Childhood tinea capitis: a retrospective study in 5 years

Abstract

Introduction:  Tinea capitis is a common fungal infection in childhood especially in prepubertal children. There is a great variation in worldwide epidemiology, clinical manifestations and treatment of tinea capitis. We performed a retrospective study in 5 years at Thammasat hospital, analyzing the clinical manifestations, causative pathogens, and treatment in patients with tinea capitis.

Method: This is a retrospective chart review performed in the outpatient department of pediatric dermatology at Thammasat hospital from January 2012 to December 2016. The diagnosis is confirmed by clinical presentations, direct examination in 10% potassium hydroxide (KOH) and/or fungal culture.

Result: There were 40 cases of tinea capitis at Thammasat hospital. The mean age was 6.6±2.5 years with male to female ratio of 2:1. Two forms of clinical presentations were inflammatory type 10 cases (25%) and non-inflammatory type 30 cases (75%). Fungal culture was done in 35 cases. Microsporum canis was the most common organisms noticed with 22 cases (81%), followed by Trichophyton spp. with 2 cases (7%), Microsporum gypseum with 1 case (4%), Trichophyton mentagrophytes with 1 case (4%) and Microsporum spp. with 1 case (4%). Twenty-eight cases (70%) received oral griseofulvin as the first drug and twenty cases of them responded to treatment. Itraconazole was the alternative drug in 7 cases and terbinafine in 1 case. There were 12 cases received oral itraconazole as the first drug and all of them responded to treatment. No adverse drug reaction was found in this study.

Discussion and conclusion: Microsporum canis is the most common causative pathogen of tinea capitis in Thammasat hospital. Griseofulvin is the recommended drug of choice and effective. Itraconazole and terbinafine are alternatives.