A progressive scalp lesion
Our patient’s case of “ringworm” on the scalp had been treated with 6 weeks of griseofulvin. But 13 years later, she wanted to know why the lesions had never gone away.
Finally, the patient sees some improvement
We discussed the risks and benefits of the various treatments, and our patient elected to start hydroxychloroquine (Plaquenil), 200 to 400 mg/day orally (not to exceed 6.5 mg/kg per day). We referred her for a baseline ophthalmological exam and stressed that she needed a repeat exam every 6 to 12 months while she remained on the hydroxychloroquine. We also referred her to a rheumatologist.
After 4 months of treatment, she showed some improvement (FIGURE 2), with no side effects from the medication. The patient was subsequently lost to follow-up.
FIGURE 2
A visible improvement
After 4 months of treatment with hydroxychloroquine, the patient’s scalp lesions improved and there was evidence of hair growth.
CORRESPONDENCE: Ahunna Ahiarah, MD, UB Family Medicine, 1315 Jefferson Avenue, Buffalo, NY 14208; aahiarah@buffalo.edu
