Tinea capitis

Tinea capillitii.

Fungal infection of the terminal hairy head.

• Pathogen
  • Microsporum canis (> 50%)
  • Trichophyton mentagrophytes (< 25%)
  • T. verrucosum (< 20%)
  • T. rubrum (ca. 10%)
  • Rarely: T. violaceum, tonsurans, soudanese, T. schoenleinii, M. audouinii

• Depending on whether the fungus is located in the hair shaft or outside, one speaks of an ecto- or  endotrix infection.

• Depending on the depth of infiltration, a distinction can be made between tinea capitis superficialis and tinea capitis profunda.

• Detection of pathogens by means of scale extraction, biopsy or hair epilation.
• Native potassium hydroxide preparation: The material obtained is placed on a slide and dissolved by means of 20% potassium hydroxide solution. In case of fungal infection, fungal filaments can be seen microscopically.

• Periodic acid-Schiff stain (PAS): In the context of a dermatopathological examination, the existence of fungal filaments and spores (red) can be detected by means of PAS staining.

• Fluorescence microscopy: Fluorescent dyes can be used to optically visualise the cell walls of fungi.

• Wood light lamp: Shows fluorescence in, for example,  favus, microsporiasis, tinea inguinalis.

• Culture (Gold standard): Cultural cultivation of fungi. Duration: Up to 4 weeks for dermatophytes, up to 2 weeks for moulds, approx. 3-4 days for yeasts.

• Microculture: This allows further differentiation between the various fungal species.

• Molecular diagnostics: Rapid amplification is achieved by PCR. The method is very sensitive.

1. Altindis, M., et al., Prevalence of tinea capitis in primary schools in Turkey. Die Haufigkeit von Tinea capitis in Grundschulen der Turkei. Mycoses, 2003. 46(5-6): p. 218-221.
2. Devliotou-Panagliotidou, D., et al., Tinea capitis in adults during 1981-95 in Northern Greece. Mycoses, 2001. 44(9-10): p. 398-400.
3. Elewski, B., TINEA CAPITIS. Dermatologic Clinics, 1996. 14(1): p. 23-31.
4. Elewski, B.E., Tinea capitis: A current perspective. Journal of the American Academy of Dermatology, 2000. 42(1): p. 1-20.
5. Elewski, B.E., et al., Terbinafine hydrochloride oral granules versus oral griseofulvin suspension in children with tinea capitis: Results of two randomized, investigator-blinded, multicenter, international, controlled trials∗. Journal of the American Academy of Dermatology, 2008. 59(1): p. 41-54.
6. Fuller, L.C., et al., British Association of Dermatologists' guidelines for the management of tinea capitis 2014. Br J Dermatol, 2014. 171(3): p. 454-463.
7. Ginarte, et al., Case Reports. Pityriasis amiantacea as manifestation of tinea capitis due to Microsporum canis. Mycoses, 2000. 43(1-2): p. 93-96.
8. Ginter-Hanselmayer, G. and C. Seebacher, Die Behandlung der Tinea capitis - eine kritische Bestandsaufnahme. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 2011. 9(2): p. 109-115.
9. Hamm, et al., Short duration treatment with terbinafine for tinea capitis caused byTrichophytonorMicrosporumspecies. British Journal of Dermatology, 1999. 140(3): p. 480-482.
10. Hay, R.J., et al., Tinea capitis in Europe: new perspective on an old problem. Journal of the European Academy of Dermatology and Venereology, 2001. 15(3): p. 229-233.
11. Hughes, R., et al., Corkscrew Hair: A New Dermoscopic Sign for Diagnosis of Tinea Capitis in Black Children. Arch Dermatol, 2011. 147(3): p. 355.
12. Kieliger, S., et al., Tinea capitis and tinea faciei in the Zurich area - an 8-year survey of trends in the epidemiology and treatment patterns. Journal of the European Academy of Dermatology and Venereology, 2014. 29(8): p. 1524-1529.
13. Kolivras, A., et al., Tinea capitis in Brussels: Epidemiology and New Management Strategy. Dermatology, 2003. 206(4): p. 384-387.
14. Metin, A., et al., Tinea capitis in Van, Turkey - Tinea capitis in Van, Turkei. Mycoses, 2002. 45(11-12): p. 492-495.
15. Möhrenschlager, M., et al., Tinea capitis. Der Hautarzt, 2002. 53(12): p. 788-794.
16. Möhrenschlager, M., et al., Tinea capitis of childhood: Incidence and pathogenetic role of Trichophyton tonsurans in Central Europe. Journal of the American Academy of Dermatology, 2001. 45(2): p. 320.
17. Patel, G.A. and R.A. Schwartz, Tinea capitis: still an unsolved problem? Mycoses, 2011. 54(3): p. 183-188.
18. Ravenscroft, J., M.J.D. Goodfield, and E.G.V. Evans, Trichophyton tonsurans Tinea Capitis and Tinea Corporis: Treatment and Follow-Up of Four Affected Family Members. Pediatric Dermatology, 2000. 17(5): p. 407-409.
19. Romano, C., et al., Case Reports. Tinea capitis due to Trichophyton soudanense and Trichophyton schoenleinii - Fallberichte. Tinea capitis mit Trichophyton soudanense und Trichophyton schoenleinii als Erregern. Mycoses, 2002. 45(11-12): p. 518-521.
20. Romano, C., et al., An unusual case of tinea capitis due to Trichophyton soudanense. Fallbericht. Ein ungewohnlicher Fall von Tinea capitis verursacht durch Trichophyton soudanense. Mycoses, 2003. 46(1-2): p. 64-66.
21. Seebacher, C., et al., Tinea Capitis. JDDG, 2006. 4(12): p. 1085-1091.
22. Tietz, H.J., Tinea capitis. Monatsschr Kinderheilkd, 2005. 153(4): p. 342-345.
23. Lebwohl, Mark. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. Elsevier, 2014. Print.