RESUMO
A 6-year-old Hispanic patient presented with a 1-month history of pruritic patches on her scalp, characterized by hair loss, black dots, and dandruff-like scales. The patient was seen by her primary care physician, who prescribed ketoconazole 2% shampoo. This provided little relief for her symptoms, which prompted her admission to nearby hospital, where fluconazole was administered intravenously and mometasone lotion applied. The patient was discharged and instructed to use the ketoconazole shampoo and mometasone lotion. The previously prescribed medications failed to improve her now enlarged, inflamed, scaly, pustule-speckled lesions. Given her condition, she was admitted to the University Pediatric Hospital in San Juan, where the Dermatology Department was consulted. Cultures were taken from the lesions, revealing the presence of Trichophyton tonsurans, which led to the diagnosis of tinea capitis (ringworm of the scalp) with kerion formation. In addition, multiple nits and adult lice characteristic of Pediculus humanus capitis were observed. A 6-week course of griseofulvin, a 1-week course of permethrin solution, and a 5-day course of oral prednisolone were started, effectively cleared the patient's inflammation and fungal infection. This case highlights how there exist areas of improvement in terms of interprofessional communication between physicians, as well a need to increase awareness of the proper treatment for this common pediatric skin condition. We postulate that in doing so, similar cases could be spared the unfortunate results of untreated tinea capitis, that is, kerion formation and the possible scarring this lesion can produce.
Assuntos
Antifúngicos , Tinha do Couro Cabeludo , Humanos , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/microbiologia , Feminino , Criança , Antifúngicos/administração & dosagem , Fatores de Tempo , Griseofulvina/administração & dosagem , Atraso no TratamentoAssuntos
Dermoscopia , Microsporum , Tinha do Couro Cabeludo , Tinha , Humanos , Microsporum/isolamento & purificação , Tinha do Couro Cabeludo/microbiologia , Tinha do Couro Cabeludo/diagnóstico , Masculino , Tinha/diagnóstico , Tinha/microbiologia , Tinha/patologia , Feminino , Raios Ultravioleta , Adulto , Fluorescência , Trichophyton/isolamento & purificação , Diagnóstico DiferencialAssuntos
Tinha do Couro Cabeludo , Trichophyton , Humanos , Masculino , Tinha do Couro Cabeludo/complicações , Tinha do Couro Cabeludo/diagnóstico , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/microbiologia , Trichophyton/isolamento & purificação , Lactente , Alopecia/microbiologia , Couro Cabeludo , Hiperpigmentação/microbiologia , Terbinafina/administração & dosagem , Terbinafina/uso terapêutico , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêuticoRESUMO
INTRODUCTION: Tinea capitis is a global public health concern with a unique therapeutic challenge and mostly affects children. The burden is double in developing countries. There is no study on school-going children from the urban residence in Ethiopia. OBJECTIVE: To determine the prevalence of Tinea capitis and its associated factors among school children in Gondar town northwest, Ethiopia 2021. METHODS: An institution-based cross-sectional study was conducted among school children in Gondar town from November 20 to December 20, 2021. Data was collected through an interviewer-administered structured questionnaire. A stratified simple random sampling technique was employed. Then data were entered into EPI Info version 7.22 and transferred to Statistical package for social science (SPSS) version 22 for further analysis. The binary logistic regression model was employed to identify factors associated with tinea capitis, and the strength of association and statistical significance was declared using the adjusted odds ratios with its corresponding 95% CI, and p-value ≤ 0.05 respectively. RESULT: The prevalence of tinea capitis among school children in Gondar town was found to be 29.4%. Public school student (AOR = 2.79 95% CI: 1.34-5.87), widowed mother (AOR = 6.09, 95% CI: 1.83-11.23), students in the age group of 5-8 years (AOR = 3.79 95% CI: 1.68-8.55), animal contact (AOR = 2.61 95% CI: 1.15-5.90), and family similar illness category (AOR = 8.49 95% CI: 3.73-11.39) have risen the likelihood of tinea capitis among school children. CONCLUSIONS: The prevalence of tinea capitis was higher. Young age, children from widowed marital status, illiterate mother, history of share blades, animal contact, a family similar illness, and lower number of living rooms are important factors contributing to tinea capitis among school children. Health education for the mother on the mode of transmission, prevention, and improve the low socioeconomic status of the parent is crucial. KEY TERMS: Children, Ethiopia, Gondar, School age, Tinea capitis.
Assuntos
Tinha do Couro Cabeludo , Humanos , Etiópia/epidemiologia , Tinha do Couro Cabeludo/epidemiologia , Estudos Transversais , Criança , Feminino , Masculino , Prevalência , Adolescente , Fatores de Risco , Modelos Logísticos , População UrbanaRESUMO
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.
Assuntos
Antifúngicos , Itraconazol , Microsporum , Tinha do Couro Cabeludo , Humanos , Pré-Escolar , Antifúngicos/uso terapêutico , Masculino , Feminino , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/epidemiologia , Tinha do Couro Cabeludo/microbiologia , Itraconazol/uso terapêutico , China/epidemiologia , Microsporum/isolamento & purificação , Criança , Lactente , Glucocorticoides/uso terapêutico , Resultado do Tratamento , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/epidemiologia , Dermatite Atópica/microbiologia , Fatores de Risco , Adolescente , Adulto , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
BACKGROUND: Microsporum audouinii has resurged recently. Infections with the dermatophyte are difficult to treat, which raises the question if we treat M. audouinii infections with the most effective antifungal (AF) agent. OBJECTIVES: The aims of this study was to investigate an outbreak of tinea capitis (TC) in Denmark, address the challenges in outbreak management and to conduct two reviews regarding previous outbreaks and minimal inhibitory concentration (MIC). METHODS: We used Wood's light, culture, direct microscopy, and PCR for screening and antifungal susceptibility testing (AFST) for treatment optimization. We performed two reviews to explore M. audouinii outbreaks and MIC values using broth microdilution method. RESULTS: Of 73 screened individuals, 10 had confirmed M. audouinii infections. Clinical resistance to griseofulvin was observed in 4 (66%) cases. While previous outbreaks showed high griseofulvin efficacy, our study favoured terbinafine, fluconazole and itraconazole in our hard-to-treat cases. AFST guided the choice of AF. Through the literature search, we identified five M. audouinii outbreaks, where differences in management included the use of Wood's light and prophylactic topical AF therapy. Terbinafine MIC values from the literature ranged from 0.002 to 0.125 mg/L. CONCLUSION: Use of Wood's light and preventive measurements were important for limiting infection. The literature lacked MIC data for griseofulvin against M. audouinii, but indicated sensitivity for terbinafine. The clinical efficacy for M. audouinii treatment was contradictory favouring both terbinafine and griseofulvin. AFST could have a key role in the treatment of difficult cases, but lack of standardisation of AFST and MIC breakpoints limits its usefulness.
Assuntos
Antifúngicos , Surtos de Doenças , Farmacorresistência Fúngica , Testes de Sensibilidade Microbiana , Microsporum , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Humanos , Microsporum/efeitos dos fármacos , Masculino , Feminino , Dinamarca/epidemiologia , Adulto , Criança , Terbinafina/farmacologia , Terbinafina/uso terapêutico , Pessoa de Meia-Idade , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/microbiologia , Tinha do Couro Cabeludo/epidemiologia , Griseofulvina/farmacologia , Griseofulvina/uso terapêutico , Pré-Escolar , Adolescente , Adulto Jovem , Tinha/tratamento farmacológico , Tinha/microbiologia , Tinha/epidemiologia , Itraconazol/farmacologia , Itraconazol/uso terapêutico , Idoso , Fluconazol/farmacologia , Fluconazol/uso terapêuticoRESUMO
INTRODUCTION: Tinea capitis, a common scalp infection primarily affecting children, is caused by keratinophilic dermatophytic fungi, notably Microsporum and Trichophyton species. Microsporum canis, primarily transmitted from cats and dogs to humans, is rarely reported in non-endemic regions like India. We report a cases involving three family members from Delhi, India, diagnosed with tinea capitis caused by Microsporum canis. The index case, a five-year-old boy, contracted the infection through contact with a cat, while his younger brother and sister acquired it through human-to-human transmission within the family. METHODS: Clinical examination, microscopic analysis, and molecular identification techniques confirmed the diagnosis. Antifungal susceptibility testing revealed sensitivity to itraconazole and terbinafine but resistance to griseofulvin. RESULTS: Treatment with oral terbinafine and topical ketoconazole cream led to successful outcomes for all three patients. Molecular typing confirmed clonality of the isolates, indicating human-to-human transmission. CONCLUSION: This case study underscores the significance of considering atypical sources of infection and human-to-human transmission in the diagnosis and management of tinea capitis caused by Microsporum canis in non-endemic regions. It emphasizes the necessity of thorough contact history assessment and appropriate antifungal therapy for effective control of the infection.
Assuntos
Antifúngicos , Microsporum , Terbinafina , Tinha do Couro Cabeludo , Humanos , Microsporum/genética , Microsporum/isolamento & purificação , Microsporum/classificação , Microsporum/efeitos dos fármacos , Tinha do Couro Cabeludo/microbiologia , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/diagnóstico , Masculino , Índia , Antifúngicos/uso terapêutico , Antifúngicos/farmacologia , Pré-Escolar , Terbinafina/uso terapêutico , Gatos , Feminino , Animais , Testes de Sensibilidade Microbiana , Itraconazol/uso terapêutico , Naftalenos/uso terapêutico , Naftalenos/farmacologia , Resultado do Tratamento , Cetoconazol/uso terapêutico , Tipagem Molecular , Família , Criança , Griseofulvina/uso terapêuticoRESUMO
Data on the epidemiology of tinea capitis (TC), an infection of the scalp by dermatophytes, are scarce in Cameroon. This study aimed to determine the prevalence of TC among school-children in the Dschang Subdivision, Western Cameroon. A cross-sectional study was carried out in June 2021 in Dschang including pupils aged 5-13. First, a standardized questionnaire was administered to participant for the collection of sociodemographic data. Then, samples were collected and cultured onto Sabouraud-Chloramphenicol-Gentamicin Agar. The etiological agents were identified based on their morphological features and with MALDI-TOF mass spectrometry. A total of 1070 children were clinically examined and 108 (10.1%) children presented with TC lesions. The mean age of the 1070 participants was 8.3 ± 2.6 years (range: 5-13 years); 772 (72.2%) were males. The use of borehole water (OR = 0.01, 95%CI[0.001-0.03]), spring water (OR = 0.2, 95%CI[0.08-0.50]), rainwater (OR = 0.004, 95%CI[0.001-0.016]), and hairdressing salons visits (OR = 0.413, 95%CI[0.196-0.872]) were associated with a decreased TC risk in the multivariate logistic regression analysis. In contrast, sharing bed with siblings (OR = 4.48, 95%CI[2.095-9.60]) was associated with an increased TC risk in children. Among the 32 dermatophytes isolated in culture, Microsporum audouinii was the most frequent (43.8%), followed by Trichophyton rubrum (25.0%) and T. soudanense (25.0%). Microsporum canis and T. violaceum were both rarely isolated. Further studies are warranted to assess the association of TC with domestic water usage that has been highlighted in this study.
Assuntos
Tinha do Couro Cabeludo , Tinha do Couro Cabeludo/epidemiologia , Tinha do Couro Cabeludo/microbiologia , Humanos , Camarões/epidemiologia , Criança , Masculino , Feminino , Adolescente , Estudos Transversais , Pré-Escolar , Prevalência , Inquéritos e Questionários , Microsporum/isolamento & purificação , Fatores de Risco , Arthrodermataceae/isolamento & purificação , Arthrodermataceae/classificação , Instituições Acadêmicas , Trichophyton/isolamento & purificaçãoAssuntos
Humanos , Feminino , Criança , Dermatoses do Couro Cabeludo , Tinha do Couro Cabeludo , Dermatite Seborreica , Líquen PlanoRESUMO
Tinea capitis is a dermatophytosis, which is more common in children. It is caused by dermatophytes that vary according to the region; the most frequently isolated dermatophyte in our setting is Microsporum canis. Given its anthropophilic nature, its dissemination via interpersonal transmission and through the use of hair care tools is very common. In the course of the past year, an increase has been reported in the incidence of a pathogen that was very rare in our setting: Trichophyton tonsurans. Here we describe a retrospective study of cases of tinea capitis caused by Trichophyton tonsurans identified between September 2021 and March 2023 in the Department of Pediatric Dermatology at a general hospital of the City of Buenos Aires.
La tinea capitis es una dermatofitosis, más frecuente en niños. Está causada por hongos dermatofitos que varían según la región; el más frecuentemente aislado en nuestro medio es el Microsporum canis. Dado su carácter antropofílico, la transmisión por vía interpersonal y mediante el uso de instrumentos de cuidado capilar es muy habitual. En el transcurso del último año, se ha reportado un incremento en la incidencia de un patógeno que era muy poco habitual en nuestro medio: el Trichophyton tonsurans. Presentamos un estudio retrospectivo de los casos de tinea capitis por Trichophyton tonsurans identificados en el período comprendido entre septiembre de 2021 y marzo de 2023 en la Sección de Dermatología Infantil de un hospital general de la Ciudad Autónoma de Buenos Aires.
Assuntos
Tinha do Couro Cabeludo , Tinha do Couro Cabeludo/microbiologia , Tinha do Couro Cabeludo/epidemiologia , Tinha do Couro Cabeludo/diagnóstico , Humanos , Argentina/epidemiologia , Estudos Retrospectivos , Criança , Masculino , Feminino , Pré-Escolar , Adolescente , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/microbiologia , Lactente , Arthrodermataceae/isolamento & purificaçãoRESUMO
Tinea capitis (TC) is still a frequent dermatophytosis in France, both autochthonous and imported. A nationwide retrospective survey was performed and a total of 4395 TC cases were recorded within 36 French mycology laboratories during a 6-year period. TC is a disease that occurs in childhood with 85% of the cases occurring before 10 years old and 94% before the age of 15. Anthropophilic origin was predominant with 779 cases of Trichophyton tonsurans (32.6%), 738 cases of Trichophyton soudanense/T. violaceum (31%), and 445 cases of Microsporum audouinii (19.2%). Of note, T. tonsurans represents more than 80% of the cases in the French West Indies (Martinique and Guadeloupe). By contrast, zoophilic species were less prevalent with mainly M. canis (10.3%) confirming the shift from zoophilic to anthropophilic species observed in many centers during the last decades. During this survey, diagnosis methods were also collected. Most labs had a classical process for the diagnosis: microscopic direct examination associated to cultures on Sabouraud and Sabouraud-cycloheximide media (incubated between 25 ± 5°C for at least 3 weeks) in all laboratories. Identification of the causal dermatophyte was performed by microscopic and macroscopic examination of the cultures in 100% of the labs, with various specific culture media available when fructification was insufficient (mainly malt or potato-dextrose agar, or Borelli medium). New techniques were also implemented with the introduction of MALDI-TOF mass spectrometry identification in more than two third of the labs, and molecular identification available if necessary in half of the labs.
A total of 4395 tinea capitis cases were recorded within 36 French mycology laboratories during a 6-year period. An anthropophilic origin was predominant with 33%, 31%, and 18.8% of cases due to Trichophyton tonsurans, T. soudanense/T. violaceum, and Microsporum audouinii, respectively.
Assuntos
Microsporum , Tinha do Couro Cabeludo , Humanos , Tinha do Couro Cabeludo/epidemiologia , Tinha do Couro Cabeludo/microbiologia , Tinha do Couro Cabeludo/tratamento farmacológico , Estudos Retrospectivos , França/epidemiologia , Criança , Microsporum/isolamento & purificação , Adolescente , Pré-Escolar , Masculino , Feminino , Arthrodermataceae/isolamento & purificação , Arthrodermataceae/classificação , Trichophyton/isolamento & purificação , Prevalência , Inquéritos e Questionários , Lactente , AdultoRESUMO
Tinea capitis is a common fungal infection caused by dermatophytes in children, but it is rare in infants. Although oral itraconazole has been widely used to treat tinea capitis, its use in infants is limited due to its low prevalence in this age group. A previous study reported the effectiveness of itraconazole continuous therapy in treating infantile tinea capitis caused by Microsporum canis. However, this approach has not been extended to tinea capitis caused by other fungi. In this study, we present four cases of infantile tinea capitis treated with continuous itraconazole oral solution therapy (5 mg/kg/day). Two patients were infected with M. canis, one patient with Nannizzia gypsea, and another with Trichophyton tonsurans. This study assesses the efficacy and safety of itraconazole oral solution continuous therapy, expanding our understanding by demonstrating its effectiveness for infantile tinea capitis caused by T. tonsurans and N. gypsea.
Assuntos
Antifúngicos , Itraconazol , Tinha do Couro Cabeludo , Humanos , Itraconazol/uso terapêutico , Itraconazol/administração & dosagem , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/microbiologia , Antifúngicos/uso terapêutico , Antifúngicos/administração & dosagem , Lactente , Masculino , Feminino , Administração Oral , Microsporum/efeitos dos fármacos , Resultado do TratamentoRESUMO
Kerion, a severe manifestation of tinea capitis caused by dermatophytes, is a fungal skin disease primarily affecting children. This report discusses six cases of pediatric kerion that were successfully treated with a combination of photodynamic therapy (PDT) and antifungal agents. Additionally, we conducted a literature review, identifying and analyzing six published reports on kerion and tinea capitis. The characteristics and efficacies of these cases are summarized. In summary, early combination therapy and proactive pre-treatment interventions proved effective in maximizing therapeutic outcomes, reducing disease duration and minimizing adverse reactions such as cicatricial alopecia. This approach has emerged as a favorable choice for the treatment of kerion.
Assuntos
Antifúngicos , Fotoquimioterapia , Fármacos Fotossensibilizantes , Tinha do Couro Cabeludo , Humanos , Fotoquimioterapia/métodos , Antifúngicos/uso terapêutico , Fármacos Fotossensibilizantes/uso terapêutico , Masculino , Feminino , Criança , Tinha do Couro Cabeludo/tratamento farmacológico , Pré-Escolar , Ácido Aminolevulínico/uso terapêutico , Terapia Combinada , AdolescenteRESUMO
This study aimed to evaluate the current management of tinea capitis in the United States, specifically focusing on patients aged 0-2 months, 2 months to 2 years, and 2 years to 18 years. An online survey, distributed through the Pediatric Dermatology Research Alliance and the Society of Pediatric Dermatology, revealed the following preferences: fluconazole for those under 2 months, griseofulvin for those aged 2 months to 2 years, and terbinafine for those aged 2 years and older. There exists inter-provider variation in tinea capitis treatment regimens within the pediatric dermatology community.
Assuntos
Antifúngicos , Tinha do Couro Cabeludo , Lactente , Criança , Humanos , Estados Unidos/epidemiologia , Antifúngicos/uso terapêutico , Itraconazol , Dermatologistas , Naftalenos , Tinha do Couro Cabeludo/diagnóstico , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/epidemiologia , Griseofulvina/uso terapêuticoRESUMO
In this study, we have formulated and analyzed the Tinea capitis infection Caputo fractional order model by implementing three time-dependent control measures. In the qualitative analysis part, we investigated the following: by using the well-known Picard-Lindelöf criteria we have proved the model solutions' existence and uniqueness, using the next generation matrix approach we calculated the model basic reproduction number, we computed the model equilibrium points and investigated their stabilities, using the three time-dependent control variables (prevention measure, non-inflammatory infection treatment measure, and inflammatory infection treatment measure) and from the formulated fractional order model we re-formulated the fractional order optimal control problem. The necessary optimality conditions for the Tinea capitis fractional order optimal control problem and the existence of optimal control strategies are derived and presented by using Pontryagin's Maximum Principle. Also, the study carried out the sensitivity and numerical analysis to investigate the most sensitive parameters and to verify the qualitative analysis results. Finally, we performed the cost-effective analysis to investigate the most cost-effective measures from the possible proposed control measures, and from the findings we can suggest that implementing prevention measures only is the most cost-effective control measure that stakeholders should consider.