Inflammatory Tinea capitis: a 12-year study and a review of the literature.

Inflammatory Tinea capitis (TC) is a rare form of TC. The aim of this study was to review epidemiological, clinical and mycological profile of inflammatory TC. We present a retrospective study (1999-2010), enrolled all the cases of inflammatory TC observed at a referral hospital in the northern Tunisia. One hundred and twenty-one patients with inflammatory TC, 83 male patients (68.6%) and 38 female patients (31.4%) were enrolled. The mean age was about 8 years. A majority of TC (71.9%) were in patients lesser than 10 years of age. Positive family history and contact with animals were noted in seven and 35 cases respectively. Direct examination was positive in 110 cases (59 ectothrix, 51 endothrix) and positive cultures were obtained in 105 patients (49 Trichophyton violaceum, 31 Microsporum canis, 13 Trichophyton interdigitale complex, 12 Trichophyton verrucosum). Systemic treatment was carried out in 115 patients with griseofulvin, in one with terbinafine. A complete recovery was noted in 88 cases; and persistent alopecia in 28 cases. The inflammatory TC is rare, but more common in rural families. The disease mostly affected male genders (68.6%) and T. violaceum remains the common pathogen of inflammatory TC in northern Tunisia.

Letter: Tinea capitis in infants in their first 2 years of life: A 12-year study and a review of the literature.

BACKGROUND: Tinea capitis (TC) is a dermatophyte infection that occurs mainly in childhood; but it is uncommon in infants. The aim of this study was to review the clinical and mycological profile of TC in infants. PATIENTS AND METHODS: We present a retrospective study; we enrolled all the cases of infant TC over a period of 12 years (1999-2010). RESULTS: Thirty-five infants (21 boys, 14 girls) with a mean age of 20.16 months were diagnosed with TC among a total number of 881 cases of TC (3.9%). Scalp scaling and alopecia were the most frequent clinical features. Microsporic tinea (21 cases) was the most frequent followed by Trichophytic tinea (9 cases) and inflammatory tinea (5 cases). Direct microscopy of hair was positive in 33 cases (94.2%). Culture positivity was found in 82.8 percent of infants (29 cases). Four species of dermatophytes were isolated; Microsporum canis in 18 cases (62%) followed by Trichophyton violaceum, Trichophyton mentagrophytes, and Trichophyton verrucosum. Twenty-nine infants were treated successfully with griseofulvin. DISCUSSION: TC is rare in infants. The diagnosis of TC should be considered if scaling and/or alopecia are present and should be confirmed by mycology testing prior to initiation of treatment.