Guidelines for the Management of Tinea Capitis in Children

Kakourou, Talia; Ukşal, Ümit

doi:10.1111/j.1525-1470.2010.01137.x

Cited by 125 publications

(116 citation statements)

References 14 publications

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“…The question arises, however, whether clinical management of dermatophyte infections requires species identification beyond genus-level identification. Depending on the extent of pathology, tinea infections are typically treated with either oral or topical antifungals, including griseofulvin, terbinafine, or select azoles (12). Little is mentioned in the literature regarding species-specific treatment guidelines, and while some resistance has been documented (primarily in T. rubrum against terbinafine), active alternatives remain available (22).…”

Section: Discussionmentioning

confidence: 99%

Dermatophyte Identification Using Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry

Theel¹,

Hall²,

Mandrekar

et al. 2011

J Clin Microbiol

108

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The performance of the Bruker Biotyper matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometer (MS) for the identification of dermatophytes from clinical cultures was compared to that of dermatophyte identification using 28S rRNA gene sequencing. The MALDI Biotyper library (MBL; version 3.0) was used alone and in combination with a supplemented library containing an additional 20 dermatophyte spectra (S-MBL). Acquired spectra were interpreted using both the manufacturer-recommended scores (genus, >1.7; species, >2.0) and adjusted cutoff values established by this study (genus, >1.5; species, >1.7); identifications required a minimum 10% difference in scores between the top two different organisms to be considered correct. One hundred well-characterized, archived dermatophyte isolates and 71 fresh dermatophyte cultures were evaluated using both libraries and both sets of cutoff criteria. Collectively, the S-MBL significantly outperformed the MBL at both the genus (93% versus 37.4%; P < 0,0001) and species (59.6% versus 20.5%; P < 0.0001) levels when using the adjusted score criteria. Importantly, application of the lowered cutoff values significantly improved genus (P ‫؍‬ 0.005)-and species (P < 0.0001)-level identification for the S-MBL, without leading to an increase in misidentifications. MALDI-TOF MS is a cost-effective and rapid alternative to traditional or molecular methods for dermatophyte identification, provided that the reference library is supplemented to sufficiently encompass clinically relevant, intraspecies strain diversity.Dermatophytes, comprising species within the genera Epidermophyton, Microsporum, and Trichophyton, exclusively invade and infect keratinized tissues (i.e., hair, skin, and nails). These organisms are among the most common fungal infections in humans, accounting for over 5 million physician visits annually in the United States (7, 26). Dermatophytes primarily cause superficial dermal mycoses and rarely progress to more invasive disease (8). In the United States, Trichophyton rubrum remains the most common cause of tinea infections and the most frequently isolated dermatophytic pathogen (7,24).Laboratory identification of dermatophytes is typically based on macroscopic observation of colony morphology (i.e., pigmentation, growth rate, texture, etc.) on selective media, followed by microscopic examination of conidia. In addition, specialized Trichophyton agars may be used for differentiation of species within the genera (14). These phenotypic techniques require experienced technologists and are often labor-intensive with a prolonged turnaround time. With the advancement of modern molecular techniques, some laboratories have turned to dermatophyte identification schemes involving sequencing of specific ribosomal DNA regions or real-time PCR amplification of discrete genes (2, 20). While these methods are highly accurate and rapid, they are costly and can be complex to implement.Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) m...

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Section: Discussionmentioning

confidence: 99%

Dermatophyte Identification Using Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry

Theel¹,

Hall²,

Mandrekar

et al. 2011

J Clin Microbiol

108

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“…Topical preparations containing selenium sulfide are frequently used to manage tinea versicolor, seborrheic dermatitis, and dandruff [41,42] . It is commonly incorporated into shampoo for treating dandruff.…”

Section: Discussionmentioning

confidence: 99%

In vitro and in vivo percutaneous absorption of seleno-L-methionine, an antioxidant agent, and other selenium species

Lin

Fang²,

Al‐Suwayeh

et al. 2011

Acta Pharmacol Sin

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Aim: To investigate the in vitro and in vivo percutaneous absorption of seleno-L-methionine (Se-L-M), an ultraviolet (UV)-protecting agent, from aqueous solutions. Methods: Aqueous solutions of Se-L-M were prepared in pH 4, 8, and 10.8 buffers. The pH 8 buffer contained 30% glycerol, propylene glycol (PG) and polyethylene glycol (PEG) 400. The in vitro skin permeation of Se-L-M via porcine skin and nude mouse skin was measured and compared using Franz diffusion cells. The in vivo skin tolerance study was performed, which examined transepidermal water loss (TEWL), skin pH and erythema. Results: In the excised porcine skin, the flux was 0.1, 11.4 and 8.2 μg· cm -2 ·h -1 for the pH 4, 8, and 10.8 buffers, respectively. A linear correlation between the flux and skin deposition was determined. According to permeation across skin with different treatments (stripping, delipidation, and ethanol treatments), it was determined that the intracellular route comprised the predominant pathway for Se-L-M permeation from pH 8 buffer. Aqueous solutions of seleno-DL-methionine (Se-DL-M), selenium sulfide and selenium-containing quantum dot nanoparticles were also used as donor systems. The DL form showed a lower flux (7.0 vs 11.4 μg· cm -2 ·h -1 ) and skin uptake (23.4 vs 47.3 μg/g) as compared to the L form, indicating stereoselective permeation of this compound. There was no or only negligible permeation of selenium sulfide and quantum dots into and across the skin. With in vivo topical application for 4 and 8 h, the skin deposition of Se-L-M was about 7 μg/g, and values were comparable to each other. The topical application of Se-L-M for up to 5 d did not caused apparent skin irritation. However, slight inflammation of the dermis was noted according to the histopathological examination. Conclusion: Se-L-M was readily absorbed by the skin in both the in vitro and in vivo experiments. The established profiles of Se-L-M skin absorption will be helpful in developing topical products of this compound.Keywords: seleno-L-methionine; selenium; percutaneous absorption; topical delivery; skin [5] . In humans, a low selenium status is associated with up to a 4-fold increased risk of developing skin cancer [6] . Topical selenium compounds also increase the minimum dose of UV radiation required to cause skin reddening and protect against skin damage caused by UVB [7,8] . Seleno-L-methionine (Se-L-M), the major component of dietary selenium, represents an organic form of selenium which may provide enhanced protection of the skin [9] . Se-L-M also decreases the oxidative stress of neurodegenerative diseases, rheumatoid arthritis, and HIV/AIDS [10,11] . Most ingested selenium, whether in organic or inorganic form, is converted by liver metabolism [3] . In addition, selenium toxicity can produce gastrointestinal problems [12] . Delivery of pharmacologically active compounds via the skin is an attractive alternative to oral dosing for numerous reasons including stable plasma concentrations, bypass of firstpass effects, and reduction of some si...

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“…These agents require shorter duration of treatment, but they are more expensive than griseofulvin. The treatment of TC should be stopped when new hair comes out or culturing becomes negative (17).…”

Section: Resultsmentioning

confidence: 99%

Retrospective evaluation of 104 tinea capitis cases

Külköylüoğlu

Akdemi̇r²,

Sari³

et al. 2013

Turk J Med Sci

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Aim: Tinea capitis is a superficial scalp dermatophyte infection. Tinea capitis is particularly seen during childhood and is not usually seen after puberty. In untreated cases, it can be contagious and can progress to cicatricial alopecia. This study aimed to retrospectively evaluate cases of tinea capitis. Materials and methods:We evaluated 104 tinea capitis patients presenting to our dermatology clinic between 2007 and 2011.Results: Of these patients, 38 (36.5%) were female and 66 (63.5%) were male. The median age was 6.41 ± 3.4 years (range: 1-18 years old). The clinical types appearing in descending order were tinea capitis profunda (88.5%), tinea capitis superficial (10.6%), and tinea capitis favosa (1.9%). The most frequently seen transmission route was human-to-human transmission in 23.5% of the patients, followed by animal-to-human transmission in 19.2% of the patients. Conclusion:Tinea capitis is a commonly seen dermatosis in our region. Patients with tinea capitis usually seek a physician when inflammatory lesions develop. Cases are usually misdiagnosed as eczema or psoriasis by primary care physicians, causing a delay in proper treatment. Tinea capitis can cause hair loss and scar formation, and so early diagnosis and treatment is very important. For the accurate diagnosis and treatment of tinea capitis, required health education programs should be implemented.

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Guidelines for the Management of Tinea Capitis in Children

Cited by 125 publications

References 14 publications

Dermatophyte Identification Using Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry

Dermatophyte Identification Using Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry

In vitro and in vivo percutaneous absorption of seleno-L-methionine, an antioxidant agent, and other selenium species

Retrospective evaluation of 104 tinea capitis cases

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