A practical approach j mycol mycological sci tinea capitis. Cases of tinea corporis have been observed mainly among members of. 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. Yet knowledge of the underlying pathogenetic mechanisms and the development of. Koh mount versus culture in the diagnosis of tinea capitis. Tinea capitis describes a dermatophyte infection of scalp and hair that predominately occurs in children. 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 causative organism determines the pattern of hair invasion endothrix infections there is minimal epidermal response aside from mild hyperkeratosis figure 1. Tinea capitis current concepts jama dermatology jama. 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. The diagnostic workup includes microscopic examination, culture. Favus also termed tinea favosa is a severe form of tinea capitis. Tinea capitis remains a common childhood infection in many parts of the world.
Tinea capitis is a common dermatophyte infection of the scalp in children. A significantly smaller percentage of tinea capitis is caused by microsporum canis. The infection is often contracted from another human or an animal through direct contact. Tinea capitis in infants american academy of pediatrics. Jackson, journal dermatology online journal, year2016, volume22 3. The disease is considered to be a form of superficial mycosis or dermatophytosis. 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.
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. Tinea capitis treatment in spain journal of the american. 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 is a superficial fungal infection more frequent in childhood and usually it affects children 37 years of age. Yet knowledge of the underlying pathogenetic mechanisms and the development of effective immunity have shown striking. Upon presentation, the patient was diagnosed with kerion, the most exaggerated cellular response. 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.
Describe that treatment of hair, nails, and beard compared with that for other body sites. Images in clinical medicine from the new england journal of medicine tinea capitis in a newborn. The source of the infection is usually a straight contact with cohabitants, and in adults it is mainly, but not always, associated with immunosuppression. Tinea capitis is a fungal infection of the scalp that most often presents with pruritic, scaling areas of hair loss. Sixteen subjects had no clinical lesions, but presence of fungus could be demonstrated. 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 is also called ringworm of the scalp or head. Tinea capitis also called ringworm of the scalp is a skin disorder that affects children almost exclusively. The diagnosis was confirmed by direct microscopic examination. Grading and strength of evidence for the treatment of tinea capitis. Tinea capitis dermatophyte infection of the scalp is known as tinea capitis fig 1. Tinea capitis is the most common cutaneous fungal infection in children. Dermatophytic infections of the scalp tinea capitis are characterized by involvement of the hair shaft by pathogenic fungi histology of tinea capitis.
Tinea capitis is a scalp infection caused by a fungus. The epidemiology of tinea capitis in detroit school children. Epidemiology tinea capitis is predominantly a disease of preadolescent children, adult cases being rare. Tinea capitis may resemble seborrheic or atopic dermatitis and be misdiagnosed for months. Recognize the wide variation in presentations of tinea capitis and corporis. The organisms causing tinea capitis vary according to the region.
Treatment is guided by the specific organism involved and should consist of systemic agents as well as adjuvant topical treatment. The diagnostic workup includes microscopic examination, culture andor molecular tests. Tinea capitis ringworm on scalp treatment and cure. The disease may occur in infants as young as a few weeks of age figure 1 but more often is.
Tinea capitis in north india medical mycology oxford. A randomized doubleblind comparative study of terbinafine and griseofulvin in 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 practice in many centres. Favus is a chronic infection caused most commonly by t schoenleinii and, occasionally, by t violaceum or microsporum gypsum. 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.
Nine cases with mycologically positive clinical lesions were detected. In the united states, the majority of fungal scalp infections are now caused by trichophyton tonsurans. On the basis of host preference and natural habitat, dermatophytes are also classified as anthropophilic, geophilic and zoophilic. We read with interest the article by elewski et al1 in the march 2008 issue of the journal. In the united states, tinea capitis is most often caused by a fungus not a worm called trichophyton tonsurans. The hyphae extend within the hair shaft and produce spores. In the past 20 to 30 years, the agents responsible for tinea capitis in this country have been influenced by immigration from. The differential diagnosis included acute bacterial abscesses, tinea capitis kerion, seborrheic dermatitis, atopic dermatitis, alopecia folliculitis, and psoriasis. Dermatophyte infection of the scalp is known as tinea capitis fig 1. Tinea capitis is the name used for infection of the scalp with a dermatophyte fungus.
A practical approach juarez duran er, asz sigall d, vega dc and arenas r mycology section, hospital general dr. Trichophyton and microsporum species of dermatophyte fungi are the major causes of tinea capitis. The gulf journal of dermatology and venereology volume 18, no. Answer to april 2014 photo quiz journal of clinical. 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 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. Eight hundred and sixtysix patients with tinea capitis, 381 males 44% and 485 females 56%, were enrolled in this. Guidelines bjd british journal of dermatology british association of dermatologists guidelines for the management of tinea capitis 2014 l. British association of dermatologists guidelines for the. 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. Guidelines for the management of tinea capitis in children. There were 10 boys and 5 girls ranging in age from. Affecting primarily pre pubertal children between 6 and 10 years, it is more common in males than females. Hair can be infected with trichophyton abbreviated as t.
In the past 20 to 30 years, the agents responsible for tinea capitis in this country have been influenced by. Management of tinea corporis, tinea cruris, and tinea. Tinea capitis continues to be a common problem in urban pediatric populations. Symptoms may consist of itching, scaly, inflammed balding areas on the scalp. A careful anamnesis and a complete physical examination are crucial to establish tinea capitis. Management of tinea capitis in childhood antoni bennassar, ramon grimaltdept of dermatology, hospital clinic, university of barcelona, barcelona, spainabstract. Although common in children, tinea capitis is less frequently seen in adults. Several synonyms are used, including ringworm of the scalp and. Tinea capitis is one of the more common of these fungal diseases in childhood, yet its diagnosis can be quite elusive. Tinea corporis and tinea capitis american academy of. In this report the authors compared the efficacy and safety of terbinafine hydrochloride oral granules with that of oral griseofulvin suspension in children with tinea capitis.
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