Tinea capitis

Tinea capitis is a common dermatophyte infection of the scalp in children. Dermatophytes are classified into three genera; tinea capitis is caused pre dominantly by Trichophyton or Microsporum species. On the basis of host pre ference and natural habitat, dermatophytes are also classified as anthropop hilic, geophilic and zoophilic. The etiological agents of tinea capitis usu ally fall in the first and last categories. In North America, tinea capitis is now predominantly due to Trichophyton tonsurans. During the past 100 ye ars the most common North American organism for tinea capitis was initially Microsporum canis followed later by M. audouinii. In other parts of the wo rld the epidemiology varies, Tinea capitis is generally observed in childre n 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 pustul es in the scalp. The clinical diagnosis should be confirmed by mycological examination. Wood's light examination was of value in diagnosing tinea capi tis due to M. canis and M. audouinii: however, it is not helpful in T. tons urans tinea capitis. Asymptomatic carriers may be a significant reservoir o f infection and spread of spores may also involve inanimate objects. Carrie rs may benefit from shampooing their hair, Treatment of tinea capitis requi res an oral antifungal agent. The data from the use of terbinafine, itracon azole and fluconazole are promising and suggest that these agents have an e fficacy similar to griseofulvin while shortening the duration of therapy. B oth griseofulvin and the newer antimycotics have a favorable adverse-effect profile and are associated with high compliance.