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Deng R, Chen X, Zheng D, Xiao Y, Dong B, Cao C, Ma L, Tong Z, Zhu M, Liu Z, Lu S, Fu M, Jin Y, Yin B, Li F, Li X, Abliz P, Liu H, Zhang Y, Yu N, Wu W, Xiong X, Zeng J, Huang H, Jiang Y, Chen G, Pan W, Sang H, Wang Y, Guo Y, Shi D, Yang J, Ran Y, Hu J, Yang L, Bai S, Yu J, Wang X, Li R. Epidemiologic features and therapeutic strategies of kerion: A nationwide multicentre study. Mycoses 2024; 67:e13751. [PMID: 38825584 DOI: 10.1111/myc.13751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/13/2024] [Accepted: 05/26/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Kerion is a severe type of tinea capitis that is difficult to treat and remains a public health problem. OBJECTIVES To evaluate the epidemiologic features and efficacy of different treatment schemes from real-world experience. METHODS From 2019 to 2021, 316 patients diagnosed with kerion at 32 tertiary Chinese hospitals were enrolled. We analysed the data of each patient, including clinical characteristics, causative pathogens, treatments and outcomes. RESULTS Preschool children were predominantly affected and were more likely to have zoophilic infection. The most common pathogen in China was Microsporum canis. Atopic dermatitis (AD), animal contact, endothrix infection and geophilic pathogens were linked with kerion occurrence. In terms of treatment, itraconazole was the most applied antifungal agent and reduced the time to mycological cure. A total of 22.5% of patients received systemic glucocorticoids simultaneously, which reduced the time to complete symptom relief. Furthermore, glucocorticoids combined with itraconazole had better treatment efficacy, with a higher rate and shorter time to achieving mycological cure. CONCLUSIONS Kerion often affects preschoolers and leads to serious sequelae, with AD, animal contact, and endothrix infection as potential risk factors. Glucocorticoids, especially those combined with itraconazole, had better treatment efficacy.
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Affiliation(s)
- Ruixin Deng
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Xiaoqing Chen
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Dongyan Zheng
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yuanyuan Xiao
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Bilin Dong
- Department of Dermatology, Wuhan No. 1 Hospital, Wuhan, China
| | - Cunwei Cao
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhongsheng Tong
- Department of Dermatology, Wuhan No. 1 Hospital, Wuhan, China
| | - Min Zhu
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zehu Liu
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Sha Lu
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meng Fu
- Department of Dermatology, Xijing Hospital, Xi'an, China
| | - Yun Jin
- Department of Dermatology, Dermatology Hospital of Jiangxi Province, Nanchang, China
| | - Bin Yin
- Department of Dermatology, Chengdu Second People's Hospital, Chengdu, China
| | - Fuqiu Li
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, China
| | - Xiaofang Li
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Palida Abliz
- Department of Dermatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Hongfang Liu
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Yu Zhang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Nan Yu
- Department of Dermatology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Weiwei Wu
- Department of Dermatology, The Fifth People's Hospital of Hainan Province, Haikou, China
| | - Xincai Xiong
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jingsi Zeng
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huaiqiu Huang
- Department of Dermatology and Venereology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanping Jiang
- Department of Dermatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Guanzhi Chen
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Weihua Pan
- Department of Dermatology, Shanghai Changzheng Hospital, Naval Military Medical University, Shanghai, China
| | - Hong Sang
- Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ying Wang
- Department of Dermatology, Changhai Hospital of Shanghai, Shanghai, China
| | - Yun Guo
- Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Dongmei Shi
- Department of Dermatology, Jining First People's Hospital, Jining, China
| | - Jianxun Yang
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yuping Ran
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Jin Hu
- Department of Dermatology, The Affiliated Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | | | - Shuang Bai
- The Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Jin Yu
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Xiaowen Wang
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Ruoyu Li
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
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Ali AI, Aden AI, Mohamud AK. Dermoscopic findings in Tinea Capitis among under 18 children in dermatology polyclinic patients: a hospital-based cross-sectional study. Ann Med Surg (Lond) 2024; 86:121-126. [PMID: 38222710 PMCID: PMC10783287 DOI: 10.1097/ms9.0000000000001530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/11/2023] [Indexed: 01/16/2024] Open
Abstract
Background 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. Method 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. Results 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. Conclusion 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.
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Affiliation(s)
- Ahmed Isse Ali
- Department of Dermatology, Mogadishu-Somali Turkey Training and Research Hospital
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Song G, Zhang M, Kong X, Liu W, Liang G. Tinea Capitis in Children Younger than Two Years Old: A Retrospective Study and Treatment Recommendations. Mycopathologia 2023; 188:461-478. [PMID: 36581775 DOI: 10.1007/s11046-022-00703-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Tinea capitis (TC) is a dermatophytosis of the scalp and hair, which occurs less common in children younger than two years of age, and the data of TC in this age group are still unknown. OBJECTIVES We aimed to reveal the epidemiological, clinical and mycological characteristics of TC in children under two years old. METHODS We retrospectively analyzed all reported cases of TC in children in their first two years of life from 1991 to 2022, by searching PubMed, Embase, Web of Science, CNKI, Wanfang and Weipu databases. RESULTS A total of 47 articles involving 126 cases of pediatric TC were enrolled in this study. The sex ratio (M/F) was 1.28:1. The age of the children ranged from ten days old to two years old with a median age of three months. The main clinical manifestations were alopecic patches (40 cases, 31.7%) and scaling (39 cases, 31.0%) on the scalp, and 29 infants (23.0%) appeared kerion. The most common sources of contagion were animals (35 cases, 27.78%) and humans (31 cases, 24.60%). The leading pathogens were Microsporidium canis (64 cases, 50.79%), followed by Trichophyton violaceum (13 cases, 10.32%), T. mentagrophytes complex (12 cases, 9.52%) and T. tonsurans (10 cases, 7.94%). Ninety-five children (75.40%) were treated with systemic antifungal drugs and 22 patients (17.46%) were only treated with topical therapy. Except for 10 patients with unknown final prognosis, all the other cases were cured after treatment. There was one child (0.79%) relapsed after treatment with griseofulvin and one case (0.79%) presented with gastrointestinal symptoms from griseofulvin. CONCLUSION The principal clinical symptoms of TC in children less than two years old were alopecic patches and scaling. The top four pathogens were M. canis, T. violaceum, T. mentagrophytes complex and T. tonsurans. Oral treatment for pediatric TC had achieved good therapeutic effects, and topical therapy can be an alternative choice.
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Affiliation(s)
- Ge Song
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Meijie Zhang
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Xue Kong
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China
| | - Weida Liu
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China.
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China.
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China.
| | - Guanzhao Liang
- Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China.
- CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China.
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, 210042, China.
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Cai W, Huang J, Li J, Lin L, Xi L, Zhang J, Li X, Zhou Z, Tang Y, Liu H, Zhang J, Lu S. Epidemiology and Clinical Findings of Tinea Capitis: A 23-Year Retrospective, Single-Center Study in Guangzhou, China. Mycopathologia 2023; 188:507-514. [PMID: 37097433 DOI: 10.1007/s11046-023-00730-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 03/26/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Tinea capitis (TC) is one of the most common public health concerns due to its high incidence in preadolescent children. The epidemiological and clinical characteristics of TC vary depending on geographical regions and have changed over the past decades. OBJECTIVES This study aimed to identify epidemiological changes in recent decades, including the prevalence and clinical and mycological characteristics of TC in southern China. METHODS We conducted a retrospective study at the Department of Dermatology of Sun Yat-sen Memorial Hospital, Sun Yat-sen University from June 1997 to August 2020. RESULTS We retrospectively evaluated 401 TC patients. Of these, 157 patients (39.2%) were preschool children aged 3-7 years and the majority were males. However, the prevalence in children under 3 years old is on the rise (from 19.67% during 1997-2010 to 32.49% during 2011-2020). Grey patches were the most common clinical pattern and mostly occurred in children (71.3%), while the proportion of grey patches and black dots was almost the same in adults. Although Microsporum canis (76%) was the most common causative organism, the number of the T. mentagrophytes complex, as a zoophilic fungus, has increased more than that of the anthropophilic fungi T. violaceum in the recent decade. There was a significant difference in the portion of sex among different age groups, and the gender difference was more notable in the adult group, which showed that the TC prevalence in females was 9 times that in males. In males, M. canis and the T. mentagrophytes complex were the two most common causative fungi, while M. canis and T. violaceum were the two most common causative fungi in females. Additionally, approximately 61.7% of black dot TCs occurred in females. For treatment, oral antifungal therapeutics were widely used in most patients with different treatment durations, although without a significant difference in efficacy (P = 0.106). CONCLUSIONS In the last decade, the prevalence of TC in children under 3 years old increased, and boys dramatically outnumbered girls. In adults, the TC prevalence in females is nine times that in males, and most TCs occurring in females are presented as black dots. Moreover, the zoophilic T. mentagrophytes complex has replaced T. violaceum and is now the second most prevalent organism, followed by M. canis of TC.
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Affiliation(s)
- Wenying Cai
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China
| | - Junhao Huang
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China
| | - Jiahao Li
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China
| | - Li Lin
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China
| | - Liyan Xi
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China
- Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Junmin Zhang
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China
| | - Xiqing Li
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China
| | - Zhen Zhou
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Ying Tang
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China
| | - Hsingmei Liu
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China
| | - Jing Zhang
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China.
| | - Sha Lu
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China.
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Chen XQ, Yu J. Global Demographic Characteristics and Pathogen Spectrum of Tinea Capitis. Mycopathologia 2023; 188:433-447. [PMID: 37012556 DOI: 10.1007/s11046-023-00710-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/07/2023] [Indexed: 04/05/2023]
Abstract
Tinea capitis is an important superficial fungal infection with a global distribution. It mainly affects prepubertal children and is more common in males. Anthropophilic and zoophilic dermatophytes are responsible for most infections. The pathogen spectrum of tinea capitis varies across different regions and changes over time, and is influenced by multiple factors, such as economic development, changes in lifestyle, immigration and animal distribution. This review aimed to clarify the demographic and etiological characteristics of tinea capitis worldwide and determine the common trends of causative pathogens. By mainly analyzing the literature published from 2015 to 2022, we found that the incidence and demographic characteristics of tinea capitis remained generally stable. Zoophilic Microsporum canis, anthropophilic Trichophyton violaceum and Trichophyton tonsurans were the predominant pathogens. The pathogen spectra in different countries changed in different directions. In some countries, the main pathogen shifted to an anthropophilic dermatophyte, such as T. tonsurans, Microsporum audouinii or T. violaceum; in contrast, it shifted to a zoophilic agent, such as M. canis, in some other countries. Dermatologists are advised to continue monitoring the pathogen spectrum and implement preventive measures according to the reported changes.
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Affiliation(s)
- Xiao-Qing Chen
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing, China
- Department of Dermatology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Jin Yu
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Peking University First Hospital, Beijing, China.
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6
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Wei LW, Qiao JJ. Mini-Review: The Diagnostic Methods of Tinea Capitis. Mycopathologia 2023; 188:563-569. [PMID: 37067665 DOI: 10.1007/s11046-023-00731-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/26/2023] [Indexed: 04/18/2023]
Abstract
Tinea capitis is a widespread superficial fungal infection that affects children predominately. Microscopic examination and fungal culture are the conventional gold standards for diagnosis, but they are insensitive and time-consuming. In recent years, new diagnostic methods have been developed to facilitate the diagnosis and identification of causative pathogens. Trichoscopy examination showed high sensitivity and specificity for diagnosing tinea capitis with the characteristic signs of comma hairs, corkscrew hairs, bar code-like hairs and zigzag hairs. Reflectance confocal microscopy has also been used in the rapid diagnosis of tinea capitis in several studies. Molecular assays such as polymerase chain reaction and matrix-assisted desorption/ionization time to flight mass spectrometry are extensively utilized for rapid and accurate identification of the pathogens. Early diagnosis and treatment can aid in disease control and scarring reduction.
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Affiliation(s)
- Lin-Wei Wei
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, China
| | - Jian-Jun Qiao
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, China.
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Abtahi‐Naeini B, Payandeh A, Rastegarnasab F. Successful treatment of fungal ball-associated tinea capitis in a healthy infant: An unusual presentation. Clin Case Rep 2023; 11:e7752. [PMID: 37529136 PMCID: PMC10387597 DOI: 10.1002/ccr3.7752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/06/2023] [Accepted: 07/16/2023] [Indexed: 08/03/2023] Open
Abstract
Key Clinical Message Presentation of tinea capitis with fungal mass in an infant is extremely rare. Tinea capitis with and without abscess formation is prone to be misdiagnosed in infants and should be considered as a differential diagnosis of inflammatory hair loss in infants and toddlers as well as school-aged children. Abstract Tinea capitis is the scalp fungal infection that most often affects early school children. It rarely affects neonates and adults. The presentation of fungal ball in the setting of tinea capitis is extremely rare. Herein, we describe a 7-month-old girl with a fungal ball associated with tinea capitis with a scalp mass adjacent to the scalp dermatophytosis. To our knowledge, this is the first case of fungal ball in a healthy infant with tinea capitis.
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Affiliation(s)
- Bahareh Abtahi‐Naeini
- Pediatric Dermatology Division of Department of PediatricsImam Hossein Children's Hospital, Isfahan University of Medical SciencesIsfahanIran
- Skin Diseases and Leishmaniasis Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Atefeh Payandeh
- Student Research CommitteeKerman University of Medical SciencesKermanIran
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8
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Chen XQ, Zheng DY, Xiao YY, Dong BL, Cao CW, Ma L, Tong ZS, Zhu M, Liu ZH, Xi LY, Fu M, Jin Y, Yin B, Li FQ, Li XF, Abliz P, Liu HF, Zhang Y, Yu N, Wu WW, Xiong XC, Zeng JS, Huang HQ, Jiang YP, Chen GZ, Pan WH, Sang H, Wang Y, Guo Y, Shi DM, Yang JX, Chen W, Wan Z, Li RY, Wang AP, Ran YP, Yu J. Aetiology of tinea capitis in China: A multicentre prospective study. Br J Dermatol 2021; 186:705-712. [PMID: 34741300 DOI: 10.1111/bjd.20875] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Tinea capitis is still common in developing countries, such as China. Its pathogen spectrum varies across regions and changes over time. OBJECTIVES This study aimed to clarify the current epidemiological characteristics and pathogen spectrum of tinea capitis in China. METHODS A multicentre, prospective descriptive study involving 29 tertiary hospitals in China was conducted. From August 2019 to July 2020, 611 patients with tinea capitis were enrolled. Data concerning demography, risk factors and fungal tests were collected. The pathogens were further identified by morphology or molecular sequencing when necessary in the central laboratory. RESULTS Among all enrolled patients, 74.1% of the cases were 2- to 8-year-olds. The children with tinea capitis were mainly boys (56.2%) and more likely to have an animal contact history (57.4% vs. 35.3%, P = 0.012) and zoophilic dermatophyte infection (73.5%). The adults were mainly females (83.3%) and more likely to have anthropophilic agent infection (53.5%). The most common pathogen was zoophilic Microsporum canis (354, 65.2%), followed by anthropophilic Trichophyton violaceum (74, 13.6%). In contrast to the eastern, western and northeastern regions where zoophilic M. canis predominated, anthropophilic T. violaceum predominated in central China (69.2%, P < 0.0001), where the patients had the most tinea at other sites (20.3%) and dermatophytosis contact (25.9%) with the least animal contact (38.8%). Microsporum ferrugineum was the most common anthropophilic agent in the western area, especially in Xinjiang Province. CONCLUSIONS Boys aged approximately 5 years were mainly affected. Dermatologists are advised to pay more attention to the different transmission routes and pathogen spectra in different age groups from different regions.
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Affiliation(s)
- X-Q Chen
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - D-Y Zheng
- Department of Dermatology and Venereology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Y-Y Xiao
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - B-L Dong
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - C-W Cao
- Department of Dermatology and Venereology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - L Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Z-S Tong
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - M Zhu
- Department of Dermatology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Z-H Liu
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - L-Y Xi
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - M Fu
- Department of Dermatology, Xijing Hospital, Xi'an, China
| | - Y Jin
- Department of Dermatology, Dermatology Hospital of Jiangxi Province, Nanchang, China
| | - B Yin
- Department of Dermatology, Chengdu Second People's Hospital, Chengdu, China
| | - F-Q Li
- Department of Dermatology, the Second Hospital of Jilin University, Changchun, China
| | - X-F Li
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - P Abliz
- Department of Dermatology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - H-F Liu
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Y Zhang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - N Yu
- Department of Dermatology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - W-W Wu
- Department of Dermatology, the Fifth People's Hospital of Hainan Province, Haikou, China
| | - X-C Xiong
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - J-S Zeng
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - H-Q Huang
- Department of Dermatology and Venereology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Y-P Jiang
- Department of Dermatology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - G-Z Chen
- Department of Dermatology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - W-H Pan
- Department of Dermatology, Shanghai Changzheng Hospital, Naval Military Medical University, Shanghai, China
| | - H Sang
- Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Y Wang
- Department of Dermatology, Changhai Hospital of Shanghai, Shanghai, China
| | - Y Guo
- Department of Dermatology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - D-M Shi
- Department of Dermatology, Jining No, People's Hospital, Jining, China
| | - J-X Yang
- Department of Dermatology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - W Chen
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Z Wan
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - R-Y Li
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - A-P Wang
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Y-P Ran
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - J Yu
- Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Centre for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
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