Tinea capitis in Philadelphia

The aetiological agents of tinea capitis in Zaragoza (Spain)

Between 1977 and 1997, 190 cases of tinea capitis were observed. The age groups most commonly infected were 1-10 years old. The following dermatophytes were isolated: Microsporum canis (119), Trichophyton mentagrophytes (57), Trichophyton tonsurans (seven), Trichophyton verrucosum (three), Trichophyton violaceum (one), Trichophyton schoenleinii (one), Trichophyton soudanense (one) and Microsporum audouinii (one).

Tinea capitis in California children: a population-based study of a growing epidemic

OBJECTIVE

To describe trends in tinea capitis incidence among California children and to determine subpopulations at increased risk.

DESIGN

Retrospective population-based study.

SETTING

California, 1984 through 1993.

POPULATION

Children < 10 years of age enrolled in Medi-Cal.

OUTCOME MEASURES

California Medi-Cal provider data for first-time prescriptions of oral griseofulvin suspension were used to estimate annual incidence of tinea capitis and calculate risk ratios.

RESULTS

From 1984 through 1993, the incident rate for prescriptions of oral griseofulvin suspension increased by 84.2% for all children, 140.4% for white children, and 209.7% for African-American children. In 1993, incidence rates (per 10,000 enrolled) were 252.1 claimants for African-American children, 23.1 for white, 17.5 for Hispanic, and 14.3 for Asian/Pacific Islander. The highest rate by location was San Francisco County (172.2). In age groups < 5 years and 5 to 9 years, African-American children were 13.1 and 17.6 times more likely to be prescribed griseofulvin than Hispanic children. Since 1987, incidence rates for children 5 to 9 years of age were higher compared with children ages < 5 years.

CONCLUSIONS

Tinea capitis is epidemic among California children with higher rates in the northern counties studied. African-American children are the most affected by this epidemic; however, white children have also experienced increased rates.

Trichophyton tonsurans tinea capitis in the San Francisco Bay area: increased infection demonstrated in a 20-year survey of fungal infections from 1974 to 1994

Tinea capitis caused by Trichophyton tonsurans has been increasing in the United States for the past 25 years. A retrospective study of dermatophyte culture data at the University of California, San Francisco, and a parallel study of patient visits for tinea capitis at an affiliated hospital demonstrates a dramatic rise in Trichophyton tonsurans tinea capitis in the San Francisco Bay area.

Tinea capitis: new perspectives on an old disease

Tinea capitis caused by Trichophyton tonsurans is a common infection in children, and has become a significant public health problem in the United States. Epidemics of tinea capitis occur both in families and in institutions such as schools and day care centers. Infection is often difficult to eradicate. Fomites and asymptomatic carriers likely contribute to the spread of the disease and to re-infection of treated patients. The morphology of tinea capitis is diverse, from seborrhea-like scaling to tender, inflammed nodules on the scalp. Because a lengthy course of systemic griseofulvin is required to treat this infection, management of tinea capitis can be challenging. As newer antifungal agents are developed, more effective and convenient therapy for tinea capitis may become available.

Frequency of Trichophyton rubrum in tinea capitis

Trichophyton rubrum has led to unprecedented worldwide suppression of other dermatophytes which had been predominant earlier as a causative agent of superficial dermatomycoses. In tinea capitis on the other hand, several other species of Trichophyton or Microsporum are dominant depending on the region or continent. Tinea capitis caused by T. rubrum is a rare event worldwide. Occasional concentrations may be explained by several cases occurring by chance in one family or community. The relative frequency of this causative agent in tinea capitis in children is under 1%. In adults, however, where tinea capitis occurs very infrequently indeed, the incidence of T. rubrum appears to exceed 10%. Apart from two studies from India, one from Iran, two from Portugal and observations from Germany, which in the first country report of around 30% of all cases published, while the others document some 10% each, there are not only any conspicuous, unequivocal concentrations at all. Increased frequency of T. rubrum in this clinical picture has not been easily recognizable over the last decades due to low absolute case numbers.