Continuous increase ofTrichophyton tonsuransas a cause of tinea capitis in the urban area of Paris, France: a 5-year-long study

Abstract

Tinea capitis (TC) is a highly contagious fungal infection of the scalp due to dermatophytes in children. To obtain information on the epidemiology of TC in the urban area of Paris, we analysed the microbiological results of 3090 patients seen with suspected TC from October 2010 to September 2015 at Saint Louis hospital, Paris, France. A peak of TC was observed in 3-6 year-old children, followed by a progressive decrease until 16 years of age. Of the 1311 positive cultures, 95% (1246) yielded one of the three anthropophilic species [Trichophyton tonsurans (33.5%), Trichophyton soudanense (38.3%), or Microsporum audouinii (28.2%)]. When considering one TC case per family, we observed a significant increase of T. tonsurans (P = .018) during these 5 years. The increase was more pronounced (P = .0047) in patients of West-African descent (n = 666), and was at the expense of M. audouinii and T. soudanense. On the other hand, the Caribbean patients (n = 85) remained predominantly (72.9%) infected by T. tonsurans. Our results show a better virulence of T. tonsurans over other species as already reported. Since T. tonsurans has not been reported in Africa, the infection of patients of West-African descent probably took place in the Paris area by exchanges with Caribbean patients. This increase of TC due to T. tonsurans was observed in the context of griseofulvin being the only licensed paediatric treatment for TC in France, which should deserve reappraisal because terbinafine may be more efficacious.

Epidemiological and molecular characterization of a Trichophyton tonsurans epidemic in schools of a city in the northern suburbs of Paris, France

“…Regarding the epidemiological characteristics of individuals presenting dermatophytosis, most of them originated from or had parents coming from sub-Saharan Africa (55 cases, mainly from Mali with 36 cases) followed by Haiti (nine cases) and North Africa (nine cases). This result is in accordance with reports by Alshawa et al [2] and Gits-Muselli et al [3]…”

Emergence of African species of dermatophytes in tinea capitis: A 17‐year experience in a Montreal pediatric hospital

“…In recent decades, an increase in TC due to African species of dermatophytes has been reported from cosmopolitan centers in Europe and the Middle East (Table ) . In the Montreal area over the past 17 years, although the overall number of TC cases did not change significantly (mean 344 per year), there was a sixfold increase in African species of dermatophyte infections in children mainly due to anthropophilic M. audouinii and T. soudanense (from 6/82 [7%] in 2000 to 37/95 [39%] in 2016).…”

Clinico-mycological profile of tinea capitis and its comparative response to griseofulvin versus terbinafine

“…Tinea capitis (TC) or scalp dermatophytosis is a highly contagious infection with worldwide distribution. This disease is the most common superficial mycosis in children [1, 2] and is still regarded as a major public health concern. The most important consequence of this infection is permanent hair loss, especially in untreated cases, as a result of a delay in treatment, inappropriate treatment, and inflammatory TC [3, 4].…”