Management of tinea capitis in childhood antoni bennassar, ramon grimaltdept of dermatology, hospital clinic, university of barcelona, barcelona, spainabstract. Tinea capitis is one of the more common of these fungal diseases in childhood, yet its diagnosis can be quite elusive. Tinea capitis is almost exclusively a disease of childhood, and current evidence suggests that it occurs more often in children of african or caribbean extraction. Sixteen subjects had no clinical lesions, but presence of fungus could be demonstrated. Tinea capitis treatment in spain journal of the american. The organisms causing tinea capitis vary according to the region. Tinea capitis current concepts jama dermatology jama. Several synonyms are used, including ringworm of the scalp and. Tinea capitis remains a common childhood infection in many parts of the world. Tinea capitis is a superficial fungal infection more frequent in childhood and usually it affects children 37 years of age. Tinea corporis and tinea capitis american academy of. Tinea capitis caused by species of microsporum and trichophyton is a contagious disease that is endemic in many countries.
Symptoms may consist of itching, scaly, inflammed balding areas on the scalp. We read with interest the article by elewski et al1 in the march 2008 issue of the journal. Tinea capitis is a disease caused by superficial fungal infection of the skin of the scalp, eyebrows, and eyelashes, with a propensity for attacking hair shafts and follicles see the image below. The causative organism determines the pattern of hair invasion endothrix infections there is minimal epidermal response aside from mild hyperkeratosis figure 1. The epidemiology of tinea capitis in detroit school children. There were 10 boys and 5 girls ranging in age from.
Favus is a chronic infection caused most commonly by t schoenleinii and, occasionally, by t violaceum or microsporum gypsum. Answer to april 2014 photo quiz journal of clinical. A practical approach j mycol mycological sci tinea capitis. Jackson, journal dermatology online journal, year2016, volume22 3. Trichophyton and microsporum species of dermatophyte fungi are the major causes of tinea capitis. The physicians index of suspicion regarding the possibility of tinea capitis in the adult has been lowered over the years by the medical literature emphasizing the rarity of this entity. Tinea capitis also called ringworm of the scalp is a skin disorder that affects children almost exclusively. Tinea capitis may resemble seborrheic or atopic dermatitis and be misdiagnosed for months. A significantly smaller percentage of tinea capitis is caused by microsporum canis. Affecting primarily pre pubertal children between 6 and 10 years, it is more common in males than females.
Tinea capitis is a fungal infection of the scalp that most often presents with pruritic, scaling areas of hair loss. Yet knowledge of the underlying pathogenetic mechanisms and the development of. The source of the infection is usually a straight contact with cohabitants, and in adults it is mainly, but not always, associated with immunosuppression. Koh mount versus culture in the diagnosis of tinea capitis. Tinea capitis is the name used for infection of the scalp with a dermatophyte fungus. The hyphae extend within the hair shaft and produce spores. Recognize the wide variation in presentations of tinea capitis and corporis.
The disease may occur in infants as young as a few weeks of age figure 1 but more often is. Management of tinea corporis, tinea cruris, and tinea. Epidemiology tinea capitis is predominantly a disease of preadolescent children, adult cases being rare. Yet knowledge of the underlying pathogenetic mechanisms and the development of effective immunity have shown striking. The infection is often contracted from another human or an animal through direct contact. British association of dermatologists guidelines for the.
Dermatophytic infections of the scalp tinea capitis are characterized by involvement of the hair shaft by pathogenic fungi histology of tinea capitis. In the united states, the majority of fungal scalp infections are now caused by trichophyton tonsurans. Tinea capitis ringworm on scalp treatment and cure. Favus also termed tinea favosa is a severe form of tinea capitis. Tinea capitis is a common dermatophyte infection of the scalp in children. Upon presentation, the patient was diagnosed with kerion, the most exaggerated cellular response. The differential diagnosis included acute bacterial abscesses, tinea capitis kerion, seborrheic dermatitis, atopic dermatitis, alopecia folliculitis, and psoriasis. A randomized doubleblind comparative study of terbinafine and griseofulvin in tinea capitis. A survey of 1620 school children 690 from delhi, 810 from ballabgarh and 120 from kashmir was undertaken to assess the prevalence of tinea capitis. Tinea capitis, a dermatophytic infection of the scalp, is rare in adults, even in geographic areas with high prevalence rates. Hair can be infected with trichophyton abbreviated as t. Tinea capitis continues to be a common problem in urban pediatric populations. A practical approach juarez duran er, asz sigall d, vega dc and arenas r mycology section, hospital general dr.
Tinea capitis in infants american academy of pediatrics. Cases of tinea corporis have been observed mainly among members of. On the basis of host preference and natural habitat, dermatophytes are also classified as anthropophilic, geophilic and zoophilic. Openurl1crossref2pubmed3 these investigators, representing 3 university medical centers in italy, report on 15 cases of tinea capitis observed in infants less than 1 year of age. Tinea capitis dermatophyte infection of the scalp is known as tinea capitis fig 1. The disease is considered to be a form of superficial mycosis or dermatophytosis.
The diagnostic workup includes microscopic examination, culture andor molecular tests. Images in clinical medicine from the new england journal of medicine tinea capitis in a newborn. Nine cases with mycologically positive clinical lesions were detected. Tinea capitis is the most common cutaneous fungal infection in children. Treatment is guided by the specific organism involved and should consist of systemic agents as well as adjuvant topical treatment. Tinea capitis is still the most common dermatophytosis in many regions of africa, and is frequently found in asia and the us especially among blacks and latin american immigrants, while it is rare in several european regions.
Yet knowledge of the underlying pathogenetic mechanisms and the development of effective immunity have shown striking advances, and new methods of diagnosis ranging from dermoscopy to molecular laboratory tests have been developed even though they have not been assimilated into routine practice in many centres. Grading and strength of evidence for the treatment of tinea capitis. Yet knowledge of the underlying pathogenetic mechanisms and the development of effective immunity have shown striking advances, and new methods of diagnosis ranging from dermoscopy to molecular laboratory tests have been developed even though they have not been assimilated into routine. In the united states, tinea capitis is most often caused by a fungus not a worm called trichophyton tonsurans. This survey was a retrospective of a 16year 19932008 study on the incidence, clinical features, and etiological agents of tinea capitis mainly representing the southeastern china.
The diagnostic workup includes microscopic examination, culture. Tinea capitis is an infection caused by dermatophyte fungi usually species in the genera microsporum and trichophyton of scalp hair follicles and the surrounding skin. The gulf journal of dermatology and venereology volume 18, no. The diagnosis was confirmed by direct microscopic examination. Widespread tinea corporis, particularly when it is on the face, neck, or upper chest, can be a sign of occult scalp tinea infection or asymptomatic carriage. Dermatophyte infection of the scalp is known as tinea capitis fig 1. Assistant professor of pediatrics, wayne state university, childrens hospital of michigan, detroit, mich after completing this article, readers should be able to. Tinea capitis is a scalp infection caused by a fungus. Tinea capitis is also called ringworm of the scalp or head. Tinea capitis in north india medical mycology oxford. A randomized doubleblind comparative study of terbinafine. The more recent guidelines published by the british association of dermatology and in the british medical journal have largely focused on tinea capitis and tinea unguium with scarce reference to tinea corporiscruris.
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