Tinea Capitis among Children and Adolescents in the Farwaniya Region of Kuwait

Abstract

Analysis of 325 patients (182 males, 143 females) of mycologically proven tinea capitis (TC) seen over a period of two years from January 2001--December 2002 in the Farwaniya region of Kuwait is presented in this study. The age range was 8 months to 17 years. Peak incidence was observed in the 3-14 year age group (79.6%). Positive family history and contact with pets were noted in 22% and 36.7% of the cases, respectively. The non-inflammatory 'gray patch' variety was the most common clinical type, seen in 163 (50.2%) children, followed by the black-dot variant in 100 (30.2%) patients. A significant proportion of the cases (16.6%) had the uncommonly reported seborrheic dermatitis or dandruff like pattern. Highly inflammatory kerion was encountered infrequently (2.5%). Seven species of dermatophytes were isolated; Trichophyton violaceum in 135 (41.5%), followed by Microsporum canis in 89 (27.4%), Microsporum audouinii in 48 (14.8%), Trichophyton mentagrophytes var. mentagrophytes in 31 (9.5%), Trichophyton verrucosum in 15 (4.6%), Trichophyton tonsurans in 6 (1.9%) and Microsporum gypseum in 1 (0.3%) patient. T. violaceum was the most common fungus responsible for the black-dot variety (89/100) and kerion (4/8) patients. Three cases of kerion (33.3%) grew T. verrucosum. M. canis was the most common species isolated from the 'gray patch' cases (79/163; 48.5%) followed by almost equal prevalences of T. violaceum (16.6%), M. audouinii (15.3%), and T. mentagrophytes var. mentagrophytes (12.3%). Among the seborrheic type of cases, M. audouinii was the most common fungus isolated in 20/54 (37%) followed by T. violaceum in 15 (27.8%), T. mentagrophytes var. mentagrophytes in 9 (16.7%), M. canis in 8 (14.8%) and T. verrucosum and T. tonsurans in one (0.3%) patient each. The results are significantly different from those in earlier studies in Kuwait.

A 30‐year survey of paediatric tinea capitis in southern Spain

“…Case of TC were more usual in children younger than 10 years of age, as also found in the vast majority of other studies, with TC being the most common cutaneous fungal infection in children aged 3–7 years, 6,12,13,20–22 but rare in adults 2,13 . The incidence of TC in children younger than 1 year of age old is low, with fewer than 100 cases reported, 2,4,7,11,22,24 20 of these in Spain 4,12,18 . In the present study, we found five cases in children younger than 1 year of age, which thus represents the third largest series of these particular cases in Spain, after the 10 cases reported by Gilaberte et al.…”

Prevalence of tinea capitis in southern Kuwait

“…We noticed a very high percentage of the clinical type of grey patches (Table 1), which was almost double the remaining clinical types. A similar result was noticed by others in Kuwait 17 . The other clinical types, scaly and black, had very low incidence compared with that observed in another study 16 .…”

“…Tinea capitis was most commonly caused by M. canis (62.5%) followed by T. violaceum (19.3%). These figures are in contrast to previously reported from Farawania area Kuwait, where 27% and 41% were reported for T. canis and T. violaceum respectively 17 . Infection with M. canis ranged from 34% to 69% in different studies from other parts of the world 14–16,18,19 …”

comment: A study on tinea capitis in the pre school and school going children

“…The latter also found that the grey patch form was the dominant clinical manifestation contrary to Puri N and Puri A. In Kuwait, the non-inflammatory "grey patch" variety has also been reported to be the most common clinical type, followed by black-dot variant and that T. violaceum was the most common fungus responsible for the black-dot variety (Nawaf et al 2003). It is noteworthy to mention that not only Trichophyton might be more prevalent than Microsporum and this may vary from regions to regions.…”