Tinea capitis

Abstract

Tinea capitis is a common dermatophyte infection of the scalp in children. Dermatophytes are classified into three genera; tinea capitis is caused predominantly by Trichophyton or Microsporum species. On the basis of host preference and natural habitat, dermatophytes are also classified as anthropophilic, geophilic and zoophilic. The etiological agents of tinea capitis usually fall in the first and last categories. In North America, tinea capitis is now predominantly due to Trichophyton tonsurans. During the past 100 years the most common North American organism for tinea capitis was initially Microsporum canis followed later by M. audouinii. In other parts of the world the epidemiology varies. Tinea capitis is generally observed in children over the age of 6 years and before puberty, with African Americans being the most affected group. Clinical presentations are seborrheic-like scale, 'black dot' pattern, inflammatory tinea capitis with kerion and tiny pustules in the scalp. The clinical diagnosis should be confirmed by mycological examination. Wood's light examination was of value in diagnosing tinea capitis due to M. canis and M. audouinii; however, it is not helpful in T. tonsurans tinea capitis. Asymptomatic carriers may be a significant reservoir of infection and spread of spores may also involve inanimate objects. Carriers may benefit from shampooing their hair. Treatment of tinea capitis requires an oral antifungal agent. The data from the use of terbinafine, itraconazole and fluconazole are promising and suggest that these agents have an efficacy similar to griseofulvin while shortening the duration of therapy. Both griseofulvin and the newer antimycotics have a favorable adverse-effect profile and are associated with high compliance.

Treatment of Tinea Capitis

“…The causative dermatophytes belong to two genera: Trichophyton and Microsporum [1]. In the earlier half of the 20th century, Microsporum audouinii was the predominant cause of tinea capitis in the US [4]. Currently, Trichophyton tonsurans is responsible for up to 95% of cases in the US [5].…”

Disparate SAR Data of Griseofulvin Analogues for the Dermatophytes Trichophyton mentagrophytes, T. rubrum, and MDA-MB-231 Cancer Cells

“…2,3 The compound was, until the approval of Terbinafine 4 by the US Food and Drug Administration 5 in 2007, the only drug available for treatment of tinea capitis, 6 a superficial fungal skin infection caused by dermatophytes, which predominantly affects children. 7 Upon administration to man, griseofulvin accumulates in the skin (stratum corneum), where it presumably binds to keratin.…”

“…Looking at the IC 50 values for the 16 analogues (1, 17, 18, 20, 23−25, 27, 36, 37, 45−49, and 54) tested active in both the multipolarity assay 19 and the cytotoxicitybased assay there was good correlation between the data with an R 2 of 0.70 (see Supporting Information). The IC 50 of griseofulvin (1) was determined to be 18 ± 4 μM (20 ± 1 μM in the phenotype-based spindle multipolarity assay 22 ), while an IC 50 of 25 ± 4 μM against HeLa cells was found by Panda et al 18 In the position 4 series, 4, 5, and 7 were all inactive but 6 and 8 harboring aromatic moieties had activities similar to griseofulvin (1), with IC 50 values of 20 (6) and 17 μM (8). This indicates a mode of action for cytotoxicity that does not involve induction of multipolar mitosis, as 6 was inactive in the multipolarity assay.…”

Pityriasis amiantacea-like adult tinea capitis favosa due to Trichophyton schoenleinii

“…Favus is typically a childhood disease, yet adult cases are not uncommon (3). Favus could occur during childhood or adolescence and persists to adulthood in case of absence of treatment (3,4). In this case, the condition started after puberty at the age of 24 year.…”

“…It is the anthropophilic species, T. violaceum, zoophilic species, T. verrucosum, T. mentagrophytes and Microsporum canis and geophilic species, Microsporum gypseum (3). Favus could occur during childhood or adolescence and persists to adulthood in case of absence of treatment (3,4). Contrary to the other types of tinea, tinea favosa does not disappear until puberty but persists as long as there is hair.…”