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PubMed1986

Hair loss. Common congenital and acquired causes.

Hair loss is a common problem likely to be encountered by a clinical practitioner. The most frequent causes of hair loss in pediatric patients include tinea capitis, alopecia areata, traction alopecia, and trichotillomania. In the adult population, causes to be considered are alopecia areata and hair loss associated with systemic disease and hormonal influence. The clinician must be able to separate the types and causes of hair loss into those that reflect primary dermatologic conditions and those that represent reaction to systemic disease.

Adolescent↗
PubMed2002

[Hair diseases in childhood].

This paper focuses on four important hair diseases mainly occurring in children. Trichotillomania is the most relevant differential diagnosis of alopecia areata in childhood. Meticulous inspection and lack of telogen hairs in the trichogram from the margin of the lesion usually are sufficient for differentiation. The trichogram also plays a significant role for the diagnosis of the loose anagen hair (loose anagen syndrome), a fairly new, but not rare entity, especially in distinguishing it from telogen effluvium. Five different types of clinical presentation are distinguished in tinea capitis. For the necessary systemic therapy; the new antimycotics terbinafine and itraconazole represent good alternatives to the well-tried griseofulvin. Several effective therapeutic options are also available for head lice, the most frequent parasitary infestation of school age. However, because of its neurotoxicity and the increasing problem of lice resistance lindane should not be used any longer for the treatment of head lice.

Adolescent↗
PubMed2004

Dermatophytes in the rural area of Duzce, Turkey.

A total of 227 subjects (112 were male and 115 female), who were residents of the rural region of Duzce, were examined for dermatomycosis. A total of 120 samples (47 nail fragments, 73 skin scales) were collected from 81 patients for mycological analysis on the basis of the results of clinical evaluation. All specimens collected were analysed by direct microscopy and culture. Positive results were detected in the cultures of 53 (44.1%) of the 120 samples. About 46 (86.7%) samples also presented positive results in direct microscopy. In the cases of seven samples positive results were found in culture and negative results with direct microscopy. Both culture and direct microscopy presented negative results in 67 (55.8%) samples. The most frequently isolated aetiological agents were 33 Trichophyton rubrum (62.2%), and nine T. mentagrophytes (16.9%). In conclusion, traditional and religious habits such as cohabitation and performing ritual ablutions may affect the prevalence of dermatophyte infections. The performance of ritual ablutions is not in itself a risk factor for acquiring dermatophyte infection; rather it is not drying the extremities after ablutions, that is the main risk factor for this group. Tinea capitis was not found in any of the subjects in spite of the fact that it is one of the most common infectious conditions in children. This is the first paper to report the prevalence of fungal infections in Duzce, a western Black Sea region of Turkey.

Adolescent↗
PubMedDate not supplied

Ringworm of the scalp in primary-school children in Alexandria: infection and carriage.

A total of 510 children from a primary school in Alexandria were examined for tinea capitis, and samples were taken from their scalps. Specimens were examined by direct microscopy and were cultured. Diagnosis was by clinical and mycological findings. Clinical evidence of pediculosis capitis was found in 54.1% of children, more commonly in girls. Dermatophytes were isolated from 7.4% of scalp samples (2.9% confirmed cases, 4.5% carriers). A further 2% were suspected cases as they were negative by mycology. Most of the children were under 10 years and none was aware of having the infection. All isolates were identified as Trichophyton violaceum.

Age Distribution↗
PubMed1997

Radiation-induced cerebral meningiomas. Case reports.

Two cases are presented of meningiomas following external cranial irradiation in which several features clearly indicate a causal relationship between radiotherapy and tumour development. In one patient multiple recurred meningioma was diagnosed 30 years after low-dose X-ray treatment of Tinea capitis; in the other patient the meningioma was diagnosed approximately 18 years after high-dose radiation therapy for astrocytoma. The features distinguishing radiation-induced meningiomas from other meningiomas are reviewed. The use of radiation therapy only in those cases in which there is clear evidence that it will have beneficial effects and that these effects will outweigh the risks is emphasized.

Adult↗
PubMed2006

Genotype analysis of the variable internal repeat region in the rRNA gene of Trichophyton tonsurans isolated from Japanese Judo practitioners.

Tinea capitis due to Trichophyton tonsurans is currently epidemic among Japanese Judo practitioners. T. tonsurans has seven genotypes in a variable internal repeat (VIR) region of the rRNA gene. All 101 isolates obtained from Japanese Judo practitioners had the identical genotype. This suggests that a specific genotype strain occurs throughout Japan.

Adolescent↗
PubMed2002

Unusual presentation of Microsporum canis in human hair.

This study reports an unusual presentation of Microsporum canis in infected human hair in a three-year-old boy. Infected hairs showed ectothrix colonization with a mass of small conidia and numerous macroconidia typical of the genus Microsporum. The infected hairs also showed strong invasion by hyphae bearing small numbers of arthroconidia. These hyphae were thinner and longer than those normally found in hair and scalp. It is well known that in cases of tinea capitis due to M. canis, ectothrix arthroconidia formation is extrapilary and arises from intrapilary hyphae. In this case it seems that unusual quantities of hyphae were formed, and not all of them broke down into arthroconidia. They appeared to remain in the hair and to produce macroconidia, which were not formed outside the hair in contact with air, but instead seemed to remain in a deeper layer of the hair than the arthroconidia seen.

Child↗
PubMedDate not supplied

Chronic mucocutaneous candidosis and other superficial and systemic mycoses successfully treated with ketoconazole.

Four patients with chronic mucocutaneous candidosis from early infancy were treated successfully with ketoconazole given orally. All thrush lesions were clinically and mycologically cured within a few days of treatment with 100-400 micrograms of ketoconazole daily; skin lesions were cured within a few weeks, and nails were cured after about three months of treatment. Delayed cutaneous hypersensitivity to candidin was acquired by the third month. Cellular and humoral immunologic responses were related to the suppression of Candida albicans antigen by ketoconazole. A fifth patient with chronic lingual granuloma due to C. albicans improved considerably. Favorable results also were seen in individual patients with oral and disseminated histoplasmosis due to Histoplasma capsulatum; laryngeal, pulmonary, and hepatic disease with continuous fever also due to H. capsulatum; pulmonary histoplasmosis due to Histoplasma duboisii; cutaneous sporotrichosis; and cutaneous blastomycosis due to Blastomyces dermatitidis and in three patients with favus due to Trichophyton schoenleinii; six of seven patients with tinea capitis due to Trichophyton violaceum (after one month of treatment); and four patients with infections due to Petriellidium boydii, Phialophora pedrosoi, or Beauveria species. All patients responded rapidly to 400 mg of ketoconazole per day given orally. Only the patient with hepatic histoplasmosis required 800 mg per day. Measurements of ketoconazole in the serum during treatment were useful in the evaluation of therapy.

Adolescent↗
PubMed2005

[Trichophyton violaceum infection occurring in a nursing home].

Six cases of Trichophyton (T.) violaceum infection seen in a nursing home are reported. A 66-year-old female (case 1) was found with tinea corporis on her face, chest and shoulder, associated with black dot ringworm. A KOH examination of hair showed endothrix parasitism. Reddish purple colonies were isolated from the patient on Sabouraud's dextrose agar, and intercalary and terminal chlamydospores were observed on slide culture. PCR-RFLP analysis of the microorganism showed a pattern of T. violaceum type. Therefore, the isolated fungus was identified as T. violaceum, a typical anthropophilic dermatophyte which had spread among residents and staffs easily. Using a mycological method, we examined 59 persons (21 residents and 38 staff members) who had had contact with case 1. The results were as follows. An 85-year-old female (case 2) and an 83-year-old female (case 3) were carriers of T. violaceum. A 23-year-old male (case 4) had tinea corporis on his right forearm due to T. violaceum. A 24-year-old male (case 5) probably had tinea corporis on his right forearm due to T. violaceum. One year after case 1's first visit to our clinic, we observed an 88-year-old female (case 6) of tinea capitis by T. violaceum. It seems that the organism was preserved in surroundings and members of the nursing home. The contagion in our cases could either have been caused by directly touching the person or by sharing their comb. PCR-RFLP analysis was performed within a short time, so that we managed effectively to select a way of treatment and to prevent the infection from spreading.

Adult↗
PubMed1983

[Microsporic tinea of the scalp in adults].

Five cases of "tinea capitis" by Microsporum canis in adult were studied. Cellular immunological tests were performed on four of them and the results were according to clinical forms. The hormonal studies in these patients were normal to their ages. Three of them were old women. Two cases were atypical difficult to diagnose. For this reason the authors suggest to perform mycological studies in every scalp affections were it is impossible to do a clinical and evolutive positive diagnosis. All the patients healed with local and systemie antimycotical treatment.

Adult↗
PubMed1995

[Benign meningioma following scalp irradiation in north African immigrants].

Many Jewish immigrants from North Africa in the late 1950s were treated with low-dose irradiation of the scalp for tinea capitis. In 2 such patients, a 47-year-old man and a 43-year-old woman, both with long histories of headaches and dizziness, meningiomas were found. There is a well-known correlation between low-dose irradiation of the scalp and development of meningioma. Therefore, in immigrants from North Africa with prolonged headaches and dizziness, there should be a careful history with regard to irradiation of the scalp and investigation to exclude meningioma.

Africa, Northern↗
PubMed2004

Ant-induced alopecia: report of 2 cases and review of the literature.

Localized scalp hair loss is associated with many processes, including alopecia areata, trichotillomania, tinea capitis, and early lupus erythematosus. There are several reports of localized alopecia after tick- and flea-bites and bee stings, but there are only two reports of ant-induced alopecia in the literature. We present two cases of alopecia induced by ants of genus Pheidole (species pallidula) and review the literature for insect-induced alopecia. Ant-induced alopecia should be considered in the differential diagnosis of localized sudden-onset alopecia, at least in some geographic areas of the world.

Adult↗
PubMed1990

Dermatophytosis of the scalp: incidence, immune response, and epidemiology.

Tinea capitis remains a common infection among the pediatric population of North America. The 'gray patch' Microsporum audouinii infections of the 1950's have been supplanted by the 'black dot' ringworm of Trichophyton tonsurans. The clinical presentation of T. tonsurans infection is quite variable and may be related to specific host T-lymphocyte response. This dermatophytosis is most frequently incurred from contact with an infected child either directly or via a variety of fomites. Current studies indicate that an asymptomatic adult carrier state may also exist which could contribute to the morbidity of this mycosis.

Humans↗
PubMed2005

[Survey of Trichophyton tonsurans infection in the Hokuriku and Kinki regions of Japan].

In June 2004, information was gathered on Trichophyton tonsurans infections, both past and current, in the Hokuriku and Kinki regions of central-western Honshu island, Japan, by questionnaires sent to 185 dermatologists who were members of the local medical mycologist associations Hokuriku Shinkin Kondan-kai and Kansai Shinkin Kondan-kai. Of the 111 (59.4%) who returned the completed questionnaire, 32 (28.8%) had seen patients infected with T. tonsurans including suspicious cases. The earliest recorded cases were linked to an endemic that occurred in 1994 or 1995 among a high school wrestling team in Toyama. The majority of the dermatologists saw their first case between 2001 and 2003. When the patients were grouped according to contact sports, judo players formed the largest group, followed by wrestlers. When grouped according to age, high school students formed the largest group, but the endemic had also expanded among junior high school students and adults, and there was one nursery school child who was a member of a judo club. Seventy-four of the dermatologists were sent sterilized hairbrushes to collect samples from patients suspected as having tinea capitis during July and September 2004. Trichophyton tonsurans was detected in samples from 6 patients. To investigate the molecular epidemiology, 71 of the clinical strains of T. tonsurans isolated from the Hokuriku and Kinki regions were analyzed using restriction fragment length polymorphisms of the non-transcribed spacer regions of ribosomal RNA genes. With the restriction enzyme Mva I, two molecular types were detected among the strains, indicating that the causative agents of the endemic were derived from different origins.

Adolescent↗
PubMed1993

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↗
PubMed1999

A study of the spectrum of skin disease occurring in a black population in south-east London.

We recorded the diagnosis made in 461 black patients (187 children and 274 adults) attending a dermatology clinic between January and March 1996. In the childhood population, atopic eczema and tinea capitis were the most frequent dermatoses, comprising 63% of diagnoses recorded. In the adult population, acne and acne keloidalis nuchae were seen most frequently. Other conditions observed commonly were eczema, psoriasis, keloid scarring, pityriasis versicolor and postinflammatory changes. Our study demonstrates a wide spectrum of skin disease and includes disorders more common in black skin, disorders unique to black skin, those which present a greater cosmetic disability, and normal findings which have been mistaken for pathological disease.

Acne Vulgaris↗
PubMed1982

Long-lasting cerebral functional changes following moderate dose x-radiation treatment to the scalp in childhood: an electroencephalographic power spectral study.

EEG tracings were compared in 44 young adults who received scalp x-radiation treatment for tinea capitis during childhood and 59 non-irradiated control subjects. The irradiated subjects were exposed, over 20 years previously, to a mean dose of 130 rads to the brain. Visual analysis of the EEG revealed an insignificant excess of abnormalities among the irradiated subjects compared to the controls. Power spectral density function analysis showed increased power values among the irradiated subjects, particularly in the beta wave frequencies. This finding provides further evidence for suspecting that x-irradiation during brain maturation may cause long-lasting damage to the brain tissue.

Adolescent↗
PubMed1976

Scalp ringworm among Black children in South Africa and the occurrence of Trichophyton yaoundei.

The prevalence of tinea capitis among 153 children who were selected by overt signs of scalp infestation from among 658 Black schoolchildren, was studied in two rural areas of the Transvaal. In both areas (Eastern and Northern Transvaal), Trichophyton violaceum was the predominant dermatophyte species which was isolated. Microsporum audouinii was isolated in both areas from a total of 4 children, but M. canis was the cause of only 1 infection, and that was in the Eastern Transvaal. Five infections caused by T. yaoundei, all of which occurred in the Northern Transvaal, were recorded. They are the first documented cases of endothrix scalp ringworm caused by this species in South Africa.

Black or African American↗