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PubMedDate not supplied

Superficial fungal infections: an update on pityriasis versicolor, seborrheic dermatitis, tinea capitis, and onychomycosis.

The recent advances in pityriasis versicolor, seborrheic dermatitis, tinea capitis and onychomycosis are reviewed. Some highlighted points include the new classification of Malassezia species, and the association of Malassezia species with seborrheic dermatitis. The use of terbinafine, fluconazole, and itraconazole for the treatment of tinea capitis is discussed. The management of onychomycosis, highlighting the high efficacy rates obtained with terbinafine when used to treat dermatophyte toenail onychomycosis, is discussed. The use of combination therapies in some circumstances to maximize cure rates is reviewed.

Antifungal Agents↗
PubMed1990

Tinea capitis in Tirupati.

One hundred clinically diagnosed cases of Tinea capitis were studied to know the clinical types and the causative agents. The incidence of grey patch, Kerion and black dot being 60%, 31% and 9% respectively. Tinea capitis was found to be more common in males (58%) than in females (42%) and it is more prevalent in children aged between 6-15 years. Trichophyton violaceum is the predominant (63.15%) fungal species isolated.

Adolescent↗
PubMed1982

Tinea capitis.

Trichophyton tonsurans is now a major cause of tinea capitis, affecting both children and adults. The characteristic lesions are pruritic, scaling patches with black dots; Wood's light examination is negative. Microsporum canis and Microsporum audouini, formerly the most frequent causes of tinea capitis, predominantly affect children and are Wood's light positive. Lesions caused by M. canis are inflammatory, while those of M. audouini are scaly. All three organisms respond to griseofulvin.

Administration, Oral↗
PubMed1986

A study of tinea capitis in Jordan (West Bank).

Between January 1983 and October 1984, 425 cases of tinea capitis were clinically diagnosed in the West Bank of Jordan. These comprised 38% of all dermatophytosis cases seen during the same period. The number of tinea capitis infections varied with season, the highest numbers occurring in winter and spring months and lowest numbers occurring in summer months. Females accounted for about 60% of scalp infections. Specimens from 302 tinea capitis cases were cultured and 217 isolates of dermatophytes were recovered. Trichophyton violaceum was found to be the most common aetiological agent accounting for 49.8% of total isolates. Microsporum canis was the next most common aetiological agent accounting for 31.8%; zoophilic isolates including this species comprised about 38% of all isolates.

Adolescent↗
PubMedDate not supplied

Tinea capitis in infants less than 1 year of age.

Tinea capitis is the most frequent manifestation of dermatophyte infection in children, but because it is rare in the first months of life it is often misdiagnosed. Here we report 15 cases of tinea capitis observed in Italy in infants less than 1 year of age. There were 10 boys and 5 girls (mean age 6 months). Diagnosis was confirmed by mycologic examination. Microsporum canis was isolated in nine cases and Trichophyton mentagrophytes in three. These 12 infants were Italian and animals were the source of infection. Trichophyton erinacei was isolated in one Italian infant, and the source was soil. In the other two cases, Trichophyton tonsurans and Trichophyton violaceum were isolated; these infants were from Central America and India, respectively, and had contracted the infection from humans. All achieved clinical and mycologic recovery after systemic and topical antimycotic therapy.

Age Factors↗
PubMed2003

An outbreak of tinea capitis in a child care centre.

We describe an outbreak of tinea capitis in a kindergarten. Individuals with relation to the institution were examined clinically and mycologically (n-98), Microsporum audouinii was cultured from 12 people, out of whom eight patients had tinea capitis, four patients had tinea corporis, and three patients had both. The problems with spread of anthropophilic infections and the difficulties with treatment of Microsporum dermatophytes are discussed.

Adult↗
PubMed1980

Tinea capitis an endemic disease in Madras.

A study of Tinea capitis in Outpatient Clinic, Skin Department, Government General Hospital, Madras during a three year period from November, 1973 to October, 1976, has shown a gradual increase in incidence of 3.56%, 5.09% and 6.25% respectively. Findings suggest that Tinea capitis is endemic in South India. Male children were more commonly affected than female children and the age groups chiefly affected were between 5 and 10 years. A considerably number of adults were also affected. The disease showed no correlation to environmental temperature, humidity and rainfall but was correlated to all types of mycoses and total incidence of mycoses. Among 357 isolates, Trichophyton violaceum was the commonest in 264 (73.94%) and T. tonsurans was the next common in 47 (13.16%). The other agents were T. rubrum in 30 (8.4%), T. mentagrophytes in 11 (3.08%) and T. simii in 5 (1.4%). Noninflammatory lesions were more common than inflammatory lesions and both were produced by T. violaceum and T. tonsurans, suggesting strain differences in pathogenesis. Treatment with oral griseofulvin was satisfactory in all but had to be discontinued in 4 patients due to side effects.

Adolescent↗
PubMed1994

Tinea capitis: epidemiology, diagnosis, treatment, and control.

Since the 1970s there has been a steady rise in the number of cases of tinea capitis in the United States, most of them caused by Trichophyton tonsurans. Although the infection is seen most frequently in black children, it can occur in white persons and can affect persons of all ages. Control of tinea capitis is difficult for several reasons, including subtle clinical infection, asymptomatic carriage of fungus, fomite spread, and the need for weeks to months of oral medications. Although griseofulvin remains the mainstay of therapy, preliminary studies of itraconazole and terbinafine suggest that these compounds may also be useful in the treatment of tinea capitis. Selenium sulfide shampoo, prednisone, and oral antibiotics are frequently used as adjunctive therapy. The role of fomites in the spread of tinea capitis has yet to be fully understood, as does the best means of decontamination.

Adolescent↗
PubMedDate not supplied

Frequency of Trichophyton rubrum in tinea capitis.

Trichophyton rubrum has led to unprecedented worldwide suppression of other dermatophytes which had been predominant earlier as a causative agent of superficial dermatomycoses. In tinea capitis on the other hand, several other species of Trichophyton or Microsporum are dominant depending on the region or continent. Tinea capitis caused by T. rubrum is a rare event worldwide. Occasional concentrations may be explained by several cases occurring by chance in one family or community. The relative frequency of this causative agent in tinea capitis in children is under 1%. In adults, however, where tinea capitis occurs very infrequently indeed, the incidence of T. rubrum appears to exceed 10%. Apart from two studies from India, one from Iran, two from Portugal and observations from Germany, which in the first country report of around 30% of all cases published, while the others document some 10% each, there are not only any conspicuous, unequivocal concentrations at all. Increased frequency of T. rubrum in this clinical picture has not been easily recognizable over the last decades due to low absolute case numbers.

Humans↗
PubMed1999

[Tinea capitis in primary school age children in southeastern Amsterdam: primarily due to Trichophyton tonsurans].

OBJECTIVE: To establish prevalence and aetiology of tinea capitis in children attending primary school in Amsterdam South-East. DESIGN: Prevalence survey. METHODS: The Municipal Health Service Amsterdam, the Netherlands, selected classes of four primary schools in a survey with children clinically suspected of having tinea capitis as well as classes without clinical cases. Per school at least one class with a notified case was included. Written information was provided to all parents; the parents of three children refused participation. After clinical examination by a team of physicians and nursing staff scalp cultures were taken using the brush method from 315 children (aged 4-12 years) in 16 classes. RESULTS: The clinical diagnosis 'tinea capitis' was established in 25 children, significantly more in boys than in girls (relative risk (RR) = 2.92: 95% confidence interval (95% CI) 1.20-7.11). Of all children 7% had positive cultures, more boys than girls (RR = 3.13: 95% CI: 1.18-8.28). Symptomatic cases (confirmed by culture) amounted to 3.2% of all children. The carrier rate was 3.8%. Trichophyton tonsurans was the most frequently isolated dermatophyte both in symptomatic children and in carriers. CONCLUSION: In 7% of all children (3.2% with symptoms of tinea capitis, 3.8% without) dermatophytes were cultured from scalp samples, the main aetiologic agent being T. tonsurans.

Child↗
PubMed1999

Itraconazole oral solution for the treatment of tinea capitis using the pulse regimen.

A 7-year-old boy with Trichophyton tonsurans tinea capitis was cured following the administration of itraconazole oral solution. He had difficulty swallowing tablets or capsules, so the availability of the oral solution was particularly advantageous. The itraconazole was given once daily in a fasting state at a dosage of 3 mg/kg/day as a pulse lasting 1 week. The first two pulses were separated by 2 weeks and the second and third pulse by 3 weeks. The decision whether or not to administer the third pulse was guided by the presence of clinical symptoms and signs of tinea capitis just prior to the scheduled administration. The availability of the oral solution will enable more young children to be considered for treatment of tinea capitis with itraconazole than was possible when only tablets or capsules were available.

Administration, Oral↗
PubMed1994

Tinea capitis: itraconazole in Trichophyton tonsurans infection.

BACKGROUND: Although griseofulvin is considered the standard treatment of tinea capitis, alternatives are being investigated in hopes of identifying more rapid and better cure rates. OBJECTIVE: Our purpose was to determine the efficacy of itraconazole as therapy for tinea capitis. METHODS: An open label study was performed on three patients who did not respond to or could not tolerate griseofulvin therapy. RESULTS: A 30-day course of 100 mg of itraconazole daily resulted in clinical and mycologic cure in all three patients; no side effects were reported. CONCLUSION: Although these results need to be confirmed by larger, controlled trials, it appears that itraconazole offers a viable alternative to griseofulvin for the treatment of children with tinea capitis.

Child↗
PubMedDate not supplied

Tinea capitis in Benghazi, Libya.

Mycologic examination of 402 cases of tinea capitis in Benghazi showed Trichophyton rubrum to be the most common isolate, followed by T. mentagrophytes, Microsporum canis, and T. violaceum. The clinical presentation of tinea capitis is discussed, and attention is drawn to the seborrheic type, which is easily confused with dandruff.

Adolescent↗
PubMed2000

Tinea capitis: a current perspective.

UNLABELLED: During the past 50 years, the predominant etiologic agent of tinea capitis in the United States and in Western Europe has changed from Microsporum audouinii to Trichophyton tonsurans. This is thought to be due in part to the sensitivity of M audouinii to griseofulvin treatment and, in part, due to the importing of T tonsurans by people emigrating from geographic areas where that vector had been the prominent cause of tinea capitis. With these changes, prospects for newer therapies with the novel antimycotic agents itraconazole, fluconazole, and terbinafine are reviewed. (J Am Acad Dermatol 2000;42:1-20.) LEARNING OBJECTIVE: At the conclusion of this learning activity, participants should be familiar with the history, epidemiology, and current knowledge of tinea capitis, as well as the newer antifungal agents (ie, itraconazole, fluconazole, and terbinafine) to treat this infection.

Antifungal Agents↗
PubMed2004

Tinea capitis in a dermatology center in the city of Fortaleza, Brazil: the role of Trichophyton tonsurans.

BACKGROUND: Over a 3-year period (March 1999 to March 2002), 944 patients with scalp lesions attended a dermatology reference center in the city of Fortaleza, Ceará, Brazil. Clinical specimens were examined at the Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza-CE, Brazil, to detect patients with tinea capitis. METHODS: Specimens were obtained from pus, scales, and hairs from suspected lesions of tinea capitis. Mycologic analyses were conducted by direct microscopy and by fungal culture on Sabouraud dextrose agar, with or without chloramphenicol and Mycosel agar. The culture tubes were incubated at 28 degrees C and examined daily for 1 month. RESULTS: Fungi were seen in 438 (46.4%) of the 944 clinical specimens. The percentage of positive direct microscopic examinations of the clinical specimens was 83.7%. Of those patients with tinea capitis, 157 (35.8%) were males and 281 (64.2%; P < 0.001) were females. The distribution of dermatophyte species in males, from 136 positive cultures, was Trichophyton tonsurans (54.41%), Microsporum canis (38.97%), T. rubrum (4.41%), T. mentagrophytes var. mentagrophytes (1.47%), and M. gypseum (0.74%). On the other hand, only three species, from 251 positive cultures, were present in females: T. tonsurans (80.08%), M. canis (17.53%), and T. rubrum (2.39%). There was a high proportion of positive results in children under 10 years of age (n = 309). No significant difference was detected in the seasonal distribution of tinea capitis. CONCLUSIONS: Our data show that T. tonsurans is the main etiologic agent of tinea capitis, and is more likely to be found in females and in the prepubertal population.

Adolescent↗
PubMed2002

Prevalence of tinea capitis as well as of asymptomatic carriers in school children in Nablus area (Palestine).

A study of tinea capitis was carried out during October 1998, involving 8531 school children aged 6-14 years (4718 males and 3813 females), attending 12 primary schools located in urban, rural, and refugee camp communities in the Nablus district in the Palestinian Authority. A total of approximately 1389 of the school children aged 6-12 years (724 males and 665 females) were also surveyed on three occasions at 2-3 month intervals, over a 9-month period (October 1998-May 1999) using the hair brush technique, for prevalence of asymptomatic tinea capitis carriage. Twenty-three(0.27%) mycologically proven cases of tinea capitis were detected.

Adolescent↗
PubMed1965

A controlled trial of home versus hospital treatment of tinea capitis with griseofulvin.

To test previous observations that children with tinea capitis caused by Trichophyton violaceum and treated with griseofulvin in the field showed better recovery rates than patients given similar treatment in hospital, a planned controlled trial was carried out in Yugoslavia with the assistance of the World Health Organization.Two comparable groups of patients from 15 villages in an endemic area were selected at random for treatment at home or in hospital with an identical treatment schedule. Altogether 395 children 5-14 years old were treated and resurveyed clinically and microscopically for assessment of cure two and six months later.The trial confirmed that home treatment is at least as effective as hospital treatment, the recovery rate among those treated at home (92.2%) being indeed slightly higher than that among the hospitalized (86.4%). Further investigation is needed to elucidate the factors causing this phenomenon, but it may at any rate be concluded that field campaigns with griseofulvin are justified where tinea capitis is endemic.

Child↗
PubMed1952

TINEA capitis.

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Humans↗