Kerion nightmare - any dermatologists?

[Sunorstayome]

Hi, are there any dermatologists
who can advise or anyone else with experience of a kerion?

DSS (19) had ringworm which turned into an abscess on his scalp and is now the size of a tennis ball. He was misdiagnosed with a bacterial/fungal infection and only saw a dermatologist (following numerous visits to GP and 2
to A&E via GP) 4 days ago. He was prescribed oral Terbinafine plus anti fingal
shampoo but is still in so much pain with copious amounts of pus/fluid leaking out.
It actually looks as if it could be getting worse and I’m worried he could have a bacterial infection on top of fungal. For context, he was sent to A&E on Wednesday by his GP who thought he had sepsis and his bloods were fine. Can anyone reassure us as to how long a kerion takes to start to improve and whether what we are experiencing is ok?
thank you so much for any insights!

Please call non emergency medical number for help and support, that sounds awful

Thanks custardbear 🙏

Hi, we have used griseofulvin oral antibiotics and took 2 weeks to start working and show any improvement. 6 weeks in and it’s still raw but dosent seep any more, it’s usually an 8 week treatment but I suspect we will need longer, awful things. They heal from the inside out so the outside will look worse right til inside is healed. IT’s unfortunately a painful waiting game with a Kerion :(

It is relatively common to get a bacterial infection on top of the fungal infection .
Given this is so large , I think it warrants antibiotics on top of the oral anti fungal medication and shampoo.

Make an urgent GP appt. I would buy puppy pads to put on his pillow to discard every night. Boil wash towels and clothes , disinfect combs / brushes.

Have you treated any pets especially cats who can be carriers of the fungal spores?

H34213 thank you - they are awful things from another planet - so hard to get rid of and so distressing. It’s good to know they clear from the inside out as that could explain why it still looks so alarming.

olympicsrock thank so much for advice - really good idea about puppy pads. We called the dermatologist this morning and he is going to call today. I’m hoping he will prescribe antibiotics and that Terbinafine is the right treatment for him and not just the cheaper option?
thank you both

My DC is only 2 so Griseofulvin was considered the least harmful to their liver although the one you mention rings a bell with a family member who had one. It sounds quite advanced given it’s size, would recommend a hair growth serum for after it is healed as the hair follicles can be damaged permanently, a family member had a large one similar size to a tennis ball on their DCs head, took the full 8 weeks for the outer crust to completely fall away, my DC is 6 weeks in and has about 30% of it left with very red raw skin under it, all the hair came away with the crust. Conditioner is excellent to reduce the matting and we wash the hair morning and night as the smell was horrific for the first few weeks, still smells now but not half as bad since we coped conditioner helped to take away the matting and pus stuck to the hair. Hopefully he gets some relief soon.

H34213 Can I ask how you used the conditioner and what one you used? Am scared of irritating it more but we are finding it hard to get the gunk off. Really hope your Dc recovers fully soon

Just rub it in with palm of my hand and hold the shower head on it directly, I use a baby brush then to gently brush the hair on it, started very very lightly and built up over the weeks, any conditioner would work think it’s Pantene I have here but it never irritated my DC whereas the shampoo did sting for a while. Conditioner was a game changer for us to be honest and after two weeks, my DC could tolerate normal shampoo without irritation and the medicated one as normal shampoo helped with the smell more.

Just to say, on the puppy pad recommendation, some of them can have pretty harsh chemicals in them for anti-odour which might be tough on facial skin - you might be better off with the ones for kids / elderly / incontinence.

H34213 Thank you - I will get some simple conditioner to try and the baby brush is a great idea.
WavingCatpaw - that is a very good point. We bought some today, so will go and check. Thank you