Tinea Capitis

Tinea capitis remains a common childhood infection in many parts of the world. 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. Treatment is effective although it needs to be given for at least 1 month. What is missing, however, is a systematic approach to control through case ascertainment and therapy.

BackgroundTinea capitis is a common infection especially in poor resource settings. This study was aimed at determining the prevalence Tinea capitis in children from selected schools from an urban slum in Nairobi city of Kenya.MethodsA cross-sectional study was carried out in 150 school going children during the period between May and September 2013. A questionnaire was administered and cultures of scalps, skin scrapping/hair stubs samples were performed and the etiological agents identified and confirmed.ResultsIn a total of one hundred and fifty (150) children recruited 89 (59.3%) were males and 61 (40.7%) females aged between 3 and 14 years. The overall prevalence rates in dermatophytes infection was 81.3% (122/150) with etiological agents consisting Trichophyton spp. (61.3%), Microsporum spp. (13.3%) and Epidermophyton spp. (7.3%) infections with infections occurring either singly (56%), duo (38%) or tipple co-infections (6%).ConclusionThis study demonstrates a high prevalence of Tinea infections with Trichophyton tonsurans as the predominant etiological agent in school going children of the urban slums of Nairobi.

BackgroundFungal skin infections are recognised as one of the most common health disorders globally, and dermatophyte infections of the skin, hair and nails are the most common fungal infections. Dermatophytes can be classified as anthropophilic, zoophilic or geophilic species based on their primary habitat association, and this classification makes epidemiological analysis useful for the prevention and control of these infections. The Irish contribution to the epidemiology of these infections has been scant, with just two papers (both reporting paediatric tinea capitis only) published in the last 20 years, and none in the last seven.ObjectivesTo perform a comprehensive retrospective epidemiological analysis of all dermatological mycology tests performed in University Hospital Limerick over a 20-year period.MethodsAll mycology laboratory test results were extracted from the Laboratory Information Management System (LIMS, iLab, DXC Technologies) from 2001 to 2020 inclusive for analysis. Specimen types were categorised according to the site of sampling. The data were analysed using Microsoft Excel.ResultsAbout 12,951 specimens of skin, hair and nails were studied. Median patient age was 42 years (IQR 26-57) with a slight female preponderance (57.2%). Two thirds of samples (67%, n = 8633) were nail, 32% were skin scrapings (n = 4118) and 200 hair samples (1.5%) were received. Zoophilic dermatophytes were more commonly present in females (38% F, 23% M, proportion of dermatophytes) and in those under 10 years of age or from 45 to 70 years (36% and 34% zoophiles, respectively, proportion of dermatophytes), although anthropophiles predominated every age and gender category. Anthropophiles had their highest prevalence in the 10-20 years age category (80% anthropophiles, proportion of dermatophytes), and yeast infections were more prevalent in older patients (29% of >60 year olds vs. 17% of ConclusionsThis study provides a detailed overview of the epidemiology of the fungal cultures of skin, nail and hair samples in the Mid-West of Ireland over a 20-year period. Monitoring this changing landscape is important in identifying likely sources of infections, to identifying potential outbreaks, and may help guide empiric treatment. To the best of our knowledge, this study provides the first detailed analysis from Ireland of fungal detections from skin, hair and nail samples, and is the first epidemiological fungal report of any kind in over 7 years.

The consensus-based guideline developed under the auspices of the German Dermatological Society (DDG) is intended to provide physicians with a structured framework for clinical decision-making in the management of patients with tinea capitis and to contribute to improved diagnostic accuracy, treatment adherence, and prevention. Tinea capitis is a dermatophyte-induced infection of the scalp that predominantly affects children and represents a common dermatological condition worldwide. In recent years, a marked shift in the epidemiology of causative dermatophytes has been observed in Europe, driven by migration, tourism, and socioeconomic factors, with an increasing prevalence of anthropophilic species, particularly Trichophyton tonsurans and Trichophyton violaceum. From a therapeutic perspective, a combination of systemic and topical antifungal treatment is recommended, as topical monotherapy is generally insufficient. In pediatric patients, the choice of systemic antifungal therapy is primarily guided by the identified pathogen, with Trichophyton infections preferably treated with terbinafine (off-label) and Microsporum/Nannizzia infections with itraconazole (off-label) or griseofulvin. In adult patients, terbinafine is recommended as first-line therapy irrespective of the causative species. In addition, the guideline addresses measures to interrupt chains of infection, including the treatment of asymptomatic carriers, implementation of hygiene measures, and management of outbreak situations in community settings.