Belgian National Survey on Tinea Capitis: Epidemiological Considerations and Highlight of Terbinafine-Resistant T. mentagrophytes with a Mutation on SQLE Gene.

Rosalie Sacheli,Florence Dehavay,Séverine Evrard,Kim Laffineur,Katrien Lagrou,Danielle Rousseaux,Saadia Harag,Marie-Pierre Hayette,Akole Adjetey,Laurence Seidel

doi:10.3390/jof6040195

Abstract

Background: In this last decade, a huge increase in African anthropophilic strains causing tinea capitis has been observed in Europe. The Belgian National Reference Center for Mycosis (NRC) conducted a surveillance study on tinea capitis in 2018 to learn the profile of circulating dermatophytes. Methods: Belgian laboratories were invited to send all dermatophyte strains isolated from the scalp with epidemiological information. Strain identification was confirmed by ITS (Internal Transcribed Spacer) sequencing. Mutation in the squalene epoxidase (SQLE) gene was screened by PCR. Results: The main population affected by tinea capitis was children from 5–9 years. Males were more affected than females. The majority of the strains were collected in the Brussels area followed by the Liege area. Among known ethnic origins, African people were more affected by tinea capitis than European people. The major aetiological agent was Microsporum audouinii, followed by Trichophyton soudanense. One strain of Trichophyton mentagrophytes has been characterized to have a mutation on the squalene epoxidase gene and to be resistant to terbinafine. Conclusions: African anthropophilic dermatophytes are mainly responsible for tinea capitis in Belgium. People of African origin are most affected by tinea capitis. The monitoring of terbinafine resistance among dermatophytes seems necessary as we have demonstrated the emergence of resistance in T. mentagrophytes.

Highlights

Tinea capitis is a dermatophytic infection of the hair and scalp often associated with signs of inflammation and alopecia and, more rarely, giving rise to kerion or favus
An understanding of changing epidemiology and prevalence of causative organisms is important in deciding appropriate therapy for tinea capitis, but this has been poorly explored in Belgium
Prevalence of tinea capitis was higher among males as dermatophytes infections concerns 214 males (63.5%) and 123 females

Summary

Introduction

Tinea capitis is a dermatophytic infection of the hair and scalp often associated with signs of inflammation and alopecia and, more rarely, giving rise to kerion or favus. An understanding of changing epidemiology and prevalence of causative organisms is important in deciding appropriate therapy for tinea capitis, but this has been poorly explored in Belgium For this reason, and due to the lack of recent reports concerning tinea capitis in Belgium, the National Reference Center for Mycoses decided to organise a national survey to collect information concerning the status of tinea capitis in Belgium and to evaluate the aetiological agents responsible for this pathology. The aim of this study was to evaluate the impact of immigration waves and other potential factors in the recrudescence of some African anthropophilic species in our regions, such as In this last decade, a huge increase in African anthropophilic strains causing tinea capitis has been observed in Europe. African people were more affected by tinea capitis than

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