Epidemiology of Fungal Scalp Infections in the West of Scotland 2000 – 2006

Abstract

Fungal infections of the scalp commonly affect the paediatric population and are caused by dermatophytes which have the ability to invade the keratinised structures of skin, hair and nails. This study analyses the changes in the epidemiology of fungal scalp infections in the West of Scotland during the period 2000-2006. Skin and hair from scalp specimens sent by General Practitioners and Dermatologists throughout the West of Scotland were examined microscopically for the presence of fungal hyphae and/or spores and cultured to determine the identity of the fungi. The most common dermatophyte to be isolated from scalps during 2000-2006 was Trichophyton violaceum with 29 reported cases followed by 23 cases of Trichophyton tonsurans infection. During 2000-2002, over 90% of patients were British but during 2003-2006, greater than 50% of patients were of non-UK origin. The majority of T. violaceum and T. tonsurans infections during this study were from patients originating in either Africa or Pakistan and were from people known to be seeking asylum in the UK. The overall increase and the change in pattern of reported fungal scalp infections in the West of Scotland may be explained by the migration of people to Scotland from Africa or Pakistan where T. violaceum and T. tonsurans are endemic. The increase in numbers of infections in the later period of this study reflects an increase in the awareness of General Practitioners and Dermatologists to send samples to Clinical Mycology.