Resistant Scalp Ringworm on Toddler

I was told my son has a fungus on his scalp (the culture is not complete yet). He is being treated w/ 1 tsp Griseofulvin 2 times per day as well as Selsun Blue every other day but it seems to be spreading. Its scalier and areas are getting larger and he's losing more hair.  His pediatrician diagnosed it after a Dermatologist misdiagnosed it as seberiea (spelling?) and the dermatologist had prescriped 2.5% hydrocortizone to be applied twice per day. We did the hydro. for 3 weeks, twice per day before we got a second opinion from the pediatrician.  Could the hydro. have made it worse and resistant to the Griseofulvin? Of course, we discontinued the hydro. as soon as we heard it was fungal.  He's been on the Griseo. for 14 days (with plenty of fat when administered). We called pediatrician, telling her the ringworm seems to be spreading.  She referred us to another Dermatologist but we have to wait awhile until we can get him in.  Please, ANY help would be appreciated.  I'm very worried about this. I'm concerned it may not go away, it could have been misdiagnosed again or there could be complications.  His symptoms are: patchy bald areas over pink, scaly patches, severe flaking, broken hairs, slightly inflamed, areas are not circular. He has about 4 areas or so.  Thank u so much!!

[Alan Rockoff, MD]

The test needed to tell whether sclp scaling is fungal is a culture.  Was a culture done?  If not, then it's hard to know how the pediatrician decided that the original diagnosis was wrong.  Seborrhea is a lot commoner than fungus.  What you need is a definitive opinion.  I would call the first dermatologist you saw and ask about how certain he or she was of the diagnosis.  The fact that hydrocortisone 2.5% didn't clear the problem in 3 weeks is far more likely to mean that your son needs a stronger anti-seborrhea preparation than that he has a fungus.  And if he doesn't have a fungus, he shouldn't be taking griseofulvin.   A Dermatologists knows what scalp fungus looks like.  That's whom you should ask.

Best.

Dr. Rockoff

[Jakebb]

It's my understanding that Hydrocortizone FEEDS the fungus as it relieves itching. (Sorry, no cite, but I've got ringworm on my legs and have been doing a lot of researching).
If it is a fungus he's got try Lamisil. It seems to be working for me, but Tinea Corpus takes a while to cure. Good Luck, and see that dermatologist!