Tinea capitis update: a continuing conflict with an old adversary

Infection with tinea capitis in childhood is a common, age-old problem that continues to plague patients and their families. As is true for most infec tious diseases, the epidemiology of tinea capitis is in a constant state of flux and varies considerably with respect to geography and specific patien t populations. Trichophyton tonsurans is now the most common cause of tinea capitis in the United States. A recent epidemiologic observation is a stri king increase in the incidence of tinea capitis, particularly among African -Americans. Clinical studies over the past decade that have investigated th e response of tinea capitis to griseofulvin, the mainstay treatment for thi s condition, suggest a decrease in sensitivity to this pharmacologic agent, in association with this new epidemiology, Important advances in the diagn osis and treatment of tinea capitis include a renewed interest in the use o f the cotton swab method of diagnosing fungal cultures in children, and the ongoing investigation of promising new medications for the treatment of ti nea capitis, including terbinafine, itraconazole, and fluconazole in this e ra of resistant organisms. (C) 2001 Lippincott Williams & Wilkins, Inc.