Getting ahead of tinea capitis

Abstract

The clinical presentation of tinea capitis (fungal infections of the scalp) ranges from mild scaling, to widespread alopecia, to markedly inflamed and suppurating kerions. Tinea capitis tends to be most common in children aged between 6 and 10 years, although adolescents and adults can contract fungal scalp infections and be asymptomatic carriers. The dermatophyte Trichophyton tonsurans causes between 50% and 90% of tinea capitis cases in the UK. However, the wide range of potential pathogens—especially among people originating in, or who have visited, foreign countries—and diagnostic difficulties mandate mycological testing. Fungi can infect the hair shaft, which protects the dermatophyte from topical antifungals. Yet despite tinea capitis being common, there are relatively few approved oral antifungals licensed for the condition. Nevertheless, a 6–12-week course of oral griseofulvin produces mycological cures in between 70% and 100% of tinea capitis cases. Topical antifungals may reduce transmission and nurses can encourage the family to follow some simple steps that reduce the risk of further infection.