroids and antifungal medications) and systemic treatment (namely antibiotics or antifungal drugs depending on whether the bacteria or fungi respectively have caused the condition). The disease itself typically cause hair loss resulting from the removal of the crusts, but you have to remove them, however, if treated appropriately the hair will grow back again. UV treatment is not recommended when it comes to the scalp, as the hair protects the skin from the ultraviolet so this treatment won’t be effective at all.

      Reply
  5. Joan

    I was diagnosed with Tinea Amantacea after seeing a dermatologist who said I had “age-related hair loss”. He prescribed Rogaine for Men and a medicated shampoo every other day. Then the itching started. He then told me to stop all and use Tea Tree Oil on my scalp and it seems to be working so far.

    Reply

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