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PubMed1989

Tinea capitis caused by Microsporum praecox in a patient with sickle cell anaemia.

Microsporum praecox Rivalier ex Padhye, Ajello et McGinnis is the validated name for the taxon originally published as Sabouraudites praecox Rivalier. We describe here the first case of small-conidial, ectothrix type hair invasion caused by M. praecox in an adult woman from Oklahoma, U.S.A., suffering from sickle cell anaemia. This fungus is now being encountered with greater frequency as an etiologic agent of ringworm infection.

Adult↗
PubMed1956

Therapy of tinea capitis; the value of x-ray epilation.

Roentgen ray epilation, which is at present the most important single weapon against M. audouini infection of the scalp, should not be withheld except in special circumstances, from a child who has the disease. It can quickly cure the disease and halt spread from one child to another. Harmful sequelae and medicolegal complications can be averted by competent use of the method and simple precautions. The Keinbock-Adamson technique of epilation can be recommended without hesitancy, provided it is carried out meticulously in every detail, and administered by an operator of suitable training and experience in roentgen therapy of the skin.

Child↗
PubMed2003

Surgical treatment of tinea capitis in childhood.

Fungal infections of the scalp can cause kerion, pus-filled swellings, that may look like bacterial abscesses. We report on two children who underwent incision and drainage of their kerions under local and general anesthesia. This treatment was inappropriate: it carried the risk associated with general anesthesia and surgery without providing the therapeutic chance linked to adequate antimicrobial chemotherapy. We recommend that children who are present at emergency departments with pus-filled swellings on the scalp should be referred to a dermatology unit where appropriate clinical and laboratory investigations and antifungal treatment can be provided, if considered adequate.

Abscess↗
PubMed1980

An unusual case report: tinea capitis, verrucae vulgares and other infections in a girl with T and B cell disturbances.

Hereby described is a case of a young girl suffering from widespread dermatophytosis caused by Trichophyton violaceum which proved intractable to accepted methods of therapy throughout a number of years. The girl was also found to have a history or recurrent respiratory tract infection and pyoderma in addition to verrucae vulgares, and Giardia lamblia in the gastrointestinal tract. Investigation revealed a marked immunological deficit seen in both the cellular and humoral system. It is suggested that in similar cases resistant to therapy it may be helpful to carry out a comprehensive investigation of the immunological system.

Antibody Formation↗
PubMed1999

[Tinea capitis and corporis caused by Trichophyton soudanense in an immigrant family from Africa].

HISTORY AND FINDINGS: Several weeks before coming to Germany the two daughters (aged 3 and 6 years) of a family from Togo had developed desquamating skin changes over the hairy scalp. These had then spread to the trunk and limbs. The 8-weeks-old son also had discrete lesions on the hairy scalp and neck. In all of them these lesions had then spread and begun to itch markedly. When first seen as out-patients the father was free of symptoms, but the other members of the family had multiple, sharply circumscribed, partly confluent, dry and desquamating lesions, about 2-4 cm in diameter, with areas of alopecia and hair breaking off at skin level. In addition there were dry, desquamating, sharply circumscribed, partly hyperpigmented, partly infiltrated plaques, 1-3 cm in diameter, disseminated over the entire body surface, but especially the neck and limbs. INVESTIGATIONS: Typical micromorphological characteristics for T. soudanese were demonstrated in the outer zones of a primary culture and the organism was also demonstrated in culture on Sabouraud-glucose-agar. Typical colonies on Löwenstein-Jensen medium allowed differentiation from Microsporum ferrugineum. TREATMENT AND COURSE: The patients were treated systemically with griseofulvin and locally with ciclopiroxolamine. Marked clinical improvement occurred within 2 months and cultures became negative. But as fungal elements were still demonstrated in native preparations from two of the patients, treatment was continued. CONCLUSION: Efficacious treatment of tinea needs reliable diagnosis of the pathogen. Human infection with T. soudanese usually results from contact with other humans. If this infection occurs in persons not from Africa there is usually the history of indirect or direct contact with Africans. Increased international migration and tourism is likely to result in more cases of this kind: this pathogen should be considered in the differential diagnosis of tinea of scalp and body.

Adult↗
PubMed1976

Kerion-like tinea capitis and barbae caused by Microsporum gypseum in Israel.

Four cases of hair invasion by Microsporum gypseum are reported. In three the scalp was involved and in one, the beard. All presented a kerion type of invasion. In 3 cases hair penetration was of the ectothrix type, while in one case the kerion of the scalp resembled the type of invasion seen in T. schonleini infection. None of the invaded hairs showed fluorescence in Wood's light. The soil was the source of infection in 3 patients, the fungus having been isolated from soil samples collected in the vicinity of the houses of these patients through the hair bait method. In one case the source of contamination was the family dog, in which scaly, alopecic, follicularlike lesions caused by the same agent were found.

Adult↗
PubMed1978

Follow-up study of patients treated by X-ray epilation for tinea capitis: psychiatric and psychometric evaluation.

To investigate the late effects of radiation to the head upon subclinical mental disorders, a psychiatric and psychometric evaluation was performed on 177 cases treated 10-29 years earlier for ringworm of the scalp by X-ray therapy (N :109) or, by chemotherapy (N :68). Analyses which controlled for educational level and family psychiatric disorders showed that, among whites, the irradiated group manifested more psychiatric symptoms and more deviant MMPI (Minnesota Multiphasic Personality Inventory) scores. They were also judged more maladjusted from their MMPI profiles, and more frequently had a history of treated psychiatric disorders; however, the psychiatrist's overall rating of current psychiatric status showed only a borderline differnece between the two groups. There were no significant differences between irradiated and chemotherapy treated blacks.

Adult↗
PubMed1987

The infected hairs of tinea capitis due to Microsporum canis: demonstration of uniqueness of the hair cuticle by scanning electron microscopy.

Scanning and transmission electron microscopic studies were done on scalp hairs of four patients infected with ectothrix Microsporum canis. Both freeze fracture and cross-sectioning of hairs revealed a thick sheath of fungal spores encircling the hair shaft beneath an intact cuticle. These spores were not visible on surface inspection but became apparent only where the cuticle had been rubbed off or broken. Daily selenium sulfide shampoos removed all of the spores from these sites. The cuticle is viewed as being an effective barrier to the penetration of fungi, so that the hair is vulnerable to fungus infection only deep within the hair follicle below the level of the mature cuticle. Once the fungus enters the hair cortex just above the hair bulb, it produces myriads of spores that remain trapped and hidden beneath the cuticle for the length of the intact hair.

Child↗
PubMed2003

[A case of Tinea capitis caused by Trichophyton tonsurans].

A 10-year-old Peruvian girl, living in Japan since 1996, visited our hospital in August 2000 complaining of alopecia which had been present on her scalp for one year. The bald areas appeared as multiple small, scattered, angular patches with indistinct margins. Follicular pustules, erythemic nodules and lymphadenopathy were also seen. In the culture of the affected hair, a tan surface with wiry undulations grew on Sabouraud's media. The colony reverse had reddish-brown central pigmentation. Slide cultured fungi produced great numbers of round and short club-shaped microconidia, hyphae and intercalary chlamydospores. These fungi showed the following characteristics: positive urease test, no pigment production on cornmeal agar and positive thiamine dependency. The restriction fragment length polymorphism pattern and the nucleotide sequences of ribosomal-DNA internal transcribed spacer region of the causative fungus was compatible with Trichophyton tonsurans. Daily administration of 125 mg of terbinafine resulted in a satisfactory response and the lesion healed almost completely.

Administration, Oral↗
PubMed1999

Short duration treatment with terbinafine for tinea capitis caused by Trichophyton or Microsporum species. The Study Group.

Thirty-five patients with mycologically proven scalp infections were enrolled in a randomized, double-blind clinical trial with oral terbinafine (dose adjusted according to patient weight) for either 1 or 2 weeks. Patients were observed for 12 weeks; after 4 weeks, non-responders were offered an additional 4 weeks of treatment followed by a second observation period. The causative organisms were Microsporum canis (n = 12), Trichophyton tonsurans (n = 12) and other Trichophyton spp. (n = 11). The Trichophyton infections were treated effectively in five of nine (56%) patients treated for 1 week and 12 of 14 (86%) patients treated for 2 weeks. Three of the non-responders were treated for an additional 4 weeks, and one responded. In the Microsporum group only one of seven patients treated for 1 week and none of five treated for 2 weeks responded. However, treatment was effective in four of six (66%) patients treated for an additional 4 weeks. Mild to moderate adverse events believed to be drug related occurred in four patients in each of the two groups. Terbinafine is well tolerated, and requires 2 weeks of treatment in most patients with Trichophyton scalp infections and 4 weeks or more in Microsporum scalp infections, to achieve a successful clinical and mycological response.

Adolescent↗
PubMed1995

[Trichophyton soudanense as the pathogen of tinea corporis et capitis].

Tinea capitis and corporis caused by Trichophyton soudanense were identified in a 6-year-old coloured boy who was born in Zaire and had been living for 3 years in Germany. This dermatophyte is very rarely seen outside the region in Africa where it is endemic. The disease is frequently overlooked at diagnosis because of the pathogen's capacity for causing chronic and oligosymptomatic infections. In our case the tinea did not a become apparent until the patient had been in Germany for 3 years. No-one else in his family had any comparable scalp or skin lesions. Consistent therapy with itraconazole (Sempera) dosed at 3 mg/kg body weight per day over a period of 4 weeks led to a permanent cure.

Black People↗
PubMed2005

[Epidemic of Trichophyton tonsurans tinea capitis in a nursery school in the Southern suburbs of Paris].

INTRODUCTION: In March 2001 a school and family survey was conducted in a nursery school in the Southern suburbs of Paris, during an epidemic of Trichophyton tondsurans tinea. PATIENTS AND METHODS: One hundred twenty-nine children aged 3 to 6 were examined as well as 15 adults working in the school. A survey of the contaminated children or asymptomatic carriers was performed. All the children and adults concerned were treated at the same time, without eviction from school. RESULTS: T. tonsurans was detected in 10 cases of tinea (7.7 p.cent of the persons examined), in 18 cases of cutaneous lesions (13.9 p.cent) and in 25 asymptomatic carriers on the scalp (19.4 p.cent). The majority of the positive cases came from the same school class as the original case: 23 of the 26 children (88 p.cent), with 6 tinea, 14 asymptomatic carriers and 13 cutaneous lesions. Only one of the 15 adults exhibited a T. tonsurans cutaneous lesion. Among the 13 families studied, 2 had several members involved, the first being that of the original case (3 tinea and 2 asymptomatic carriers). DISCUSSION: Several important points are underlined by this study: 1) the high contagiousness of T. tonsurans; 2) the detection of 2 mechanisms of indirect contamination (rag doll mascot in the class and the family hair-clipper); 3) the one-year time lapse between the arrival of the contaminating child in the class and the survey, explaining the extent of the contamination; 4) the underestimation of the epidemic due to the lack of mycological examinations; 5) the identification of several dermatophytes in the same school:M. canis, T soudanense and T. tonsurans, and 7) the futility of eviction from school when all the children can be treated.

Adult↗
PubMed2001

[Tinea capitis by Microsporum audouinii].

We report the case of a four year-old girl from Equatorial Guinea who had been living in Spain for the last month. She presented several alopecic patches on the scalp. The direct study of the hair with 40% KOH showed an ectothrix infection and the mycological study revealed the etiologic agent was Microsporum audouinii. We present this case because of its rarity in our country and we point out the increasing interest of the imported tineas due to immigration from African countries.

English Abstract↗
PubMed1996

A U.S. epidemiologic survey of superficial fungal diseases.

BACKGROUND: Large-scale studies performed outside the United States have demonstrated that most cases of onychomycosis and tinea pedis are caused by dermatophytes, primarily Trichophyton rubrum. However, other studies have suggested that yeasts and nondermatophytic molds may play a role, particularly in onychomycosis. OBJECTIVE: This study was undertaken to determine the epidemiology of superficial fungal infections in a U.S. population. METHODS: Fungal cultures were performed on patients with clinically suspected tinea cruris, tinea corporis, tinea capitis, tinea pedis, and onychomycosis. RESULTS: Dermatophytes were the most commonly isolated fungi in each type of superficial fungal disease studied. T. rubrum was the most commonly isolated dermatophyte species, although Trichophyton tonsurans was more common in tinea capitis and equally common in tinea corporis/tinea cruris. In tinea pedis and onychomycosis, dermatophytes appeared in approximately 95% and 82% of isolates, respectively. Candida albicans and nondermatophyte molds played only a minor role in onychomycosis; C. albicans was isolated in 7% of nail cultures and nondermatophytic molds were isolated in 11%. CONCLUSION: These results are in general agreement with other major epidemiologic studies performed outside the United States. Dermatophyte fungi cause most superficial fungal infections.

Arthrodermataceae↗