Adult tinea capitis in China: A retrospective analysis from 2000 to 2019

Abstract

Summary Background Tinea capitis (TC) is an infection of the scalp hair due to dermatophytes. Most commonly seen in prepubescent children, but data of adults tinea capitis (ATC) in China mainland are limited. Objectives We aimed to evaluate epidemiological, clinical and mycological characteristics of ATC in China from 2000 to 2019. Methods We retrospectively analysed all ATC reported cases in China mainland, confirmed by mycological examination, by searching PubMed, Wanfang, Weipu and CNKI database. Results In sum, 40 papers involving 269 clinical cases were included. The average morbidity of ATC was calculated as 9.04% after standardisation. The sex ratio is 1:5.2 (31 male, 163 female); 76 people between 18 and 44 age level and 137 people between 45 and 89 age level were diagnosed as ATC. Culture or ITS sequencing identified Trichophyton violaceum in 70 cases (35.2%), Microsporum canis in 42 cases (21.1%), Trichophyton mentagrophyte in 32 cases (16.1%), Trichophyton rubrum in 23 cases (11.5%), Microsporum gypseum in 18 cases (9.0%), Trichophyton tonsurans in 6 cases (3.0%), Trichophyton schoenleini in 4 cases (2.0%), Epidermophyton floccosum in 2 cases (1.0%), Trichophyton verrucosum and Microsporum ferrugineum in one case (0.5%). ATC was easily to be diagnosed as furfur, seborrhoeic dermatitis (13%) or pustular and dermatocellulitis (11.15%).Six immunocompromised persons were recorded (2.2%). Conclusions ATC mainly involves postmenopausal women. Trichophyton violaceum, M canis, T mentagrophyte remain the most common aetiological agent of ATC in China. Trichophyton rubrum own the much higher frequency in ATC than in children. For diversified clinical manifestations, recognising ATC profiles will help clinicians avoid misdiagnosis.

Clinical and epidemiological characteristics of tinea capitis in northern Taiwan during 2014‐2019: An unusual bimodal distribution of patients and comparison of paediatric and adult cases

“…The annual incidence of adult TC also varies among countries, and the incidence may be the highest in Taiwan in accordance with our understanding. Liang et al collected 269 cases in 20 years (13.5 cases per year), 29 Park et al 3 collected 82 adult cases during an 18‐year period (4.5 cases per year) and Diop et al 2 collected 121 in 6 years (20.2 cases per year), while we collected 104 adult TC in merely 4.5 years (23.1 cases per year). One possible explanation is that adult TC has been underestimated in other countries.…”

“…The pathogen prevalence of adult TC depends on the regional‐specific epidemiology in different geographic areas. For example, Diop et al 2 revealed that the predominant pathogens in adult TC were anthropophilic T. soudanense (65.0%) and anthropophilic M. audouinii (21.0%) in Senegal, while M. canis , T. violaceum and T. rubrum were the main pathogens of TC in China, South Korea and Taiwan 3,16,29 . T. soudanense and M. audouinii have been reported infrequently in Asia because these pathogens are not endemic, but they have been reported to cause TC in South and West Asian countries such as Pakistan, Nepal and Kuwait 18,30,31 …”

Tinea capitis in children: A single‐institution retrospective review from 2011 to 2019

“…The distribution of pathogens varies geographically worldwide 14 . Liu et al 15 results showed that M .…”

Tinea Capitis by Microsporum canis in an Elderly Female with Extensive Dermatophyte Infection

“…In mainland China, adults took up 6.0–13.6% of the tinea capitis population in the 1980s–1990s [ 12 ]. This number remained to be 9.0% in the 21th century [ 13 ]. In contrast, up to 63% of tinea capitis patients were reported to be adults in a single centre of Taiwan, China [ 14 ].…”

“…These indicate that adult tinea capitis is becoming less uncommon in some regions, especially in postmenstrual elder women, due to their reduced secretion of fungistatic sebum after menopause. In adult patients, the female-to-male ratio was reported to be 2.2–5.4:1 [ 4 – 6 , 11 , 13 , 15 ] and 26.7–93.5% of the female adults were postmenopausal [ 10 , 11 ]. Apart from severe immunosuppressive diseases such as HIV infection and post-transplantation, systemic chronic disease including HCV infection (34.4%) and diabetes mellitus (22.4%) has been reported to associate with tinea capitis [ 6 ].…”