8 Year Old With Unilateral Lymphadenopathy

8 yo African American Female With Tender Posterior Cervical Lymphadenopathy

Patient was brought in by mother for 2 tender lymph nodes that were noted the day of the visit. Child has had no other symptoms and has had no history of this in the past. Mom is very worried about lymphoma.

No significant PMHx.
No sick contacts.
No URI symptoms.
No headache, no weight loss, no fatigue.
Child is completely well otherwise.
No family history of cancers in the immediate members.

 

2 isolated tender soft lymph nodes.
2 isolated tender soft lymph nodes.
Small area of hair loss towards the right of the image.
Small area of hair loss towards the right of the image.

 

Vitals unremarkable.
On exam there are 2 soft mobile tender lymph nodes on the left posterior cervical column with no erythema.
Child appears well with no signs of anemia or dehydration.
Rest of body exam reveals no other lymphadenopathy.
No oral lesions noted, normal cardiopulmonary exam.
Examining the scalp reveals a slightly shinier surface about the size of a quarter, slightly hyperpigmented and hair loss with broken hair shafts. Small brown-black dot noted as well.

Diagnosis: Black Dot Tinea Capitis.
Confirmed: No biopsy done or culture done.
Treatment: Griseofulvan for 8 weeks.
Outcome: Lost to follow-up.

 

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