Tinea Capitis Infections Research Articles

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.

Antifungal Activity of Neem Leaf Extract With Eucalyptus citriodora Oil and Cymbopogon martini Oil Against Tinea Capitis: An In-Vitro Evaluation.

Introduction Tinea capitis, often known as ringworm of the scalp, is a fungal infection that affects the scalp, eyelashes, and eyebrows. It is generally caused by dermatophytes from the genera Trichophyton and Microsporum. Trichophyton tonsurans and Microsporum canis are the main etiological agents responsible for most of the cases of tinea capitis globally. Tinea capitis commonly manifests as itchy, scaly patches of hair loss. Tinea capitis is the prevailing dermatophyte illness among children globally. Methods An in-vitroevaluation study was conducted to assess the antifungal properties of ethanolic extracts of neem leaves and the oils of Eucalyptus citriodora and Cymbopogon martini, both individually and in combination. The agar-well diffusion method and the M38-A2 microbroth dilution method were employed to evaluate the antifungal efficacy against pathogenic dermatophyte strains, namely Microsporum canis and Trichophyton tonsurans. The fully mature green leaves were treated with ethanol to make the neem leaf extract. Additionally, high-performance liquid chromatographic analysis was carried out to determine the contents of the terpenoids. Fluconazole, an antifungal drug, is used as a standard. Results The findings demonstrated an overall inhibition of the growth of dermatophytes at a minimal inhibitory concentration of 187.5 and 375 μg/ml for neem leaf extractand 0.625 to 2.5 μl/ml for selected herbal oils,whereas it was0.25μg/mland 0.50 μg/ml forpositive controlagainstMicrosporum canisandTrichophyton tonsurans,respectively. Conclusion The phytochemical investigation of theethanolic extracts in neem leaves revealed the presence of terpenoids, which are known for their significant biological activity. The study's findings demonstrated the therapeutic capabilities of neem leaf extract in combination with the oils of Eucalyptus citriodora and Cymbopogon martini for managing the tinea capitis infection. A broader and improved antifungal spectrum was seen when neem leaf extract and oils were combined. Therefore, it can be developed into a suitable formulation for the management of tinea capitis.

Analysis of optimal control strategies on the fungal Tinea capitis infection fractional order model with cost-effective analysis

In this study, we have formulated and analyzed the Tinea capitis infection Caputo fractional order model by implementing three time-dependent control measures. In the qualitative analysis part, we investigated the following: by using the well-known Picard–Lindelöf criteria we have proved the model solutions' existence and uniqueness, using the next generation matrix approach we calculated the model basic reproduction number, we computed the model equilibrium points and investigated their stabilities, using the three time-dependent control variables (prevention measure, non-inflammatory infection treatment measure, and inflammatory infection treatment measure) and from the formulated fractional order model we re-formulated the fractional order optimal control problem. The necessary optimality conditions for the Tinea capitis fractional order optimal control problem and the existence of optimal control strategies are derived and presented by using Pontryagin’s Maximum Principle. Also, the study carried out the sensitivity and numerical analysis to investigate the most sensitive parameters and to verify the qualitative analysis results. Finally, we performed the cost-effective analysis to investigate the most cost-effective measures from the possible proposed control measures, and from the findings we can suggest that implementing prevention measures only is the most cost-effective control measure that stakeholders should consider.

Dermoscopic findings in Tinea Capitis among under 18 children in dermatology polyclinic patients: a hospital-based cross-sectional study.

Tinea capitis is a fungal infection that affects the scalp. It is caused by a group of fungi known as dermatophytes, which thrive in warm and moist environments. In Somalia, there is a data shortage regarding dermatological conditions, especially in Mogadishu, the most populous city in the country. Tinea capitis has gone unreported despite its high prevalence in Somali dermatology clinics and the Somali diaspora in Western countries. The absence of up-to-date information hampers the capability to diagnose, treat, and prevent Tinea capitis. Therefore, the study aims to evaluate dermoscopic signs about isolated organisms and potassium hydroxide (KOH) examination. A hospital-based cross-sectional study was implemented between January and April 2023 in Mogadishu, Somalia. All eligible Tinea capitis-infected children were included in the study. Microscopically, analysis was conducted by adding 10% of KOH in fungal elements. Data were analyzed using descriptive statistics and the χ2 test at P value less than 0.05. A total of 76 tinea capitis-infected children participated in the study; 56% were age group between 5-9 years old, 68.4% were male, and 92.1% showed KOH positivity. Trichophyton violaceum (65.8%) and Trichophyton sudanense (14.5%) were the most common fungal organisms detected in the culture. comma hairs (93.10%), scales (40.80%), and corkscrews (32.90%) were the most common dermoscopic signs of tinea capitis. The demographical characteristics and dermoscopic signs of tinea capitis significantly associated with the positivity of KOH examination were age, sex, comma hairs, corkscrew hairs, broken hair, Scales, and Zigzag hair. Children in Mogadishu, Somalia, bear a significant burden of Tinea Capitis infections. Trichophyton violaceum and Trichophyton sudanense were the predominant causative agents identified in the cultures. The most common dermoscopic signs of tinea capitis observed in this study were comma hairs, scales, and corkscrew patterns. Hence, early diagnosis of Tinea Capitis infections and timely, effective treatments with contact tracing are highly needed.

P32 ‘Skin fade’ haircut: an independent risk factor for tinea capitis?

Abstract Tinea capitis is a highly contagious infection, with peak incidence at 3–9 years; transmission occurs between infected persons or via contaminated surfaces. We examine three different cases, all presented to our department this summer. Each gave a synchronous history of a friend or family member that contracted tinea capitis from the same ‘Turkish barbershop’ visit. We compare similar clinical features and timeframes. Two brothers aged 12 and 9 years, presented with multiple inflamed scaly plaques of alopecia on the occipital scalp. An 8-year-old boy presented with a 3-month history of tinea capitis infection affecting his occipital and temporal scalp. A 9-year-old boy presented with a 2-month history of inflammatory scaling scalp alopecia, spreading to involve his face and neck. All three groups attended different schools, different barbershops and had received a ‘skin fade’ haircut a few weeks prior to developing symptoms. Mycology confirmed Trichophyton tonsurans. ‘Skin fade’ is a type of haircut that has a graded hair length, starting at top of the head and gradually getting shorter towards the neckline. This is produced by using clippers and often cut-throat razors. The technique was introduced in 1930s. Its popularity has varied since and has enjoyed another resurgence recently in South Wales. T. tonsurans is well recognized as an important cause of inflammatory scarring alopecia in South Wales and barbers represent an important source of cross-contamination if hygiene measures are not followed carefully. These consecutive cases suggest that ‘skin fade’ haircuts represent a risk factor for the spread of tinea capitis.

Prevalence of Tinea Capitis, Mycotic infection among Primary School Children in Erbil city

Tinea capitis is a worldwide public health problem that generates specific therapeutic challenges. Tinea capitis is dermatophytosis or ringworm of the scalp and hair. Tinea capitis is the most common superficial mycosis in school children, in developed and undeveloped regions. To the best of our knowledge there is currently no review on prevelance of Tinea capitis in study area, so this study was undertaken to determine the prevelance and intensity of Tineacapitis as well as identify the causative fungal agents of dermatophyte infection among five primary school childrens scattered in three quarters in Erbil city (Zanko1, Zanko 2 and new Zanko village. The study population composed of (180) school children aged (6-13) years who had important clinical signs of scalp dermatophytosis. Out of this number (68.33%) were males, while (31.7%) were femels. Tinea capitis infection was higher in age group(8-9) years and lower in age group(11-12)years.Cultures of hair samples were done, then macroscopical and microscopical examination were performed for dermatophyte isolates, direct microscopy and culture was positive in(78.33%) and(6.66%) of the cases were positive in direct microscopy and negative culture. The invasion of hair was Ectothrix type, forming masses of arthroconidia on the outside of the hair shaft in 117 (76.47%) specimens, while the invasion of hair was Endothrix type, and abundant sporulation inside the hair shaft causes breakage of the hair near the surface of the scalp in 36 (23.52%)specimen. Predominant isolates in the study were T. mentagrophytes (34.52%) and Microsporumspeacies (26.19%), Candida albicans and other Candida species were also isolated from five school childrens.

Evaluation of a Liquid Media MALDI-TOF MS Protocol for the Identification of Dermatophytes Isolated from Tinea capitis Infections.

One of the most common types of tinea is the superficial infection of the hair and scalp area known as tinea capitis. It is responsible for frequent outbreaks in nurseries and schools and represents a global health problem. Correct identification of the infection agent is essential in the determination of the infection source, epidemiological course, and treatment initiation. The conventional identification methods (direct exam, culture, DNA sequencing) are time-consuming, require experienced staff, are time-consuming, and the latter is expensive for routine identifications. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is gaining new ground for routine identification of filamentous fungi. The main advantages of MALDI-TOF MS are its rapid and accurate identification capability, relatively low cost, and easy integration into the laboratory routine. Its accuracy heavily depends on the quality of the reference spectra database. Identification of clinical isolates with MALDI-TOF MS protocol requires a sub-culturing step to ensure reliable identification. It can take days to weeks before fungal growth appears on solid medium. In this study, a unique MALDI-TOF MS protocol using liquid cultures of dermatophyte species was developed in order to shorten the turnaround time for the culture and identification of clinical isolates. Material and Method A standard MALDI-TOF MS protocol was adapted for liquid instead of solid cultures. Three different databases were tested. Results Using the liquid media MALDI-TOF MS protocol, a global rate of 62% correct identification (RCI) was obtained, compared with 87% for the protocol based on solid cultures. Trichophyton tonsurans was not correctly identified in all isolates using liquid cultures, with 88% of the isolates misidentified as Trichophyton interdigitale. The turnaround time for primary isolates for the solid and liquid protocols were respectively 11.7 and 11.6 days (no significant difference between both methods (p = 0.96)). Conclusions The newly designed liquid MALDI-TOF MS protocol did not lead to a significantly shorter turnaround time for the identification of dermatophytes isolated from tinea capitis infections. The turnaround time for the method with primary isolates was not significantly lower, and the rate of correct identification decreased remarkably, which emphasizes the need for a sub-culturing step. Using different database did not lead to improvement in turnaround time or rate of correct identification. This study highlights the importance of the medium and the reference database when performing MALDI-TOF MS.

Cat Contact as A Risk Factor for Tinea Capitis Infection

Background: Tinea capitis (TC) is common infection caused by dermatophytes on the scalp. Cat contact is one of the TC risk factors. Microsporum canis is the most abundant fungi in cats and humans as a zoophilic infection. Cats and carrier cats can infect humans, mostly children. Purpose: To evaluate cat contact as a risk factor for TC patients at the Dermatology and Venereology Outpatients Unit of Dr. Soetomo General Academic Hospital Surabaya in January 2017 - December 2018. Methods: A retrospective study by observation and recording data. The results obtained as a result of the data recap were then processed using tabulation to obtain conclusions. Result: The results obtained from TC cases in 2017 and 2018 are 20 patients. The results were cat contact in 9 patients (45%), aged > 5 years (55,6%), male (55,6%), and lived in Surabaya (88,9%), hair loss (88,9%), crust (100%), M. canis in culture (55,6%), Grey patch type (55,6%), combination of oral Griseofulvin and Ketoconazole 2% scalp solution (88,9%), and patients’ follow up (44,4%). Discussion: More people keeping cats will increase the risk of being infected with feline dermatophytosis. Combination therapy is the best treatment for M. canis. It is important to educate parents to be careful with pet cats that can become carriers. Conclusion: Cat contact was positive in almost half patients, mostly in a male and > 5 years old. The most common signs and symptoms were crust and hair loss, and grey patch.

Scalp and Skull Reconstruction in Patients Irradiated for Tinea Capitis in Childhood: The Scalp Exchange Procedure

AbstractBackground Approximately 70,000 Israelis underwent scalp irradiation for tinea capitis infection during their childhood, as did many other children worldwide. Long-term follow-up data showed that these children had an increased risk of aggressive and multiple nonmelanoma skin cancers, meningiomas, and other malignancies. Resection of these lesions creates a defect of soft tissue, bone, and dura, and requires scalp and skull reconstruction with local or free flaps in the irradiated field.Methods Sixteen patients with a history of childhood scalp irradiation underwent scalp and skull reconstruction in our department (2000–2018). Data on demographics, oncological status, operative details, and postoperative outcome were retrospectively collected and analyzed.Results The study group included 11 males and 5 females (average age at surgery, 70 years). The most common lesions were meningiomas (n = 9) and basal cell carcinomas (n = 8), and the most common indication for reconstruction was chronic exposure of deep structures (skull, dura, brain tissue, and titanium mesh; n = 9). Thirteen patients underwent primary free flap reconstruction and three underwent primary local flap reconstruction. Flap failure requiring reoperation occurred in one patient of the free flap reconstruction group (7%) and in all three patients of the local flap reconstruction group.Conclusion Long-term consequences of childhood depilatory treatments of the scalp by irradiation are now surfacing. Our experience showed that in such cases, surgeons should aim for a more aggressive approach with wide resection and primary free flap reconstruction, and that favorable long-term functional and aesthetic results can safely be achieved using this reconstruction approach.

FSH1 regulates the phenotype and pathogenicity of the pathogenic dermatophyte Microsporum canis.

Microsporum canis (M. canis) is a common pathogen that causes tinea capitis and is present worldwide. The incidence of M. canis infection, particularly tinea capitis, has been increasing in China. In our previous studies, family of serine hydrolases 1 (FSH1) was identified as a potential virulence factor in tinea capitis infection caused by M. canis. To determine the function of this gene in M. canis, FSH1 was knocked down using double-stranded RNA interference mediated by Agrobacterium tumefaciens. Reverse transcription-quantitative PCR analysis was used to confirm gene knockdown. Loss of FSH1 expression by RNAi resulted in a minor phenotype alteration, but M. canis pathogenicity in guinea pig cutaneous infection was decreased compared with the wild-type strain. To the best of our knowledge, the present study is the first to demonstrate that FSH1 is associated with macroconidia septa formation and is an important contributor to M. canis virulence. These findings may advance the understanding of the function of the FSH1 gene and provide a foundation for future studies on macroconidia septa formation and pathogenicity of M. canis.

Estimated Burden of Fungal Infections in Namibia.

Namibia is a sub-Saharan country with one of the highest HIV infection rates in the world. Although care and support services are available that cater for opportunistic infections related to HIV, the main focus is narrow and predominantly aimed at tuberculosis. We aimed to estimate the burden of serious fungal infections in Namibia, currently unknown, based on the size of the population at risk and available epidemiological data. Data were obtained from the World Health Organization (WHO), Joint United Nations Programme on HIV/AIDS (UNAIDS), and published reports. When no data existed, risk populations were used to estimate the frequencies of fungal infections, using the previously described methodology. The population of Namibia in 2011 was estimated at 2,459,000 and 37% were children. Among approximately 516,390 adult women, recurrent vulvovaginal candidiasis (≥4 episodes /year) is estimated to occur in 37,390 (3003/100,000 females). Using a low international average rate of 5/100,000, we estimated 125 cases of candidemia, and 19 patients with intra-abdominal candidiasis. Among survivors of pulmonary tuberculosis (TB) in Namibia 2017, 112 new cases of chronic pulmonary aspergillosis (CPA) are likely, a prevalence of 354 post-TB and a total prevalence estimate of 453 CPA patients in all. Asthma affects 11.2% of adults, 178,483 people, and so allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS) were estimated in approximately 179/100,000 and 237/100,000 people, respectively. Invasive aspergillosis (IA) is estimated to affect 15 patients following leukaemia therapy, and an estimated 0.13% patients admitted to hospital with chronic obstructive pulmonary disease (COPD) (259) and 4% of HIV-related deaths (108) — a total of 383 people. The total HIV-infected population is estimated at 200,000, with 32,371 not on antiretroviral therapy (ART). Among HIV-infected patients, 543 cases of cryptococcal meningitis and 836 cases of Pneumocystis pneumonia are estimated each year. Tinea capitis infections were estimated at 53,784 cases, and mucormycosis at five cases. Data were missing for fungal keratitis and skin neglected fungal tropical diseases such as mycetoma. The present study indicates that approximately 5% of the Namibian population is affected by fungal infections. This study is not an epidemiological study—it illustrates estimates based on assumptions derived from similar studies. The estimates are incomplete and need further epidemiological and diagnostic studies to corroborate, amend them, and improve the diagnosis and management of these diseases.

Prevalence of Tinea Capitis among Children in Osogbo, Nigeria, and the Associated Risk Factors.

Tinea capitis is a fungi infection of the scalp that disproportionately affects children in rural and underserved communities in Nigeria. A case-control study was conducted to identify the causative agents and factors that predispose school pupils to tinea capitis in two selected government-owned public primary schools in Osogbo, Southwestern Nigeria. A total of 230 participants were included in the study: 115 cases and 115 controls. Head scrapings were collected from pupils with suspected T. capitis lesions, viewed under Potassium Hydroxide smear microscopy and cultured in Sabouraud’s Dextrose Agar (SDA) for characteristic fungal elements. A total of 105 (91%) samples were successfully cultured, of which 56% (59/105) were from male pupils. Tricophyton rubrum (34%), Tricophyton mentagrophyte (31%) and Microsporum canis (18%) were the most prevalent organisms. Other dermatophytes obtained include Microsporum nanuum (3%), Epidermophyton floccusum (6%), Tricophyton verucosum (1%), and Microsporum gypseum (8%). Pupils between the ages of 4 and 7 years had the highest distribution (67%) followed by those between the ages of 8 and 11 years (39%). Playing with animals, the sharing of combs and not bathing with soap were significantly associated with tinea capitis infection (P < 0.05) in each case. This study showed a high prevalence of tinea capitis caused by the identified dermatophytes in the area.

Hair loss in children in rural population

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Among children worldwide, dermatophyte infections are most common constituting a public health problem. The aim of the study is to determine the prevalence and causative agents of tinea capitis in school children attending primary school located in Hyderabad and to perform an analysis of risk factors associated with tinea capitis as the etiological factor.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is a school based, cross sectional, prospective study which was conducted in July 2015. This study was conducted in a school located near Hyderabad.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of 600 school children, 298 boys and 302 girls, 100 were diagnosed with a tinea capitis infection after clinical and microbiological examination, with an estimated prevalence rate of 15.0%. The most prevalent dermatophytes isolation in tinea capitis in children were &lt;em&gt;Trichophyton verucosum&lt;/em&gt; (90), &lt;em&gt;Trichophyton tonsurans&lt;/em&gt; (30), &lt;em&gt;Trichophyton mentagrophytes&lt;/em&gt; (28), &lt;em&gt;Microsporum audiouium&lt;/em&gt; (15), &lt;em&gt;Trichophyton soudanese&lt;/em&gt; (9), &lt;em&gt;Trichophyton violaceum&lt;/em&gt; (5), &lt;em&gt;Microsporum ferrugineum&lt;/em&gt; (3), &lt;em&gt;Trichophyton schoenleineii&lt;/em&gt; (3), &lt;em&gt;Microsporum gallinae&lt;/em&gt; (2) and culture negative and KOH positive (10).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; This study concluded that the findings suggest that the practices resulting in entrenchment of dermatophyte infections and fungal infection. The promotion of public health action plan based on self hygiene education, which aimed to counteract the epidemiological burden specifically, and it should play an pivotal role in reduction of the prevalence in future of this common infection.&lt;/p&gt;

Theraputic and Identifecation Study of Tinea Capitis Infection in Basra City

The current study included isolation and identifecation of some types of dermatophytic fungi that causes Tinea capitis in the province of Basrah from the patients of the Basra General Hospital and a private clinic in the province. The results showed that the number of positive samples of the culture was 110 samples and 61.11% as cases of Tinea capitis, as the number of male infected 78 samples and 70.90%, while the number of female infected was 32 and 29.09%, and found that the age group 6 - 10 years is Were more infection to develop tinea capitis and 47.27%,.The dermatophytes that causing tinea capitis were diagnosed using a number of diagnostic tests. Microsporumcanis was found to be more frequent by percentage 49.09%, The other side of the study was to test the inhibitory activity ofcloves extracts and peel of pomegranate in M.canis, using Agar Well Diffusion Method by using several different types of polar solvents .The results of the study showed that the Hexane extract of the clove plant had the highest effect in M.canis,, A comparison of Griseofulvin was found to be the most effective fungal antifungal against M.canis,.GC-MS has been used to diagnose fatty acids for the hexane extract of cloves..

English

Tinea capitis is the most common dermatophyte infection in school age children in developing countries and is known to impact negatively on their health and well-being. This study determined the prevalence of T. capitis and its relationship with hygiene among primary school pupils in Ile-Ife. This descriptive cross-sectional study recruited randomly selected pupils from public and private schools in Ile-Ife from March to April 2017. The data was collected with the use of a pre&ndash;tested interviewer-administered questionnaire on hygiene followed by physical examination. Children with a clinical diagnosis of tinea capitis had scalp and hair scrapings for microscopy and culture. Data were analyzed using descriptive and inferential statistics. A total of 420 pupils participated, 240 (57.1%) males and 180 (42.9%) females aged between 4 and 16 years. The overall prevalence rate of T. Capitis infection was 21.7% with etiological agents consisting of Epidemophyton floccosum (12.0%), Microsporum gypseum (7.7%) and Trichophyton mentagrophytes (7.7%) while 33% grew Aspergillus niger (a contaminant) and no organism was isolated in 36 (39.6%) clinically diagnosed cases. The infection was prevalent among pupils sharing combs, had close contact with animals, playing with sand and lower socio-economic status. School type and personal hygiene were the major determinants of tinea capitis infection. Prevalence of T. capitis infection among school children was high and the infection is associated with poor level of hygiene and low socio-economic status. Health promotion and health education interventions are needed to promote good hygiene, early identification and treatment of the infection. Key words: Tinea capitis, primary school children, poverty, hygiene. &nbsp

Griseofulvin vs. Terbinafine in the Treatment of Tinea Capitis

Background: Two oral antifungal agents, griseofulvin and terbinafine, have regulatory approval but it is unknown whether one has superior overall efficacy. Genus-specific differences in efficacy are believed to exist for the two agents. It is not clear at what doses and durations of treatment these differences apply. Purpose: The purposes of this meta-analysis were to determine whether a statistically significant difference in efficacy exists between these agents at a given dose and duration of each in tinea capitis infections overall and to determine whether a genus-specific difference in efficacy exists for these two treatments at a given dose and duration of each. We performed a literature search for clinically and methodologically similar randomized controlled trials comparing 8 weeks of griseofulvin (6.25–12.5 mg⁄kg⁄day) to 4 weeks of terbinafine (3.125–6.25 mg⁄kg⁄day) in the treatment of tinea capitis. A meta-analysis was performed using the Mantel–Haenszel method and random effects model; results were expressed as odds ratios with 95%. Results: Meta-analysis of randomized controlled trials did not show a significant difference in the overall efficacy of the two drugs at the doses specified, but specific efficacy differences were observed based on the infectious species. For tinea capitis caused by Microsporumspp., griseofulvin is superior (p = 0.04), whereas terbinafine is superior for Trichophyton spp. infection (p = 0.04). Conclusion:Our results support species-specific differences in treatment efficacy between griseofulvin and terbinafine and provide a clinical context in which this knowledge may be applied.

A one-year survey of Microsporum audouinii infections in Belgium: epidemiological and genotypic characterization

During recent years the proportion of tinea capitis infections due to Microsporum audouinii has increased in both Belgium and other European countries. To better understand the emergence of this species, the Belgian National Reference Centre for dermatophytes launched an epidemiological survey on the main anthropophilic dermatophytes causing tinea capitis in Belgium and included the genomic characterization of M. audouinii isolates. In total, 116 strains of M. audouinii were confirmed and characterized by the DiversiLab® system (bioMérieux). Six genotypic variants were identified, among which one major group included 90 isolates and the reference strain. Another variant group (11 strains) was exclusively confined to a geographical region in south Belgium. Analysis of epidemiological characteristics of the infected population showed that the main age category was 5- to 9-year-old children with a sex ratio (male/female) of 1.97. Data concerning the geographic origin of the family revealed a majority of Belgian nationality (44.7%), suggesting that the infection originated in Belgium. Other nationalities were primarily African. At this time, no clear correlation has been established between one particular strain and a specific country of origin.

Barriers to Treatment of Tinea Capitis in Children Living in the Jane Finch Community of Toronto.

Tinea capitis is a common fungal infection of the scalp. If left untreated, tinea capitis infection can cause severe inflammatory reactions and the development of kerion. Tinea capitis is effectively treated with oral antifungals, but at present these are not covered under government assistance programs. To assess the potential impact of a limited use code for antifungal therapy in the treatment of childhood tinea capitis. Fourteen family physicians practicing in the Jane Finch area were surveyed on their experience treating tinea capitis in this community. Seventy-one percent of surveyed family physicians felt that cost impedes the treatment of tinea capitis in their practice, and 100% felt that a limited use code would have a positive impact on their patients. A limited use code for oral antifungal treatments of tinea capitis may provide a simple, cost-effective solution to a major problem impacting children in the Jane Finch area.

Dermatophyte and non dermatophyte fungi in Riyadh City, Saudi Arabia

BackgroundDermatophytes are a scientific label for a group of three genera (Microsporum, Epidermophyton and Trichophyton) of fungus that causes skin disease in animals and humans. Conventional methods for identification of these fungi are rapid and simple but are not accurate comparing to molecular methods. ObjectiveThis study aimed to isolate human pathogenic dermatophytes which cause dermatophytosis in Riyadh City, Saudi Arabia and to identify these fungi by using conventional and molecular methods. MethodsThe study was conducted in Medical Complex, Riyadh and King Saud University. Samples of infected skin, hairs and nails were collected from 112 patients. Diagnosis of skin infections, direct microscopic test, isolation and identification of dermatophytes by conventional and molecular methods were carried out. ResultsThe results indicated that the tinea capitis infection had the highest prevalence among the patients (22.3%) while Tinea barbae had the lowest. In this study the identified dermatophyte isolates belong to nine species as Trichophyton violaceum, Trichophyton verrucosum, Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton schoenleinii, Trichophyton concentricum, Microsporum canis, Microsporum audouinii and Epidermophyton floccosum which cause skin infections were isolated during this study. Non dermatophyte isolates included 5 isolates from Aspergillus spp. 4 isolates from Acremonium potronii and 15 isolates from Candida spp. M. canis were the most common species (25% of isolated dermatophytes). Out of the 52 dermatophyte isolates identified by conventional methods, there were 45 isolates identified by the molecular method. ConclusionsThe results concluded that approximately M. canis caused a quarter of dermatophyte cases, tinea capitis infection was prevalent and the molecular method was more accurate than conventional methods.

Thyroid and parathyroid tumours in patients submitted to X-ray scalp epilation during the tinea capitis eradication campaign in the North of Portugal (1950-1963).

Tinea capitis attained epidemical proportions in the fifth and sixth decades in Portugal, as in other countries. Before starting the utilization of griseofulvin in 1959, the best approach to treat tinea capitis infection was X-ray scalp epilation combined with topical antimycotic ointments. A long-term side effect of this therapy is thyroid disease, namely thyroid cancer; data on parathyroid lesions (hyperplasia, adenoma and carcinoma) are scarce. We observed clinically 1,375 individuals irradiated in childhood for tinea capitis treatment in the North of Portugal with the main purpose of evaluating thyroid and parathyroid tumours as possible sequelae of the irradiation treatment. For each individual, a cervical ultrasound and a serum calcium measurement were proposed. Fine needle aspiration cytology was suggested whenever ultrasound thyroid nodules presented suspicious features. We observed a 54 % frequency of thyroid nodules and a 2.8 % frequency of thyroid carcinoma (38/1,375). Nineteen of the 38 (50 %) carcinomas were diagnosed by us, whereas the remaining 19 carcinomas had been diagnosed and treated prior to our observation. The carcinomas were significantly more frequent in women than in men. Benign excised lesions were also significantly more frequent in women and in patients irradiated at younger ages. Seven women, considered asymptomatic until our clinical observation, had laboratory signs of hyperparathyroidism. The data we have obtained, namely high thyroid cancer frequency, corroborate previous data from childhood irradiated cohorts and highlight the need for the close follow-up of these populations in order to identify and treat early undiagnosed head and neck lesions. No evidence of increased parathyroid disease was found in this cohort of head and neck X-irradiated patients.