Successful treatment of kerion with itraconazole and ALA-PDT: A case report

•PDT is increasingly used in the management of both superficial and deep cutaneous mycoses.•We presented a case of kerion which was successfully cured by three sessions of ALA-PDT combined with itraconazole.•ALA-PDT provides a good alternative and adjutant choice for kerion with safety, less side effects, and good repeatability. Kerion refers to the severe inflammatory reaction which occurs in some cases of fungal infection of the hair or hair follicles. Successful treatment is a challenge for the small number of kerion patients who show poor efficacy of oral antifungal agents. In recent years, photodynamic therapy (PDT) has been proven to be a useful treatment for a variety of fungal infections. In this case report, a 9-year-old Chinese girl presented with erythema, pustular and tender plaques on her scalp for 2 month. The diagnosis of kerion was made based on clinical features and positive mycological findings. After the disease relapsed with oral administration of itraconazole for 6 weeks, she was successfully cured by three sessions of ALA-PDT combined with itraconazole. This case report suggests that ALA-PDT provides a good alternative and adjutant choice for kerion with safety, less side effects, and good repeatability.