To the Editors: We read the recent paper by Trivino-Duran et al1 with great interest. As mentioned by the authors, point prevalences for tinea capitis may vary according to the region under examination. Several countries (including Spain) have reported a rising incidence of scalp ringworm cases.2,3 For instance, in the United Kingdom, dermatology departments in large urban areas have documented rates of positive scalp isolates up to 20 times higher than previous baseline rates.4 To obtain data from Germany, we conducted a cross-sectional study among 5- to 6-year-old preschool children from Augsburg, Germany in 1996. The study was embedded in the multicentric international study for risk assessment of indoor and outdoor air pollution on allergy and eczema morbidity (MIRIAM). After parental informed consent was obtained, 1000 unselected preschoolers participating in the medical school entrance examination received a detailed dermatologic examination of the whole body. Additionally a brush sampling method was used to identify fungal organisms located at the scalp region. After cleansing with 70% alcoholic solution, a sterile tooth brush was run over the scalp ≈10 times to collect infected scales and hair debris. Afterward the brush was pressed into Sabouraud's dextrose agar containing chloramphenicol and cycloheximide. Cultures were read after 4 weeks of incubation at 26°C and identified by using recognized methods for morphologic classification. Among the 1000 examined preschoolers, clinical signs of tinea capitis were completely absent. Analysis of cultures revealed the presence of Trichophyton terrestre in a single case. This unexpected low prevalence of overt tinea capitis and asymptomatic carriers is in contrast to figures from the United States, where prevalence rates range between 3 and 8%,2 although also prevalence rates of <1% have been mentioned, at least for the Kansas region in the setting of an urban pediatric clinic.5 Our findings are similar to the results obtained by Cuétara et al from Madrid6 and now Trivino-Duran et al from Barcelona,1 adding hereby more epidemiologic data to this important infectious disease. Matthias Möhrenschlager, MD Harald Bruckbauer, MD Hans P. Seidl, PhD Johannes Ring, MD, PhD Heidelore Hofmann, MD Department of Dermatology and Allergy Biederstein Technical University of Munich Munich, Germany