RESUMO
Tinea capitis is still common in Wuhan, and there exists significant difference in its pathogen spectrum between this area and other parts of China. In the present study, we aimed to clarify the epidemiological characteristics of tinea capitis and changes of pathogen spectrum in Wuhan and its surrounding areas from 2011 to 2022, and further to present potential risk factors focusing on some major etiological agents. Briefly, a retrospective single-center survey was performed on 778 patients with tinea capitis from 2011 to 2022 in Wuhan, China. The isolated pathogens were identified to species level by morphological examination or by ITS sequencing. The data were collected and statistically analyzed by Fisher's exact test and Bonferroni method. Among all enrolled patients, the most common pathogen was Trichophyton violaceum in both child (310, 46.34%) and adult tinea capitis (71, 65.14%). There existed significant difference in pathogen spectrum between child and adult tinea capitis. Furthermore, black-dot type represented the most common type of tinea capitis for both children (303, 45.29%) and adults (71, 65.14%). Notably, the number of cases caused by Microsporum canis consecutively exceeded that caused by Trichophyton violaceum in children from Jan, 2020 to Jun, 2022. Additionally, we suggested a series of potential factors that might increase the risks of acquiring tinea capitis by focusing on several major agents. Considering the different risk factors related to specific pathogen, it was meaningful to adjust the measures against the spreading of tinea capitis according to the changes of pathogen distribution within recent years.
RESUMO
@#Abstract: Objective To investigate the clinical types of children's tinea capitis and the distribution of fungal pathogens in Wuhan from 2011 to 2020, and to provide scientific basis for the prevention, diagnosis and treatment of children's tinea capitis. Methods Laboratory data of children with tinea capitis in outpatient and inpatient department of dermatology in Wuhan No.1 Hospital from January 2011 to December 2020 were collected. A total of 542 cases of pediatric tinea capitis were included, with 239 male cases and 303 female cases. Microscopic examination of fungi and culture identification were performed on the affected skin lesions of the children. Chi-square test was used to analyze the differences in pathogen spectrum of children with different age groups and clinical type. Results Among the pediatric tinea capitis patients, the age group with the highest prevalence was preschool children（3 to <7 years old), accounting for 48.52%（263/542). The top three pathogenic fungi were Trichophytes violaceum（49.26%, 267/542), Microsporum canis（31.55%, 171/542) and Trichophyton mentagrophytes （9.96%, 54/542). Trichophyton violaceum was the main pathogen in all ages, followed by Microsporum canis. The infection rate of Microsporum canis in children over 7 years old was lower than that in children under 7 years old, and the infection rate of Trichophyton rubrum in infants was higher than that in other ages. The distribution of Trichophytes violaceum, Trichophyton mentagrophytes, Nannizzia gypseum and Microsporum ferrugineum was uniform in all age groups. Trichophytes violaceum and Trichophyton tousurans mainly caused black-dot ringworm, Microsporum canis mainly caused tinea alba, Trichophyton mentagrophytes,Nannizzia gypseum and Trichophytonrubrum mainly caused kerion. Except for Microsporum ferrugineum, the composition ratios of other fungi species showed statistically significant differences among different clinical types of tinea capitis（P<0.05). Conclusions Preschool children are the most commonly affected age group by pediatric tinea capitis, and black-dot ringworm caused by Trichophytes violaceum is the main clinical type. Analysis of the high-riskage group, pathogenic fungi and clinical types of tinea capitis in children can enhance the understanding of its epidemiological characteristics, which is helpful for early diagnosis and targeted standardized treatment of pediatric tinea capitis.