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, not the presence of organisms. The differential diagnosis is extensive, including conditions like folliculitis, alopecia areata, seborrheic dermatitis, atopic dermatitis, psoriasis, and trichotillomania.