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Müller VL, Kappa-Markovi K, Hyun J, Georgas D, Silberfarb G, Paasch U, Uhrlaß S, Nenoff P, Schaller J. Tinea capitis et barbae caused by Trichophyton tonsurans: A retrospective cohort study of an infection chain after shavings in barber shops. Mycoses 2020; 64:428-436. [PMID: 33341968 DOI: 10.1111/myc.13231] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Tinea capitis is a highly contagious infectious disease caused by dermatophytes. In Central Europe, it is mainly caused by zoophilic dermatophytes, as, for example Microsporum (M) canis or Trichophyton (T) mentagrophytes and increasingly by anthropophilic fungi. T tonsurans was commonly related to the Tinea gladiatorum, where transmission occurred between infected persons or via contaminated floors. OBJECTIVE Reporting the transmission of this highly contagious dermatophyte for the first time via beard shaving and hairdressing in barber shops in Germany. PATIENTS AND METHODS 18 young male patients developed tinea capitis and/or barbae shortly after shavings of the beard and/or hair in a barber shop. Native, cultural and molecular diagnostics as well as tissue biopsies and resistance tests were performed of skin and hair samples. RESULTS In all samples, T tonsurans could be identified. The medical history and the clinical picture suggest a transmission through contaminated hairdressing tools. The patients were treated with terbinafine or itraconazole in combination with or exclusively with topical antimycotics. CONCLUSION The transmission and a resulting increase in the incidence of infections with T tonsurans may be due to shavings with direct skin contact of insufficiently disinfected hairdressing tools. This path of infection has already been observed in Africa and is now being described for the first time in Germany. Knowledge of the pathogen and its transmission ways are essential to interrupt the chain of infection.
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Affiliation(s)
- Valentina Laura Müller
- Klinik für Dermatologie, Allergologie und Phlebologie, Helios Klinikum Duisburg, Duisburg, Germany.,Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Korina Kappa-Markovi
- Klinik für Dermatologie, Allergologie und Phlebologie, Helios Klinikum Duisburg, Duisburg, Germany
| | - Julia Hyun
- Klinik für Dermatologie, Allergologie und Phlebologie, Helios Klinikum Duisburg, Duisburg, Germany
| | - Dimitrios Georgas
- Klinik für Dermatologie, Allergologie und Phlebologie, Helios Klinikum Duisburg, Duisburg, Germany
| | | | - Uwe Paasch
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Silke Uhrlaß
- Labor für Medizinische Mikrobiologie, Partnerschaft Prof. P. Nenoff und Dr. C. Krüger, Rötha OT Mölbis, Germany
| | - Pietro Nenoff
- Labor für Medizinische Mikrobiologie, Partnerschaft Prof. P. Nenoff und Dr. C. Krüger, Rötha OT Mölbis, Germany
| | - Jörg Schaller
- Dermatopathologie Duisburg, Prof. J. Schaller und Dr. C. Hendricks, Duisburg, Germany
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2
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Mayser P, Nenoff P, Reinel D, Abeck D, Brasch J, Daeschlein G, Effendy I, Ginter-Hanselmayer G, Gräser Y, Hipler UC, Höger P, Kolb-Mäurer A, Ott H, Schaller M, Zidane M. S1 guidelines: Tinea capitis. J Dtsch Dermatol Ges 2020; 18:161-179. [PMID: 32026639 DOI: 10.1111/ddg.14026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Tinea capitis describes a dermatophyte infection of scalp and hair that predominately occurs in children. The diagnostic workup includes microscopic examination, culture and/or molecular tests. Treatment is guided by the specific organism involved and should consist of systemic agents as well as adjuvant topical treatment. The aim of the present update of the interdisciplinary German S1 guidelines is to provide dermatologists, pediatricians and general practitioners with a decision tool for selecting and implementing appropriate diagnostic and therapeutic measures in patients with tinea capitis. The guidelines were developed based on current international guidelines, in particular the 2010 European Society for Pediatric Dermatology guidelines and the 2014 British Association of Dermatologists guidelines, as well as on a review of the literature conducted by the guideline committee. This multidisciplinary committee consists of representatives from the German Society of Dermatology (DDG), the German-Speaking Mycological Society (DMykG), the German Society for Hygiene and Microbiology (DGHM), the German Society of Pediatric and Adolescent Medicine (DGKJ) and the German Society for Pediatric Infectious Diseases (DGPI). The Division of Evidence-based Medicine (dEBM) provided methodological assistance. The guidelines were approved by the participating medical societies following a comprehensive internal and external review.
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Affiliation(s)
| | - Pietro Nenoff
- Partnership Pietro Nenoff, PhD, MD & Constanze Krüger, MD, Laboratory for Medical Microbiology, Rötha OT Mölbis, Germany
| | | | | | - Jochen Brasch
- Department of Dermatology, University Medical Center of Schleswig Holstein, Kiel, Germany
| | - Georg Daeschlein
- Department of Dermatology, Greifswald University Medical Center, Greifswald, Germany
| | - Isaak Effendy
- Department of Dermatology, Bielefeld Medical Center, Bielefeld, Germany
| | | | - Yvonne Gräser
- National Reference Laboratory for Dermatophytes, Institute for Microbiology and Hygiene, Charité - University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
| | | | - Peter Höger
- Department of Pediatrics and Pediatric Dermatology/Allergology, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
| | - Annette Kolb-Mäurer
- Department of Dermatology, Venereology and Allergology, Würzburg University Medical Center, Würzburg, Germany
| | - Hagen Ott
- Department of Pediatric Dermatology and Allergology, Auf der Bult, Hanover, Germany
| | - Martin Schaller
- Department of Dermatology, Tübingen University Medical Center, Tübingen, Germany
| | - Miriam Zidane
- Department of Dermatology, Venereology and Allergology, Division of Evidence-based Medicine (dEBM) and Berlin Institute of Health, Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt University of Berlin, Berlin, Germany
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3
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Mayser P, Nenoff P, Reinel D, Abeck D, Brasch J, Daeschlein G, Effendy I, Ginter-Hanselmayer G, Gräser Y, Hipler UC, Höger P, Kolb-Mäurer A, Ott H, Schaller M, Zidane M. S1‐Leitlinie Tinea capitis. J Dtsch Dermatol Ges 2020; 18:161-180. [PMID: 32026649 DOI: 10.1111/ddg.14026_g] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
| | - Pietro Nenoff
- Partnerschaft Prof. Dr. med. Pietro Nenoff & Dr. med. Constanze Krüger, Labor für medizinische Mikrobiologie, Rötha OT Mölbis, Deutschland
| | | | | | - Jochen Brasch
- Universitäts-Hautklinik Kiel, Universitätsklinikums Schleswig-Holstein, Kiel, Deutschland
| | - Georg Daeschlein
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Hautkrankheiten, Greifswald, Deutschland
| | - Isaak Effendy
- Hautklinik, Klinikum der Stadt Bielefeld, Bielefeld, Deutschland
| | | | - Yvonne Gräser
- Konsiliarlaboratorium für Dermatophyten, Institut für Mikrobiologie und Hygiene, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland
| | | | - Peter Höger
- Pädiatrie und Pädiatrische Dermatologie/Allergologie, Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg, Deutschland
| | - Annette Kolb-Mäurer
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Hagen Ott
- Pädiatrische Dermatologie und Allergologie, Auf der Bult, Hannover, Deutschland
| | - Martin Schaller
- Universitäts-Hautklinik Tübingen, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Miriam Zidane
- Department of Dermatology, Venerology und Allergology, Division of Evidence-based Medicine (dEBM) and Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Deutschland
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Abstract
We report the case of a 19-year-old patient who presented with recurrent circular and scaly skin changes. The patient reported wrestling as his main leisure activity. After an unsuccessful attempt at local antibiotic treatment, detailed dermatological work-up revealed the skin changes to be tinea corporis gladiatorum. According to dermatological guidelines for dermatophytosis, systemic treatment with fluconazole and local ointments containing ciclopirox olamine and ketoconazole were administered, which rapidly led to significant improvement.
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Affiliation(s)
- H Gärtner
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg/Saar, Deutschland.
| | - C S L Müller
- Klinik für Dermatologie und Venerologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland
| | - S L Becker
- Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland.,Schweizerisches Tropen- und Public-Health-Institut, Basel, Schweiz.,Universität Basel, Basel, Schweiz
| | - A Bozzato
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg/Saar, Deutschland
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