Childhood tinea capitis in Tunis

Abstract

Tinea capitis is a dermatophytic infection of the scalp. It is frequent in Tunisia especially in children. We retrospectively report a six-year study involving children seen in the Habib Thameur teaching Hospital of Tunis with the diagnosis of tinea capitis. The purpose of the current study was to determine the prevalence, clinical types, and causative species of childhood tinea capitis in Tunis. Our study was conducted from January 2000 to December 2006. Patients included in this study fulfilled the following criteria: they were younger than 18 years and have an evocative clinical aspect of tinea capitis. Skin scrapings and hair roots were collected from each patient. According to these data, our patients were divided into three groups: tinea capitis superficialis, tinea capitis profunda (kerion celsi) and favus. Two-hundred and four patients were enrolled in the study. Pre-school children were affected in 47% (96/204) of the cases. Trichophyton violaceum and Microsporum canis were the two most causative dermatophytes. Cats were found to be reservoir in 26 (13%) patients. Tinea corporis was simultaneously present in 27 (13%) patients. Treatment was based on griseofulvin (20 mg/kg/day for 5 weeks) and was efficient in 192 (94%) patients. Tinea capitis remains a common affection in Mediterranean children. The causative fungi vary with geography and time. In Tunisia, thanks to improvement in socio-economic conditions, favus becomes a very rare affection. T. violaceum, the most predominant causative agent of tinea capitis since the eighties is currently caught by M. canis. This is probably related to a frequent cohabitation with pets. Griseofulvin remains the reference regarding first line treatment of tinea capitis in our country.