Do There Need to Be Visible Lesions to Diagnose Tinea Capitis?

Tinea capitis can present in various forms, such as circular patches of alopecia with scaling, widespread scalp scaling with patchy hair loss, a "black dot" pattern with broken hairs, or kerion, an inflamed area. These presentations may also include eczematous, papular, or pustular lesions due to an immune response, known as an Id reaction, which lacks organisms. The differential diagnosis for tinea capitis is broad, encompassing conditions like folliculitis, alopecia areata, seborrheic dermatitis, atopic dermatitis, psoriasis, and trichotillomania.