Tinea Capitis In Adults Research Articles

TINEA CAPITIS IN ADULTS: ABOUT 10 CASES

Tineacapitis (TC)is a superficialfungal infection primarilyseen in school-agedchildren. Adulttineacapitis (ATC) is rare, with distinct clinicalfeatures and ofteninvolvesidentifying local and generalpredisposingfactors. We report a series of 10 adult patients.

Comprehensive Review of Tinea Capitis in Adults: Epidemiology, Risk Factors, Clinical Presentations, and Management.

Tinea capitis is a fungal infection of the scalp and hair caused by dermatophyte molds, that most often affects children and may also affect adults. Previous estimates suggest that between 3% and 11% of all tinea capitis cases worldwide occur in adults, although updated epidemiological studies are needed to reassess the prevalence of tinea capitis in adult populations specifically. Postmenopausal adult women are most often affected by tinea capitis, with African American or Black women particularly at risk. Adults who experience crowded living conditions, who live in close proximity to animals, who are immunosuppressed, and/or who live in households with affected children are at greatest risk of infection. Tinea capitis can be non-inflammatory or inflammatory in nature, and the subtype affects the extent and severity of clinical symptoms. Fungal culture and potassium hydroxide preparations are the most commonly used diagnostic tools. Trichoscopy, defined as dermoscopic imaging of the scalp and hair, is a useful adjunct to the physical examination. The mainstay of therapy is oral antifungal therapy, and topical therapy alone is not recommended. Since tinea capitis infection is uncommon in adults, there are no widely accepted treatment guidelines. Rather, the same medications used for tinea capitis infection among children are recommended for adults at varying doses, including griseofulvin, and terbinafine, and, less commonly, itraconazole and fluconazole. The prognosis for tinea capitis in adults is typically excellent when prompt and adequate treatment is administered; however, delayed diagnosis or inadequate treatment can result in scarring alopecia. Over the past decade, dermatophyte infections resistant to treatment with topical and oral antifungal agents have emerged. While tinea capitis infections resistant to antifungal therapy have been rarely reported to date, antifungal resistance is rising among superficial fungal infections in general, and antifungal stewardship is necessary to ensure that resistance to treatment does not develop among dermatophytes that cause tinea capitis.

Neglected Adult Tinea Capitis in South China: A Retrospective Study in Nanchang, Jiangxi Province, from 2007 to 2021.

Tinea capitis (TC) in adults is much less frequently diagnosed in comparison to TC in children. In this study, we explored retrospectively adult TC in a specialized dermatology hospital, located in South China, during the years 2007-2021. Among 1037 TC cases, 168 (16.2%) patients were older than 18years. The majority of adults with TC, 77.38% (130/168), were older than 40, with a peak in the age of 51-60years (40/168, 23.81%). Before presenting at our hospital, many of patients did not got proper treatment due to misdiagnosis or simply did not consulted an appropriate clinic. 60.71% (102/168) of the patients reported symptoms lasting for more than 1year and 29.76% (50/168) reported chronic scalp problems of at least 10years. And 27.38% (46/168) of the patients had an immunocompromised status, including long-term use of corticosteroids shampoo, type 2 diabetes mellitus (DM), psoriasis vulgaris, rheumatoid arthritis, systemic lupus erythematosus or bullous pemphigoid. As for clinical presentation, 87.5% (147/168) of the cases presented as black dot type of TC and anthropophilic dermatophytes were the predominant etiology, with Trichophyton violaceum (126), T. tonsurans (15), T. rubrum (8) and T. shoenleinii (6). Grey patch type of TC (3.57%, 6/168) was seldom in Jiangxi Province and zoophilic/geophilic dermatophytes were rare. Our study indicates that anthropophilic Trichophyton species can cause long-lasting TC in adults. Not in all cases, the manifestation had symptom clearly indicating a dermatophyte-related TC. Thus, patients with long-lasting scalp inflammation, also older ones, should be examined for the presence of dermatophyte-related TC.

Epidemiology and Aetiology of Tinea Capitis in Wuhan and Its Surrounding Areas from 2011 Till the Present: A Single-Center Retrospective Study.

Tinea capitis is still common in Wuhan, and there exists significant difference in its pathogen spectrum between this area and other parts of China. In the present study, we aimed to clarify the epidemiological characteristics of tinea capitis and changes of pathogen spectrum in Wuhan and its surrounding areas from 2011 to 2022, and further to present potential risk factors focusing on some major etiological agents. Briefly, a retrospective single-center survey was performed on 778 patients with tinea capitis from 2011 to 2022 in Wuhan, China. The isolated pathogens were identified to species level by morphological examination or by ITS sequencing. The data were collected and statistically analyzed by Fisher's exact test and Bonferroni method. Among all enrolled patients, the most common pathogen was Trichophyton violaceum in both child (310, 46.34%) and adult tinea capitis (71, 65.14%). There existed significant difference in pathogen spectrum between child and adult tinea capitis. Furthermore, black-dot type represented the most common type of tinea capitis for both children (303, 45.29%) and adults (71, 65.14%). Notably, the number of cases caused by Microsporum canis consecutively exceeded that caused by Trichophyton violaceum in children from Jan, 2020 to Jun, 2022. Additionally, we suggested a series of potential factors that might increase the risks of acquiring tinea capitis by focusing on several major agents. Considering the different risk factors related to specific pathogen, it was meaningful to adjust the measures against the spreading of tinea capitis according to the changes of pathogen distribution within recent years.

Tinea capitis in adults: case series and mini-review of brazilian literature

Tinea capitis in adults: case series and mini-review of brazilian literature

Aetiological changes of tinea capitis in the Hubei area in 60years: Focus on adult tinea capitis.

Tinea capitis is a common dermatophyte infection of the scalp primarily affecting children, with less frequent, though not rare, observation in adults. This study aimed to assess changes in the causative agents of adult tinea capitis over a 60-year period in the Hubei area. A retrospective, single-centre study was performed on 164 adults with tinea capitis between 1960 and 2020. Out of 1113 cases of tinea capitis, 164 patients were adults, representing 14.7% of all patients. Adult tinea capitis was slightly more prevalent in males (91, 55.5%) than in females (73, 44.5%), but gender difference was not statistically significant between adults and children. Adult tinea capitis was most prevalent between the ages of 18 and 29years, with a mean age of 22years. Trichophyton schoenleinii was the most common dermatophyte in adult tinea capitis (78, 47.6%), followed by Trichophyton violaceum (58, 35.4%). Most adult tinea capitis cases before the 1980s were caused by T.schoenleinii, but T.violaceum has become the leading pathogen for recent adult tinea capitis cases. Tinea capitis is not a disease exclusive to children. On the contrary, an upward trend of tinea capitis in adults has been observed in recent years. T.violaceum has become the dominant causative agent of adult tinea capitis in the Hubei area, replacing T.schoenleinii. These results provide a better understanding of the treatment and prevention of tinea capitis in adults.

Tinea Capitis by Microsporum canis in an Elderly Female with Extensive Dermatophyte Infection

Tinea capitis is a type of dermatophyte infection primarily affecting children. We report a case of an elderly woman with well-controlled diabetes mellitus presenting with a six-month history of erythema with yellow crusts on her scalp and extensive erythematous patches with scales on the body skin. She adopted a stray cat before the disease onset. Dermoscopic findings and manifestation under the Wood’s lamp favoured the diagnosis of tinea capitis. Further microscopic examinations of her scalp, including direct KOH and fluorescence stain examination, fungal culture and polymerase chain reaction sequencing identification confirmed the diagnosis of tinea capitis caused by Microsporum canis. Treatment with oral terbinafine was effective. Adult tinea capitis is often misdiagnosed due to its rarity and atypical presentation. However, in some regions, the incidence of tinea capitis in immunocompetent adults is rising which requires the awareness of clinicians. A thorough history (including the animal contacting history), physical examination and further mycological examinations are required for diagnosis. Trichophyton violaceum is the most common dermatophyte species in most regions while adult tinea capitis caused by Microsporum canis is less common. Terbinafine, griseofulvin and itroconazole have been reported to be effective drugs for the treatment of tinea capitis, and terbinafine can be considered as systemic treatment in elderly patients with comorbidities to reduce the drug–drug interaction.

Adult tinea capitis in China: A retrospective analysis from 2000 to 2019.

Tinea capitis (TC) is an infection of the scalp hair due to dermatophytes. Most commonly seen in prepubescent children, but data of adults tinea capitis (ATC) in China mainland are limited. We aimed to evaluate epidemiological, clinical and mycological characteristics of ATC in China from 2000 to 2019. We retrospectively analysed all ATC reported cases in China mainland, confirmed by mycological examination, by searching PubMed, Wanfang, Weipu and CNKI database. In sum, 40 papers involving 269 clinical cases were included. The average morbidity of ATC was calculated as 9.04% after standardisation. The sexratio is 1:5.2 (31 male, 163 female); 76 people between 18 and 44 age level and 137 people between 45 and 89 age level were diagnosed as ATC. Culture or ITS sequencing identified Trichophyton violaceum in 70 cases (35.2%), Microsporum canis in 42 cases (21.1%), Trichophyton mentagrophyte in 32 cases (16.1%), Trichophyton rubrum in 23 cases (11.5%), Microsporum gypseum in 18 cases (9.0%), Trichophyton tonsurans in 6 cases (3.0%), Trichophyton schoenleini in 4 cases (2.0%), Epidermophyton floccosum in 2 cases (1.0%), Trichophyton verrucosum and Microsporum ferrugineum in one case (0.5%). ATC was easily to be diagnosed as furfur, seborrhoeic dermatitis (13%) or pustular and dermatocellulitis (11.15%).Six immunocompromised persons were recorded (2.2%). ATC mainly involves postmenopausal women. Trichophyton violaceum, M canis, T mentagrophyte remain the most common aetiological agent of ATC in China. Trichophyton rubrum own the much higher frequency in ATC than in children. For diversified clinical manifestations, recognising ATC profiles will help clinicians avoid misdiagnosis.

Adult Tinea Capitis: a Clinical Entity in Increasing Frequency

This review summarizes the fungal literature currently available for adult tinea capitis (ATC), as well as providing data for clinical practice. Available studies in ATC are scarce; however, they provide essential information for treating ATC. Treatment of TC is effective; however, it needs a minimum of 1 month to watch clinical efficacy. Systemic treatment is often needed to favor drug penetration to the deepest part of the hair follicle. The newest oral antifungal has higher efficacy rates than conventional therapy, as well as much shorter duration of treatment but at higher costs. We review the literature concerning ATC, including treatment schemes.

Adult tinea capitis and tinea barbae in a tertiary Portuguese hospital: A 11‐year audit

Adult tinea capitis and tinea barbae are nowadays considered uncommon in developed countries. Despite their potential for morbidity and healthcare costs, few series have attempted to characterise these infectious disorders. We conducted a cross-sectional study to analyse the epidemiological, clinical and mycological characteristics of adult tinea capitis and tinea barbae of a large tertiary centre in Southern Europe. All adult patients with a mycological-confirmed tinea capitis or barbae over a 11-year period (January 2008 to December 2018) were considered for the analysis. Concerning tinea capitis, 860 culture-confirmed diagnoses were made during this 11-year period, of which only 15 (1.5%) occurred in adults (15 patients). A disproportionately high number of patients were female and immunocompromised. Microsporum audouinii (20%) and Trichophyton rubrum (20%) were the most common isolates. Half of the cases were initially misdiagnosed. Regarding tinea barbae, 7 cases were diagnosed over this time period. Overuse of topical steroids was widespread in this population. Trichophyton rubrum was the infectious agent in all cases. Initial misdiagnosis was very common (43%). Adult tinea capitis and tinea barbae can still be observed in contemporary practice and remain a public health concern, with the immunosuppressed patient being particularly affected. Initial misdiagnosis is a common occurrence. Anthropophilic fungi are now the most common aetiologic agents of these infections, and they will probably continue to do so as the large urban centres expand peripherally. Awareness for this diagnosis is necessary to prevent unwarranted morbidity and costs.

Tinea capitis in adults: A 18-year of clinical and mycological study in Korea

Tinea capitis in adults: A 18-year of clinical and mycological study in Korea

Tinea capitis in adults: A 18-year retrospective, single-centre study in Korea.

Tinea capitis (TC) is a dermatophyte infection involving hair and scalp and occurs primarily in prepubertal children. However, data on adults are limited. The aim of this study was to evaluate epidemiological, clinical and mycological characteristics of TC in adults in Korea. We retrospectively evaluated 82 adults (44.3%) among 185 TC patients at a tertiary hospital during June 2000-2017. Mean patient age was 66.9±15.8 (20-90) years with female predominance; mean disease duration until mycological diagnosis, 22.5 (1-144) weeks; and misdiagnosis rate, 65.9%. Most common presumptive initial diagnoses were seborrhoeic dermatitis (24.4%) and bacterial folliculitis (18.3%). Chronic systemic illness and accompanying alopecia were found in 61 (74.4%) and 46 (56.1%) patients, respectively. Pustular type was found in 26.8% patients, followed by seborrhoeic dermatitis-like 25.6%, grey patch 23.2%, kerion celsi 22.0% and black dot 2.4%. Forty-eight patients (58.5%) had tinea infection at other skin areas. Microsporum canis (56.5%) and Trichophyton rubrum (21.7%) were the most common causative organisms; 92.7% patients achieved complete resolution, and seven patients (9.2%) had a recurrence. We report the largest, most recent series of case studies of adult TC. Adult TC is not an uncommon problem, especially in elderly women, and has distinctive epidemiological and clinicomycological characteristics compared to those in prepubertal children. Recognising adult TC profile will help clinicians avoid misdiagnosis and provide appropriate treatment.

Profil épidémio-clinique et étiologique des teignes du cuir chevelu chez l’adulte à Dakar (Sénégal)

To determine the epidemiological and etiological profile of tinea capitis in adults in Dakar (Senegal). A 9-month prospective, multicenter, descriptive and analytic study. Patients included were aged over 18 years. Mycological tests were used to confirm the diagnosis. 121 patients were included with a mean age of 36.1 years and a hospitalisation frequency of 0.8%. The age range of 64.4% of patients was between19 and 38 years. 51% of patients were housewives. A low socioeconomic level was found in 72.8% of cases. In 3.3% of patients, the disease began in childhood. 31.4% of patients had already consulted a traditional healer. Similar familial cases were noted in 60.3% of patients. Contact with a sheep was noted in 32.2% of cases, deliberate skin lightening in 64% of women, hair salon attendance in 46.7% of women, and immunosuppression in 17.3% of patients, while itching was present in 95.5%. Dermatologic examination showed scaled plaques and a diffuse form, with 92.6% and 64% (n=75) respectively. Wood's light examination was positive in 40.2% of patients. A positive culture test was found in 71%. The most frequently encountered species were: T.soudanense (65%), M.audouinii (21%), T.rubrum (4.7%), M.gypseum (3.5%), T.violaceum (2.3%), T.verrucosum (2.3%) and M.canis (1 case). The clinical course was favorable under treatment with griseofulvin or terbinafine. Tinea capitis in adults mainly affects young women. The diffuse form is the most common. The most frequently encountered species was T.soudanense.

Factors in Etiology and Predisposition of Adult Tinea Capitis and Review of Published Literature.

Tinea capitis is a common fungal infection in children but is less frequently encountered in adults, especially in immunocompromised individuals. To determine the incidence of tinea capitis in adults, the predisposing factors and causative species. A retrospective study was conducted over a period of 5years, from 2010 to 2015, on cases of tinea capitis diagnosed in the Department of Dermatology and Mycology Research Center in Tehran, Iran. The information was collected from the patients including age, gender, location of the lesions, results of direct examination and culture, cause of immunosuppression and the prescribed treatment. Twenty-five (20.6%) patients (10 men and 15 women) with a mean age of 45.28years were affected by tinea capitis among a total number of 121 positive cases. Most of these adults (80%) had a grade of immunodeficiency due to the underlying syndromes or diseases, and the rest were immunocompetent. Trichophyton species were isolated from 84% of these adult patients, indicating Trichophyton violaceum (T. violaceum) as the most common fungal agent. Treatment with oral terbinafine or itraconazole was successful in all these cases. The results showed that most cases affecting the adult population were caused by species of the genus Trichophyton. T. violaceum was the most common dermatophyte of adult patients. Thus, it is important to consider tinea capitis as a differential diagnosis in immunocompromised adults, even though it is considered to be rare in adults.

Tinea capitis in adults in southern Spain. A 17-year epidemiological study

BackgroundTinea capitis is an infection of the hair due to keratinophilic fungi, known as dermatophytes. Although the disease is common in children, several studies have also shown that it is far from unusual in adults, especially in post-menopausal women and immunocompromised persons. AimsTo determine the incidence of tinea capitis in adults in our area, as well as the predisposing factors (gender, immunity), and causative species. Materials and methodsA retrospective study was conducted over a period of 17 years, from 1995 to 2011, collecting data on cases of tinea capitis diagnosed in our dermatology department. Information collected for all patients included age, gender, location of the lesions, results of direct examination and culture, immune status, cause of immunosuppression, and the prescribed treatment. ResultsThirty-three cases (11.4%) out of 289 cases of tinea capitis occurred in adults. Most of these adults (72%) were immunocompetent, and the rest were immunocompromised for different reasons. Three of the patients were men and 30 women, with 70% of the latter being post-menopausal. Trichophyton species were isolated in 76% of these adult patients, with Trichophyton violaceum being the most common. Treatment with oral terbinafine was successful in all these cases. Microsporum species were responsible for the other cases, all treated successfully with oral griseofulvin. ConclusionsThis series of tinea capitis in adults is one of the largest to date. It shows that tinea capitis is not uncommon among the immunocompetent adult population. In our geographical area, except for prepubescent patients, most cases affecting the adult population were caused by species of the genus Trichophyton. In these cases the treatment of choice was oral terbinafine, which considerably shortened the treatment time, and was associated with fewer side effects than the classical griseofulvin.

Tinea capitis in adults

Tinea capitis is caused by dermatophyte fungi that utilize keratin as a nutrientsource. Scalp erythema, scaling, andcrusting are typical signs of this disease. Although most commonly seen in prepubescent children,tinea capitis can occur in adults. Endothrix tinea capitis owing to Trichophyton tonsurans commonly produces generalizedscaling and localized perifollicular inflammation reminiscent of lichen planopilaris. Ectothrixtinea capitis owing to Microsporum sp. produces well- demarcated erythematous plaques suggestive ofpsoriasis. H&E stained biopsy specimens, KOH preparations or fungal cultures will confirm thediagnosis. Because of a low index of suspicion for tinea capitis in adults with scaling andalopecia, diagnosis and appropriate treatment are often delayed. Resistance to treatment forseborrheic dermatitis or psoriasis should prompt a KOH, fungal culture orbiopsy to confirm the diagnosis of tinea capitis and initiate systemic antifungal agents.

Tinea Capitis in 31 Year Old Adult Male: A Rare Entity

Tinea capitis also called as ring worm of the hair is a superficial fungal infection (dermatophytosis) of the scalp. The clinical presentation is typically single or multiple patches of hair loss, sometimes with a 'black dot' pattern (often with broken-off hairs), that may be accompanied by inflammation, scaling, pustules, and itching. Tinea Capitis affects primarily pre-pubertal children between 6 and 10 years, it is more common in males than females; rarely does the disease persist past age sixteen.3 When it occurs in adults the clinical features may be atypical and this may delay the diagnosis. The most common clinical features are severe itching of the scalp, dandruff, and bald patches where the fungus has rooted itself in the skin. It is uncommon in adults, but an immune defect may facilitate hair invasion. Physical barriers such as the intact keratinized layer of skin, as well as the effect of UV light, physiochemical factors of temperature, moisture and pH, and fungistatic fatty acids on the skin play a vital role in resisting contact with the organism. The quantity of fungistatic saturated fatty acids in sebum increases at puberty, and this is thought to explain the rarity of tinea capitis in adults.

Tinea Capitis in Adults

Objective: To determine the epidemiology and the aetiology of tinea capitis in the elderly in Turin (Italy). Methods: We prospectively collected all cases of adult tinea capitis in the Dermatology Clinic of the University of Turin from January 1997 to December 2012. Results: 13 patients (4 males and 9 females) with a mean age of 56.5 years were found to be affected by tinea capitis among a total number of 508 (2.6%). Diagnosis was made on clinical appearance and mycological examination. Culture identified M. canis in 7 patients (53.8%), T. mentagrophytes in 3 patients (23.1%), T. rubrum in 2 patients (15.4%) and T. violaceum in 1 patient (7.7%). 6 cases reported contact with animals. Treatment consisted in administration of Griseofulvin at the dose of 500 mg/d or Terbinafine at the dose of 250 mg/d for at least 8 weeks. A complete recovery was observed in 10 patients, whereas 3 of them suffered from cicatritial alopecia. Conclusion: This study wants to highlight the importance of considering tinea capitis as a differential diagnosis in elderly patients with scaly scalp lesions, even though it is considered to be rare in adults.

TINEA CAPITIS NO ADULTO – UM DIAGNÓSTICO A CONSIDERAR?

A tinea capitis, uma infecção por fungos dermatófitos do couro cabeludo, é uma patologia rara no adul- to, mesmo em áreas geográficas onde a doença é prevalente. Nestes casos está muitas vezes, mas não exclusivamen- te, associada a imunodepressão e habitualmente surge por exposição ao agente infeccioso em contactantes próximos. São fundamentais uma história clínica e um exame objectivo minuciosos que permitam equacionar a tinha do couro cabeludo como hipótese diagnóstica e proceder à colheita de amostras para exame micológico. Esta metodologia pode evitar a realização de exames complementares exaustivos ou a prescrição de tratamentos inadequados. Os autores descrevem três casos de tinea capitis em mulheres adultas – dois casos de infecção por Microsporum au- douinii e um caso por Trichophyton soudanense. É apresentado o registo iconográfico dos casos e é efectuada breve revisão da literatura.PALAVRAS-CHAVE – Adulto, Dermatófitos; Tinea Capitis; Micologia.

Aspects mycologiques et épidémiologiques des teignes du cuir chevelu dans la région de Sousse (Tunisie)

Tinea capitis continues to be considered a public health problem in Tunisia. The purpose of our study was to investigate trends in the incidence and the mycological and epidemiological aspects of tinea capitis in the Sousse region (Central Tunisia). Our work is a retrospective study concerning all scalp samples taken by the parasitology laboratory of the Farhat Hached Hospital in Sousse, Tunisia, over a 26-year period (1983-2008). A total of 10,505 specimens were examined. Of these, 5593 were positive with positive direct examination and/or positive culture. The average incidence was 215 cases per year. Patients were aged under 12 years in 89.3% of cases. A total of 175 cases of tinea capitis in adults were diagnosed. Ten dermatophyte species were isolated: Trichophyton (T.) violaceum (66.7%), Microsporum (M.) canis (29.3%), T. schoenleinii (1.6%), T. mentagrophytes (1.1%), T. verrucosum (0.6%), T. tonsurans (0.2%), T. rubrum (0.2%), M. gypseum (0.1%), M. audouinii (0.03%) and M. nanum (0.01%). Our study showed a decrease in the annual incidence of tinea capitis over the study period with an evident decrease in trichophytic tinea and disappearance of favus giving way to microsporic and inflammatory tinea.