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Microsporum canis scalp ringworm: its primary or secondary ectothrix character.

This study supports the view that, in cases of tinea capitis due to a Microsporum canis infection, ectothrix arthroconidium formation is extrapilary and arises from intrapilary hyphae. The hyphae of M. canis perforate and digest the hair cuticle to alter its appearance from a normally identifiable structure of imbricated cells with a distal free border, to a grossly altered and pathological layer. Conidium production mainly takes place outside the hair shaft and forms thick clusters between the cuticular tiles. Finally, a shaft of conidia is formed around the hair. The cuticular covering of such a conidium sheath belongs to the root sheath of the hair follicle, and not to the hair structure proper.

Child↗

Animal ringworm.

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Animals↗

The ringworm riddle: an outbreak of Microsporum canis in the nursery.

Tinea capitis, the most common fungal infection in children, is rare in neonates. We report six patients in a Level II intermediate care nursery who developed nosocomial dermatophyte infections caused by Microsporum canis. The investigation, which led to the identification of a nurse as the common source, is described. The nurse had an indolent infection with M. canis. Human to human transmission is exceedingly rare for M. canis. The literature regarding neonatal dermatophyte infections is discussed in relation to the reported outbreak.

Antifungal Agents↗

Tinea gladiatorum: Pennsylvania's experience.

OBJECTIVE: To describe the impact of ringworm infections in high school wrestlers (tinea gladiatorum) in Pennsylvania during the 1998-1999 scholastic wrestling season. DESIGN: Retrospective 23-item mail-out survey. SETTING: Pennsylvania high schools with varsity wrestling programs in 1998-1999. PARTICIPANTS: Athletic trainers, athletic directors, and wrestling coaches who responded to the mail-out survey. MAIN OUTCOME MEASURES: Frequency of ringworm infection during the 1998-1999 season. Methods of prevention, diagnosis, and treatment of ringworm among respondent schools. Summary of beliefs concerning transmission and the way ringworm is approached compared with other skin infections. Any associations between the methods of prevention, diagnosis, and treatment and the frequency of ringworm infections. RESULTS: Response rate was 42.4%. Of the respondent schools, 84.7% had at least one wrestler diagnosed with ringworm. Of these teams with infected wrestlers 33% had a wrestler miss a match because of the infection. A majority of schools (68.7%) have a written guideline for return after a ringworm infection. Most respondents believe ringworm is transmitted by personal contact or from contact with mats. An overwhelming majority of schools (97%) use preventive practices. Interestingly, schools that used a greater number of preventive practices had more ringworm infections (p < 0.05). Larger teams were associated with more ringworm infections. In the respondent schools, 60% of coaches were involved in making a diagnosis of ringworm. Return decisions are made predominantly by a physician and/or the athletic trainer (79%). CONCLUSIONS: Ringworm infections in wrestlers are a common occurrence. There is a lot of variation among schools in Pennsylvania in regard to prevention, diagnosis, treatment, guidelines, and beliefs about ringworm. More study is needed to determine risk factors, transmission patterns, microbiology patterns, and evidence-based prevention and treatment recommendations.

Guidelines as Topic↗

[Tinea capitis in Madagascar: a survey in a primary school in Antsirabe].

BACKGROUND: Tinea capitis is a common infection among schoolchildren in developing countries. This condition is still under-reported in Madagascar. In order to assess the prevalence of Tinea capitis in Madagascar, we conducted a study in a primary school in Antsirabe, a town located in the country's high central territories. METHODS: Samples were taken from 210 children in the 4 school classes aged between 6 and 14 years. Only children with scaling lesions or with alopecia were sampled. No microsporic gray-patch ringworm was found in any of the children. Samples were obtained from a total of 83 children. Cotton swabs moistened with distilled sterilized water were rubbed on the children's scalps for 15 seconds and the scales thus collected were then seeded on 2 separate tubes of Sabouraud-Dextrose-Agar media containing chloramphenicol, one with and the other without cycloheximide. The tubes were incubated at a temperature of 27 degrees C for 4 weeks. All the micromycetes were identified (dermatophytes, yeasts and molds). RESULTS: Three species of dermatophytes were isolated: one anthropophilic species, responsible for black-dot ringworm (Trichophyton tonsurans), and 2 geophilic dermatophytes, unusual in human disease (Microsporum boullardii and Trichophyton terrestre). Of the 83 children sampled, 17 had 20 dermatophytes (in 3 children, 2 different species of dermatophytes were associated). We collected 15 Trichophyton tonsurans (2 Trichophyton tonsurans were associated with Microsporum boullardii, and 1 with Trichophyton terrestre), and 2 Microsporum boullardii. The prevalence of carriers of dermatophytes was 8 p. 100 for all children and 20.5% for the sampled children. DISCUSSION: Children in Madagascar, unlike those in Central Africa, do not develop microsporic gray-patch ringworm caused by Microsporum langeronii. However, they may present tinea capitis with small alopecic lesions, or they may frequently have Trichophyton tonsurans and seem to have healthy scalps. In contrast with Central Africa, where T. soudanense is the main cause of black-dot ringworm, and with North Africa, where T. violaceum is most frequently seen, these 2 species are not found in Antsirabe. Studies carried out in coastal regions with a more tropical climate could perhaps show other dermatophytes responsible for tinea capitis. Anthropophilic tinea capitis caused by Trichophyton tonsurans is endemic in the Antsirabe area. The lesions are inconspicuous with diffuse scaling, like those reported in surveys conducted in the USA. Mycological investigation followed up by topical treatment with a fungicide could diminish the spread of this anthropophilic, and thus contagious, dermatophyte. Trichophyton tonsurans has also reappeared regularly in France over the past few years.

Adolescent↗

Experimental systemic dermatophytosis.

Albino guinea pigs with abraded skin were inoculated cutaneously with 27 strains of dermatophytes from animals and humans. The same strains were inoculated i.v. in guinea pigs with intact skin. Zoophilic dermatophytes and human isolates of Trichophyton mentagrophytes var. granulare produced ringworm after cutaneous application. After i.v. inoculation, the fungus was reisolated from skin samples from a considerable number of animals with and without clinical ringworm lesions, and also from lungs, liver, and kidneys. In the lungs, hyphal aggregates were noted. Some strains produced generalized dermatophytosis affecting all parts of the skin and internal organs. T. mentagrophytes B32663, selected for further study, was inoculated i.v. in the guinea pig, rabbit, rat, mouse, and chicken. Ringworm lesions occurred in the guinea pig and rabbit; in the mouse, rat, and chicken other organs were involved. Administration by other routes did not produce a generalized infection. The infection was not self-limited and the deep-seated lesions may be responsible for the recurrence of infection.

Animals↗

Prevalence of undetected tinea capitis in a school survey in Spain.

From October 1994 to November 1995, a prospective study aiming to detect dermatophytes on the scalp was undertaken in 5000 unselected school children aged between 3 and 16 years (mean age 8.34 years, SD +/- 3.83). Thirty-two (0.64%) had dermatophytes in the scalp, 22. (0.44%) had tinea capitis and 10 were asymptomatic scalp carriers. It is important to point out that 33% of the patients with tinea capitis and 60% of the asymptomatic scalp carriers also had ringworm in other body sites. There was a significantly higher proportion of cases of tinea capitis (P < 0.001)(particularly due to Trichophyton tonsurans, P < 0.001) and of cases of asymptomatic scalp carriers (P < 0.05) (particularly due to Trichophyton tonsurans, P < 0.001) in the immigrant population of African origin. In all the child index cases with positive scalp cultures (tinea capitis and carriers), the household members were studied clinically and mycologically. One child had a body ringworm caused by Microsporum canis. Twelve adults had positive cultures with dermatophytosis (one tinea capitis and eleven body ringworm). Three adult patients were also carriers of dermatophytes in other body sites. Our data indicate a change in the causative agents of tinea capitis seen in Madrid over a 12-month period, with cases due to antropophilic species (T. tonsurans, T. soudanense, M. audouinii and T. violaceum) occurring in the immigrant population from Africa; as a consequence, there is an emergence of T. tonsurans in the Spanish population.

Adolescent↗

Pediatric tinea capitis: recognition and management.

Tinea capitis (ringworm of the head) is the most common dermatophytosis of childhood with an increasing incidence worldwide. If suspected clinically, further diagnostic procedures, including direct microscopy and culture, should be performed. Other scalp alterations, such as seborrheic dermatitis, atopic eczema, psoriasis, alopecia areata, folliculitis, and pseudopelade, may mimic ringworm of the head and must be identified. A proven fungal infection of scalp skin and hairs warrants immediate initiation of systemic treatment. At present, only oral griseofulvin is approved for therapy of scalp ringworm in children by health authorities. However, the advent of several newer antifungal agents such as itraconazole, fluconazole, and terbinafine has broadened the therapeutic armamentarium in recent years. These agents offer shorter treatment intervals, and their adverse effects and drug interaction profiles appear to be well within acceptable limits. In patients with tinea capitis, systemic therapy at weight-dependent dosages for an appropriate amount of time in conjunction with topical supportive measures will help to prevent disfiguring hair loss, permanent formation of scar tissue, spread of fungal organisms to other cutaneous regions, and infection of other persons.

Antifungal Agents↗

[The effectiveness of LTF 130 Trichophyton vaccine under field conditions].

The preventive action of ringworm vaccine LTF 130 was studied in calves. A number of these calves were found to develop ringworm despite vaccination when they came into contact with infected animals during the build-up of immunity. The incidence of ringworm was reduced when the animals were vaccinated at an early age or when the dosage was increased on vaccination later in life.

Animals↗