Tiña Capitis en niños / Tinea capitis in children

La tiña capitis (TC) es una infección por dermatofitos con una alta prevalencia en la población pediátrica. Su epidemiología ha cambiado en las últimas décadas debido a la creciente migración poblacional alrededor del mundo. Se han identificado factores de riesgo ambientales y propios del huésped, relacionados al desarrollo de esta infección. Las manifestaciones clínicas son variables y dependen del agente causal. La dermatoscopia y la luz de Wood son herramientas útiles para la aproximación diagnóstica, sin embargo, la confirmación de la infección se basa en las pruebas micológicas. El aislamiento del agente causal permite orientar el tratamiento antifúngico adecuado, siendo estos eficaces y seguros en población pediátrica. El tratamiento se centra en la terapia antimicótica sistémica en combinación con medidas locales. El objetivo del manuscrito es hacer una revisión actualizada sobre el enfoque clínico y terapéutico de la TC en población pediátrica.

Tinea capitis (TC) is a dermatophyte infection with a high prevalence in the pediatric population. Its epidemiology has changed in recent decades due to increasing population migration worldwide. Environmental and host-specific risk factors have been identified which are with the development of this infection. The clinical manifestations are variable and depend on the causal agent. Dermatosco- py and Wood's lamp are useful tools for the diagnostic approach; however, the confirmation of in fection is based on mycological tests. The identification of the causal agent allows guiding the appro priate antifungal treatment, which is specific and safe in the pediatric population. Treatment focuses on systemic antifungal therapy combined with local measures. The objective of this paper is to carry out an updated review of the clinical and therapeutic approach to TC in the pediatric population.

Dr. Julio V. Uriburu. Su destacada participación en la micología nacional / Dr. Julio V. Uriburu. His outstanding participation in the national mycology

Destacado dermatólogo, el doctor Julio V. Uriburu propició el estudio de las afecciones micóticas en nuestro medio. Realizamos una breve actualización del diagnóstico y tratamiento de tiñas de cuero cabelludo.

Dr. Julio V. Uriburu was a very important specialist in skin disorders. He worked in the investigation of micotics infections of hair and scalp disorders. We did a review of diagnostic and treatment of tinea capitis.

Aspergillus niger – a possible new etiopathogenic agent in Tinea capitis? Presentation of two cases

Abstract Tinea capitis is generally considered as the most frequent fungal infection in childhood, as it accounts for approximately 92% of all mycosis in children. The epidemiology of this disease varies widely ranging from antropophillic, zoophilic, and geophillic dermatophytes, as the main causative agent in different geographic areas, depending on several additional factors. Nowadays, the etiology is considered to vary with age, as well with gender, and general health condition. The former reported extraordinary Tinea capitis case reports have been replaced by original articles and researches dealing with progressively changing patterns in etiology and clinical manifestation of the disease. This fact is indicative that under the umbrella of the well-known disease there are facts still hidden for future revelations. Herein, we present two rare cases of Tinea capitis in children, which totally differ from the recently established pattern, in their clinical presentation, as well as in the etiological aspect, as we discuss this potential new etiological pattern of the disease, focusing on our retrospective and clinical observation. Collected data suggest that pathogenic molds should be considered as a potential source of infection in some geographic regions, which require total rationalization of the former therapeutic conception, regarding the molds’ higher antimitotic resistance compared to dermatophytes. Molds-induced Tinea capitis should be also considered in clinically resistant and atypical cases, with further investigations of the antifungal susceptibility of the newest pathogens in the frame of the old disease. Further investigations are still needed to confirm or reject this proposal.

Micoses superficiais na infância / Superficial mycoses in childhood

Os autores descrevem as principais micoses superficiais na infância. Seus fatores predisponentes, agentes etiológicos, mecanismos de transmissão e o tratamento são discutidos.

Black dot tinea affecting the eyebrows in an adult female

Tinea capitis is the invasion of the hair by dermatophytic species. It is predominantly an infection of children, although adult cases have been reported particularly with Trichophyton tonsurans. We report an adult female patient with black dot variety of tinea capitis involving the eyebrows along with scalp, body and nails

[Safety and efficacy of terbinafine in a pediatric Iranian cohort of patients with Tinea capitis]

Tinea capitis is a common infection of the scalp and hair shaft caused by dermatophyte fungi that mainly affects prepubescent children. Systemic therapy is required for treatment and to prevent spread. The aim of present study was to assess the effect of terbinafme for tinea capitis treatment in children. 30 Iranian pediatric patients with a clinical diagnosis of tinea capitis, were enrolled in the study. The Study was conducted in a general and referral teaching hospital [Imam Medical Centre - Tehran, Iran] from 2006 to 2007. Eligible patients with less than 20 kg of body weight were given 62.5 mg terbinafme and for patients between 20 to 40 kg, the dose was 125 mg, on the first visit. After two weeks, all patients had a second visit that second sample for microscopic study was taken. For each patient, direct mycology test [KOH test] and mycological culture were carried out before the study is being started and after 2[nd], 4[th], 5[th], 6[th] and 8[th] weeks. Drug's probable adverse effects were also recorded. Based on the results of mycological culture of patients' lesions, Microsporum canis and Trichophyton sheonlini were considered as major causes of Tinea capitis in these children. Out of 30 stydy patients, KOH test of 93% in the fifth and 100% in the sixth week, was negative. All patients healed completely from signs of infection, after six weeks. Also, no severe side effects were seen in any patients. According to the results of this study, Terbinafme is an effective therapy in Iranian cases of Tinea capitis in children without having severe side effects

Balanites kernel oil for the treatment of dermatophytes: a clinical trial

In a previous in vitro study, we have shown that the kernel oil of fruits of the tree Balanites aegyptiaca referred to as Balanites kernel oil [BKO] is active against dermatophytes [i.e. superficial mycosis, ringworms, tineas [T. captitis, T. cercinata and T. pedis]. We report here our clinical trials with BKO. Trials were performed on patients presenting at Wad Medani Dermatology Teaching Hospital as well as primary school children in Elsoreeba Town [5 km south of Wad Medani]. Not all patients followed treatment till completely cured. Patients treated with BKO [half of the total] achieved complete cure in 3-5 weeks, on average, while those treated with the standard antifungal drug Miconazole [half of the total patients] did the same in the longer period of 3-8 weeks. Photographs showing progress of response to BKO treatments are included. BKO has great potential for development as a commercial drug for the treatment of dertmatophytes

Tinea Capilatis causada por Trichophyton rubrum en un adulto portador de artritis reumatoidea / Tinea capilatis caused by T. rubrum in adult patient with rheumatoid arthritis

Presentamos un caso de tinea capilatis causada por Trichophyton rubrum en una mujer de 47 años de edad con artritis reumatoidea. Creemos que esta enfermedad crónica la volvió susceptible a esta dermatofitosis poco común

Tinea capitis en la senectud / Tinea capitis in the elderly

Se presenta un caso de tinea del cuero cabelludo (tinea capitis) causada por Mycrosporum canis en un paciente de sexo masculino de 90 años de edad. Según nuestro conocimiento es el paciente de mayor edad en estas condiciones presentado hasta este momento. En la literatura se menciona otro caso de una enferma de 89 años con la misma patología

Tiña de la cabeza. Tratamiento actual en cinco pacientes / Tinea capitis. Current treatment in five patients

Se discuten las opciones terapéuticas en cinco pacientes con tiña de la cabeza. Se concluye que los antimicóticos de los que se dispone en el mercado: griseofulvina, itraconazol y terbinafina, son efectivos y presentan pocos efectos adversos. La griseofulvina sigue siendo utilizada por su eficacia y bajo costo

Querion de Celso: ¿un problema diagnóstico?: experiencia en 6 pacientes / Kerion Celsi: a diagnostic problem?: experience in 6 patients

We report 6 patients with Kerion Celsi due to trichophyton verrucosum. Five of the patients were hospiotalized with the diagnosis of Staphylococcal abscess. This confusion is due to that highly suppurative and inflammatory nature of the infection. Griseofulvin is the antimicrobial of choice for treatment, asociated with imidazolics and corticosteroids to prevent alopecia. The authors suggest that an adequate use of simple microbiological diagnosis tests in the diagnosis of pyodermitis in rural children, may prevent unnecessary hospitalizations and permanent hair loss

Tinha por Trichophyton violaceum no Rio Grande do Sul / Tinea capitis by Trichophyton violaceum in Rio Grande do Sul

Relata-se um caso de tinha do couro cabeludo por Trichophyton violaceum em crianca residente em Santiago. E revisada a literatura sul-riograndense sobre a infeccao

Mycological and therapeutic studies on tinea capitis

A total of 321 cases of tinea capitis representing scaly [60%], favus [29%], kerion [10%] and black dot [1.4%] clinical types were studied. The microscopic and cultural examinations were positive in 63% and 84.5%, respectively. 267 strains of dermatophytes representing Trichophyton violacium [106 strains], Trichophyton schoenleinii [77], Trichophyton mentagrophytes [5], Microsporum canis [68] and Microsporum audounii [11] were recovered. The hair brush and soil- bait techniques seem to be much better in the isolation of T. Schoenleinii and M. audounii. M. canis was isolated by direct method more frequently than the other methods, M. Audounii was only isolated by using the hair brush and soil-bait procedures. The growth of all tested strains was inhibited at different concentrations of dehydroemetine. T. mentagrophytes and T. schoenleinii were more sensitive, while M. canis was least sensitive. DHE was prepared in 0.8% concentration to form an ointment which was used for treatment of 15 selected patients. After three-six weeks, all lesions were cured completely. Clearance of infection was detected mycologically and histopathologically

Inmunodeficiencia primaria y microsporia cutánea extensa / Primary immunodeficiency and extensive microsporia cutaneous

Se presenta una paciente de 21 años de edad con inmunodeficiencia primaria que había padecido en la infancia una candidiasis mucocutánea crónica y que, a partir de los 11 años, sufrió una infección de cuero cabelludo por M. canis. En el momento de ser examinada presentaba una microsporia extensa que abarcaba cuero cabelludo, cabeza, cuello, extremidades superiores y tronco hasta la cintura. Estas lesiones inusualmente extensas exhibían zonas hiperqueratósicas de aspecto vegetante. Al mismo tiempo se comprobó candidiasis bucofaríngea y vaginal. Se instituyó inicialmente un tratamiento combinado de griseofulvina y fluconazol que debió ser interrumpido por intolerancia gástrica y escasa mejoría clínica. en segunda instancia fue medicada con itraconazol a razón de 300 mg/día durante 4 meses y luego series de este mismo antifúngido de 100 y 200 mg diarios con excelente resultado terapéutico y buena tolerancia