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Alkeswani A, Cantrell W, Elewski B. Treatment of Tinea Capitis. Skin Appendage Disord 2019; 5:201-210. [PMCID: PMC6615323 DOI: 10.1159/000495909] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/29/2018] [Indexed: 11/26/2023] Open
Abstract
Tinea capitis is a common fungal infection of the hair of the scalp affecting predominately prepubertal children. In the US, griseofulvin has been considered a first-line therapy agent for tinea capitis since the 1960s. However, it has been falling out of favor due to significant treatment failure, high cost, and long duration of treatment. Other antifungal agents have been researched as an alternative to griseofulvin. This paper will review the relevant pharmacologic properties, dosing, cost, efficacy, and adverse events profile for griseofulvin, terbinafine, itraconazole, fluconazole, and some adjuvant therapy options such as selenium sulfide shampoos and topical ketoconazole.
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Affiliation(s)
- Amena Alkeswani
- University of Alabama Birmingham, School of Medicine, Birmingham, Alabama, USA
| | - Wendy Cantrell
- UAB Department of Dermatology, Dermatology at the Whitaker Clinic, Birmingham, Alabama, USA
| | - Boni Elewski
- University of Alabama Birmingham, Department of Dermatology, Birmingham, Alabama, USA
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Dhaille F, Dillies A, Dessirier F, Reygagne P, Diouf M, Baltazard T, Lombart F, Hébert V, Chopinaud M, Verneuil L, Becquart C, Delaporte E, Lok C, Chaby G. A single typical trichoscopic feature is predictive of tinea capitis: a prospective multicentre study. Br J Dermatol 2019; 181:1046-1051. [DOI: 10.1111/bjd.17866] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2019] [Indexed: 12/25/2022]
Affiliation(s)
- F. Dhaille
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - A.‐S. Dillies
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - F. Dessirier
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - P. Reygagne
- Centre Sabouraud Hôpital Saint Louis ParisFrance
| | - M. Diouf
- Biostatistics Department Clinical Research and Innovation Directorate Amiens University Medical Center AmiensFrance
| | - T. Baltazard
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - F. Lombart
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - V. Hébert
- Department of Dermatology Rouen University Medical Center RouenFrance
| | - M. Chopinaud
- Department of Dermatology Caen University Medical Center CaenFrance
| | - L. Verneuil
- Department of Dermatology Caen University Medical Center CaenFrance
| | - C. Becquart
- Department of Dermatology Lille University Medical Center Lille France
| | - E. Delaporte
- Department of Dermatology Lille University Medical Center Lille France
| | - C. Lok
- Department of Dermatology Amiens University Medical Center AmiensFrance
| | - G. Chaby
- Department of Dermatology Amiens University Medical Center AmiensFrance
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da Cunha MM, Capote-Bonato F, Capoci IRG, Bonato DV, Ghizzi LG, Paiva-Lima P, Baeza LC, Svidzinski TIE. Epidemiological investigation and molecular typing of dermatophytosis caused by Microsporum canis in dogs and cats. Prev Vet Med 2019; 167:39-45. [PMID: 31027719 DOI: 10.1016/j.prevetmed.2019.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 03/04/2019] [Accepted: 03/25/2019] [Indexed: 12/27/2022]
Abstract
The objective of the present study was investigate the prevalence of dermatophytes in dogs, cats and environment floor through molecular epidemiology tools to identify the genetic profile of these infectious agents. This was an observational study with cross-sectional surveys design. Sample were collected from the hair and skin of 52 dogs and cats with the clinical suspicion of dermatophytosis, over a period of one year in Maringá, in the state of Paraná, Brazil. Household samples (carpets and floor), were collected from animals that were positive for dermatophytosis by morphological colonies characteristics, and samples of dogs or cats living in the same household as with the positive animals were also collected. After mycological confirmation, molecular typing was performed by random amplified polymorphic DNA (RAPD). Microsporum canis was the unic dermatophyto isolated whose prevalence was 26.9% (14/52) in animals with the clinical suspicion of dermatophytosis and four other animals that lived with positive animals. As some animals had more than one lesion site, there were 22 total positive cultures from samples from animals and another ten from abiotic sources. The majority of the animals that provided positive cultures for M. canis were aged up to five months (77.8%) and were female (66.7%). Molecular typing using the P1 primer revealed genetically distinct profiles in the symptomatic, asymptomatic and environmental animal samples, or the same animal, furthermore, showed that M. canis could have microevolution.
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Affiliation(s)
- Michele Milano da Cunha
- Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, PR, 87020-900, Brazil.
| | - Francieli Capote-Bonato
- Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, PR, 87020-900, Brazil.
| | - Isis Regina Grenier Capoci
- Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, PR, 87020-900, Brazil.
| | - Denis Vinicius Bonato
- Department of Animal Science, State University of Londrina, Londrina, PR, 86057-970, Brazil.
| | - Lucas Ghedin Ghizzi
- Department of Animal Nutrition and Production, University of São Paulo, Pirassununga, SP, 13635-900, Brazil.
| | - Patrícia Paiva-Lima
- Departament of Veterinary Medicine, Teaching Union of Southwest Paraná, Dois Vizinhos, PR, 85605-040, Brazil.
| | - Lilian Cristiane Baeza
- Center for Medical and Pharmaceutical Sciences, State University of Western Paraná, Cascavel, PR, 85819-110, Brazil.
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Tinea Capitis: Current Review of the Literature. CURRENT FUNGAL INFECTION REPORTS 2018. [DOI: 10.1007/s12281-018-0320-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Schechtman RC, Silva NDV, Quaresma MV, Bernardes Filho F, Buçard AM, Sodré CT. Dermatoscopic findings as a complementary tool in the differential diagnosis of the etiological agent of tinea capitis. An Bras Dermatol 2016; 90:13-5. [PMID: 26312662 PMCID: PMC4540496 DOI: 10.1590/abd1806-4841.20153787] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 09/09/2014] [Indexed: 11/22/2022] Open
Abstract
Tinea capitis is a scalp infection caused by fungi. In Brazil, the main causative agents are Microsporum canis and the Trichophyton tonsurans. Etiological diagnosis is based on suggestive clinical findings and confirmation depends on the fungus growth in culture. However, it is not always possible to perform this test due to lack of availability. We reveal the dermoscopic findings that enable distinction between the main causative agents of Tinea capitis, M. canis and T. tonsurans. The association of clinical and dermatoscopic findings in suspected Tinea capitis cases may help with the differential diagnosis of the etiological agent, making feasible the precocious, specific treatment.
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Affiliation(s)
- Regina Casz Schechtman
- Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Nanashara Diane Valgas Silva
- Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Maria Victória Quaresma
- Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Fred Bernardes Filho
- Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Alice Mota Buçard
- Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Celso Tavares Sodré
- Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, BR
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Bennassar A, Grimalt R. Management of tinea capitis in childhood. Clin Cosmet Investig Dermatol 2010; 3:89-98. [PMID: 21437064 PMCID: PMC3047946 DOI: 10.2147/ccid.s7992] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Indexed: 11/23/2022]
Abstract
Tinea capitis (TC) is a common dermatophyte infection affecting primarily prepubertal children. The causative pathogens belong to only two genera: Trichophyton and Microsporum. Although there is a great local variation in the epidemiology of TC worldwide, T. tonsurans is currently the most common cause of TC with M. canis second. Even though there is an emerging number of anthropophilic scalp infections, M. canis remains the predominant causative organism in many countries of the Mediterranean basin, the most important dermatophyte carriers being stray cats and dogs as well as pet puppies, kittens and rabbits. TC always requires systemic treatment because topical antifungal agents do not penetrate down to the deepest part of the hair follicle. Since the late 1950s, griseofulvin has been the gold standard for systemic therapy of TC. It is active against dermatophytes and has a long-term safety profile. The main disadvantage of griseofulvin is the long duration of treatment required which may lead to reduced compliance. The newer oral antifungal agents including terbinafine, itraconazole, ketokonazole, and fluconazole appear to have efficacy rates and potential adverse effects similar to those of griseofulvin in children with TC caused by Trichophyton species, while requiring a much shorter duration of treatment. They may, however, be more expensive.
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Affiliation(s)
- Antoni Bennassar
- Dept of Dermatology, Hospital Clinic, University of Barcelona, Barcelona, Spain
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Seebacher C, Abeck D, Brasch J, Cornely O, Daeschlein G, Effendy I, Ginter-Hanselmayer G, Haake N, Hamm G, Hipler C, Hof H, Korting HC, Kramer A, Mayser P, Ruhnke M, Schlacke KH, Tietz HJ. Tinea capitis: ringworm of the scalp. Mycoses 2007; 50:218-26. [PMID: 17472621 DOI: 10.1111/j.1439-0507.2006.01350.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The guideline tinea capitis, as passed by three German medical societies, is presented in the present study.
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Seebacher C, Abeck D, Brasch J, Cornely O, Daeschlein G, Effendy I, Ginter-Hanselmayer G, Haake N, Hamm G, Hipler UC, Hof H, Korting HC, Kramer A, Mayser P, Ruhnke M, Schlacke KH, Tietz HJ. Tinea Capitis. J Dtsch Dermatol Ges 2006; 4:1085-91. [PMID: 17176418 DOI: 10.1111/j.1610-0387.2006.06133.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Tinea capitis (ringworm of the head) is the most common dermatophytosis of childhood with an increasing incidence worldwide. If suspected clinically, further diagnostic procedures, including direct microscopy and culture, should be performed. Other scalp alterations, such as seborrheic dermatitis, atopic eczema, psoriasis, alopecia areata, folliculitis, and pseudopelade, may mimic ringworm of the head and must be identified. A proven fungal infection of scalp skin and hairs warrants immediate initiation of systemic treatment. At present, only oral griseofulvin is approved for therapy of scalp ringworm in children by health authorities. However, the advent of several newer antifungal agents such as itraconazole, fluconazole, and terbinafine has broadened the therapeutic armamentarium in recent years. These agents offer shorter treatment intervals, and their adverse effects and drug interaction profiles appear to be well within acceptable limits. In patients with tinea capitis, systemic therapy at weight-dependent dosages for an appropriate amount of time in conjunction with topical supportive measures will help to prevent disfiguring hair loss, permanent formation of scar tissue, spread of fungal organisms to other cutaneous regions, and infection of other persons.
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Affiliation(s)
- Matthias Möhrenschlager
- Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany.
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Abstract
Tinea capitis is an important fungal infection that may at times be a clinical, diagnostic and therapeutic challenge. It is common in childhood around the world, becoming almost epidemic in some communities. The central European and American experience with it is somewhat variable, due to different etiologic fungi. The use of topical antifungal agents and other approaches is stressed as of value alongside the use of systemic antifungal medication.
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Affiliation(s)
- O Ceburkovas
- Dermatology, Kaunas Medical University, UMD-New Jersey Medical School, Newark 07103-2714, USA
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