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PubMedDate not supplied

Tinea capitis in the Florence area between 1985 and 1993.

This paper describes the main epidemiological findings in 203 patients with tinea capitis and in seven other patients with dermatophytosis that had also extended to the scalp. The patients were observed over a 9-year period (from 1985 to 1993) at the Department of Dermatology of the University of Florence. Tinea capitis was the fourth most frequent dermatophytosis. Most of the patients were children, although 23 were adults. The most frequent aetiological agent was Microsporum canis. It is interesting to note that there were 12 cases of tinea capitis due to Trichophyton violaceum in African immigrants. This dermatophyte was believed to have disappeared from Italy. One case was due to Epidermophyton floccosum.

Adolescent↗
PubMed2006

[Profile of basal cell carcinomas of the scalp after radiotherapy for tinea capitis (about 63 cases)].

The induction of basal cell carcinoma (BCC) of the scalp by X-ray therapy for tinea capitis is well known. The aim of the study was to specify the epidemiological, clinical and histological characteristics of this disease. In a retrospective study, we collected data from the files of 63 patients, with a history of radiotherapy for tinea capitis, followed between January 1995 and December 2004. Fifty one men and 12 women with a total of 108 BCC of the scalp are reported (1.76 lesion per patient and 1.13 cm on average of diameter). The mean age at the occurrence of the BCC was 45.5 years. Thirty seven percent of BCC occurred on the occipital area; 28.7% were in the parietal site. The most frequent clinical aspect was the nodular BCC (51%) and the cicatricial BCC (35%). Histological study showed a nodular aspect in 74 % and pigmentation in 62% of cases. It is concluded that BCC of the scalp following X-ray therapy for tinea capitis have some clinical and histological particularities. It represents the most frequent tumour developing on irradiated scalp.

Adult↗
PubMed1986

[Course of the dermatophytic spectrum in tinea capitis. Apropos of 124 cases seen in Bordeaux].

The purpose of this study was to evaluate the epidemiology of tinea capitis in the Bordeaux area (Dermatology Unit of the Hôpital des Enfants, Bordeaux) during a 6-year period (January, 1979 to December, 1984). Dermatophytic infection of the hair was proven by culture in 124 patients, 21 of whom had a negative potassium hydroxide direct examination. Age and sex distribution are shown in figure 1. One case was observed in a 15 days old infant, and 4 cases in adult females (3 young black mothers of affected children, 1 elderly white woman). Table I indicates the geographical origin of the patients and the isolates identified. The incidence of anthropophilic dermatophytes has increased from 13 p. 100 to 50 p. 100 since our previous survey (1975-1978). M. langeronii (29 cases), T. soudanense (19 cases) and T. violaceum (10 cases) were isolated mostly among African immigrants from Western tropical Africa and the Maghreb. However, 4 children of French origin without any history of previous sojourn in endemic areas developed tinea capitis due to M. langeronii; the source of contamination could not be determined. Zoophilic dermatophyte infection was mainly caused by M. canis (50 cases), with cats being the most frequent source of contamination. Family cases were frequent: 64 corresponding to 28 families. This may be due to either interhuman contamination or the presence of a contact pet animal in the family. The discussion is focused on: the shift in dermatophytic isolates from tinea capitis toward anthropophilic species, notably M. langeronii, mainly caused by an increased immigration from West Africa; the relevant clinical and mycological correlations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2003

[Two cases of tinea capitis by Microsporum ferrugineum believed infected in Myanmar].

We report two cases of tinea capitis by Microsporum (M) ferrugineum. A two year old boy (case 1) visited our hospital 3 months after his return from Myanmar. About a year later, we observed the same symptom on the scalp of his mother (case 2). In both cases itraconazole was effective clinically and mycologically. In Japan, although M. ferrugineum was the most common organism of tinea capitis before the 1960s, no cases of tinea are found caused by this species nowdays. We believe these cases to have been infected in Myanmar, and suggest the possibility that tinea caused by M. ferrugineum may become a re-emergent infection or an imported fungal disease in Japan.

Adult↗
PubMed1999

The predictive value of symptoms in diagnosing childhood tinea capitis.

OBJECTIVE: To determine which sign, symptom, or combination thereof best predicts cultures positive for fungi in children with possible tinea capitis. DESIGN: Convenience survey. SETTING: Urban hospital-based general pediatric practice. PATIENTS: Results were obtained on 100 consecutive children presenting with at least 1 sign or symptom (scalp pruritus, scaling, diffuse or circumscribed alopecia, or occipital adenopathy). INTERVENTION: All enrolled children had samples for scalp cultures taken. Demographic information and clinical findings were verified by the author. MAIN OUTCOME MEASURE: Whether detected clinical findings can predict the outcome of fungal cultures. RESULTS: Cultures positive for fungi were found in 68 children. There was a significant relationship (Fisher exact test; P<.001) between the number of signs and symptoms and a culture positive for fungi. Positive likelihood ratios were 7.5, 3.3, 1.4, and 1.1 for the presence of adenopathy, alopecia, pruritus, and scaling, respectively, for children with cultures positive for fungi. All children (n = 55) who presented with both adenopathy and alopecia and 60 of 62 children who presented with both adenopathy and scaling had cultures positive for fungi. No cultures positive for fungi were found in children without adenopathy and scaling; only 1 of 68 children without adenopathy and alopecia had a culture positive for fungi. CONCLUSIONS: In children who are suspected of having tinea capitis, there is a high likelihood of cultures positive for fungi in those with adenopathy. A fungal infection is rarely the cause when neither adenopathy nor alopecia is present. Attention to signs and symptoms in children with suspected tinea capitis can result in better diagnostic and treatment precision.

Child, Preschool↗
PubMed1995

Semiquantitative study of tinea capitis and the asymptomatic carrier state in inner-city school children.

OBJECTIVE: To quantify and characterize the asymptomatic carrier state of tinea capitis in school children from the inner city. METHODS: All students attending a parochial school (kindergarten through seventh grade) in the city of Philadelphia were cultured for tinea capitis periodically over 16 months (1404 hemi-scalp cultures from 224 children). RESULTS: Our initial prevalence study of this all-black population (ages 5 to 13 years) found a 3% rate of index cases (symptomatic) and a 14% rate of asymptomatic carriers (without black-dot lesions, obvious hair loss, scaling, crusts, pustules, or erythema). Trichophyton tonsurans was the predominant dermatophyte (96% of 125 positive cultures; Microsporum canis was the only other isolate). Fifty percent of all positive cultures came from children in kindergarten and first grade; first grade had the highest rate of index cases. The overall prevalence of asymptomatic carriers was not higher in the classes containing index cases. Fifty-nine percent of asymptomatic carriers had a 1+ spore load (1 to 10 colonies isolated per scalp), while 74% of index cases had a 4+ spore load (> 150 total colonies). Forty-five untreated asymptomatic carriers were followed for 2 to 5 months: 19 (42%) became culture-negative; of these, 17 (90%) had a 1+ spore load. CONCLUSIONS: We found that inner-city black school children who are asymptomatic carriers of T tonsurans had lower spore loads than index cases. Index cases did not appear to be the primary mode of transmission within a classroom. More than half of untreated asymptomatic carriers remained culture-positive after 2 months and probably play a role in the transmission of tinea capitis within this population.

Adolescent↗
PubMed2003

Tinea capitis in Brussels: epidemiology and new management strategy.

BACKGROUND: We found pre-established directives inadequate to cope with the current increase in anthropophilic tinea capitis in Brussels. OBJECTIVES: To study new epidemiological profiles and to define new strategies for management and prevention. PATIENTS AND METHODS: A total of 122 children affected by tinea capitis were followed in our department from October 1, 2001, until September 30, 2002. The results were assessed retrospectively. RESULTS: Anthropophilic tinea capitis represented 89.34% of the cases. The implicated anthropophilic dermatophytes were by decreasing frequency: Microsporum langeronii (39.34%), Trichophyton soudanense (28.69%), Trichophyton violaceum (18.03%) and Trichophyton tonsurans (3.28%). CONCLUSION: The responsible pathogens reflect immigration flows originating mostly from Black and North Africa. Precise recommendations for each visit are detailed.

Adolescent↗
PubMed1983

Tinea capitis in Philadelphia.

From 1962 to 1979, there was a dramatic change in tinea capitis infections in children in the Philadelphia area. This has been primarily due to the virtual disappearance of tinea capitis due to Microsporum organisms. This dramatic change in a common, highly infectious childhood disease is most likely due to a sudden change in hair styles, particularly in black boys, which prevents infectious spores from reaching the scalp.

Female↗
PubMed2002

Itraconazole in the treatment of tinea capitis in children. Case reports with long-term follow-up evaluation. Review of the literature.

Although griseofulvin is considered the standard treatment of tinea capitis in children, alternatives are being investigated. Our purpose was to determine the efficacy of itraconazole for kerion and noninflammatory tinea capitis. An open label study was performed on five patients. It was planned to treat them with itraconazole until they were mycologically and clinically cured. A 28-112-day course of 100 mg itraconazole daily, combined with a topical antifungal treatment resulted in clinical and mycological cure in all children. One child stopped taking itraconazole after 28 days, before it was clinically cured, because of nausea. Nevertheless, this child also achieved clinical and mycological cure. No other side-effects were reported. In long-term follow-up evaluation of between 2 and 3.5 years no recurrence or reinfection was observed. There was complete regrowth of hair, even after kerion. These findings and the review of the literature suggest that itraconazole offers an alternative to griseofulvin for the treatment of tinea capitis in children, although it is more expensive and not approved by German state authorities for this indication.

Administration, Oral↗
PubMed2004

[Basal cell carcinoma of the scalp after radiation therapy for tinea capitis: 33 patients].

Occurrence of basal cell carcinoma (BCC) following radiotherapy for tinea capitis is well known. The aim of this study was to specify the clinical and histological features of these BCC seen in 33 patients (1995-2000). Twenty seven men and six women were diagnosed with BCC. The age of onset varied between 32 an 62 years. Radiotherapy was received between 5 and 17 years of age. The interval between irradiation and the onset of carcinoma varied between 21 and 51 years. Total number of lesions was 55. Forty percent of BCC occurred on the occipital area, the number varied from 1 to 5 and the size from 2 to 45 mm. Clinically, the nodular type was found in 51% of cases. Pigment was present in 64% of cases. Histological study showed a nodular aspect in 76% and pigmentation in 63% of cases. Nodular and pigmented type were the predominant BCC occurring after radiotherapy for tinea capitis in our series. In the literature, BCC are the most frequent carcinomas occurring after radiotherapy (70-100%). Pigmentation was not described in other series. The nodular histological form was the most frequent.

Adult↗
PubMed1981

Tinea capitis in an Anglo-Indian school.

Tinea capitis due to Trichophyton violaceum was seen in 34% of 157 Anglo-Indian female children at Madras. The common age group and the class affected were between 10 and 15 years and 6th and 7th standards. A proportionally higher number of children were present in this group. T. violaceum infection in areas other than the scalp was negligible.

Adolescent↗
PubMed1985

Tinea capitis caused by Trichophyton tonsurans.

Children with tinea capitis caused by Trichophyton tonsurans often have a lifetime of association with the organism and, in spite of intermittent therapy, as adults pass the infection to successive generations. While most current treatment regimens are directed at treating the individual patient, our study supports the need to evaluate and possibly treat all family members and their home environment.

Adolescent↗
PubMedDate not supplied

Microsporum canis tinea capitis in an 8-month-old infant successfully treated with 2 weekly pulses of oral itraconazole.

We report an 8-month-old girl with tinea capitis caused by Microsporum canis which was successfully treated with two pulses of oral itraconazole 50 mg/day, each of 1 week duration with an interval of 2 weeks. M. canis tinea capitis can be a difficult therapeutic problem in an infant, as the treatment is usually long, lasting up to 4-6 weeks with griseofulvin and 6-12 weeks with terbinafine, and the desire to provide a safe systemic therapy is particularly important. With an intermittent regimen the duration of treatment with active drug can be much shorter compared to continuous therapy. We found that itraconazole pulse therapy for M. canis tinea capitis was a safe and effective treatment in an infant.

Administration, Oral↗
PubMed1995

The emergence of Trichophyton tonsurans tinea capitis in Birmingham, U.K.

The anthropophilic fungus Trichophyton tonsurans is a cause of tinea capitis in children. Since the 1950s the organism has spread from Central to North America. A similar recent emergence of T. tonsurans has not been reported previously in the U.K. T. tonsurans was found to have become the predominant cause of tinea capitis in Birmingham, U.K., accounting for 72% of infections investigated in 1993. The symptoms and signs of the infection were variable and accurate diagnosis may be initially difficult. It is, thus, important to be aware of the emergence of T. tonsurans in the U.K., so that an early diagnosis can be made to facilitate appropriate treatment and to prevent spread of infection to close contacts.

Adolescent↗
PubMed1979

Nonfluorescent tinea capitis in Charleston, SC. A diagnostic problem.

Statistics gathered at the Medical University of South Carolina from 1973 to 1978 indicate a dramatic change in the etiologic agents of tinea capitis in Charleston since the 1950s. The preponderant agent is now Trichophyton tonsurans, which produces lesions that are not fluorescent in a Wood's lamp examination (long-wave ultraviolet). Trichophyton tonsurans caused 90.6% of 265 culture-proved cases of tinea capitis in the 1970s, but in the 1950s it was responsible for only 1.6% of 378 cases. The study emphasizes that cultures are necessary because the increase in nonfluorescent tinea capitis throughout the United States presents unsuspected diagnostic problems to physicians who are not aware of the change in etiologic agents.

Black People↗
PubMed1999

An open study of tinea capitis in 50 children treated with a 2-week course of oral terbinafine.

BACKGROUND: Terbinafine is used in the treatment of dermatophyte infections. There have been several studies suggesting a good response to terbinafine in treating tinea capitis, specifically with dermatophytes of the Trichophyton species. METHODS: We enrolled 50 consecutive children with a clinical diagnosis of tinea capitis into an open study using terbinafine for 2 weeks. RESULTS: Clinical and mycologic cure occurred in more than 86% of patients with no side effects and good compliance. CONCLUSION: In this study terbinafine was a safe and effective treatment of tinea capitis in children, particularly when caused by the Trichophyton species.

Adolescent↗
PubMed2004

Treatment of Microsporum spp. tinea capitis with pulsed oral terbinafine.

Oral terbinafine is widely used in the treatment of superficial dermatomycoses as well as subcutaneous and systemic mycoses. It is also useful in treating tinea capitis, although for Microsporum canis and some ectothrix organisms, the effectiveness of the drug may be less than for some endothrix infections. In this study, we undertook a double-blind randomized trial comparing standard and double doses of terbinafine given in a pulsed protocol (1 week on, 3 weeks off) in treating Microsporum spp. tinea capitis in 42 individuals. We found that pulsed terbinafine at a higher dose did not improve treatment efficacy. However, our data clearly demonstrated that the duration of treatment is an important factor in determining clinical outcome and cure. Two pulses of standard dose terbinafine were found to be sufficient for treating most cases of Microsporum spp. tinea capitis, although additional treatment (a third pulse) may be needed if clinical improvement is not evident at 8 weeks after initiating therapy.

Administration, Oral↗
PubMed1995

Comparison of 1% and 2.5% selenium sulfide in the treatment of tinea capitis.

OBJECTIVE: To determine whether an over-the-counter shampoo containing 1% selenium sulfide would have sporicidal activity equal to that of a 2.5% selenium sulfide prescription lotion in the adjunctive treatment of tinea capitis infection. DESIGN: Prospective randomized nonblinded clinical trial. SETTING: Outpatient clinics and emergency department of a children's hospital. PATIENTS: Fifty-four patients between the ages of 1 and 15 years with culture-proved tinea capitis infection caused by Trichophyton tonsurans enrolled during a 14-month period. METHODS: Patients were randomized to receive 2.5% selenium sulfide lotion, 1% selenium sulfide shampoo, or a bland, nonmedicated shampoo with which they were instructed to shampoo twice weekly. All received 15 mg/kg per day of griseofulvin. Dermatophyte cultures of the affected area of each patient's scalp were obtained on enrollment and every 2 weeks until a negative culture was obtained from a previously infected area. RESULTS: Survival data analysis demonstrated that both the 2.5% selenium sulfide and 1% selenium sulfide preparations were superior to the nonmedicated control shampoo in terms of the time required to eliminate shedding of viable spores. When compared with each other, there was no difference between the 2.5% selenium sulfide and 1% selenium sulfide preparations in time required to produce a negative culture. CONCLUSION: Commercially available 1% selenium sulfide shampoo is an equally effective yet less expensive alternative sporicidal therapy in the adjunctive treatment of tinea capitis infection.

Adolescent↗