Background: We found pre-established directives inadequate to cope with the current increase in anthropophilic tinea capitis in Brussels. Objectives: To study new epidemiological profiles and to define new strategies for management and prevention. Patients and Methods: A total of 122 children affected by tinea capitis were followed in our department from October 1, 2001, until September 30, 2002. The results were assessed retrospectively. Results: Anthropophilic tinea capitis represented 89.34% of the cases. The implicated anthropophilic dermatophytes were by decreasing frequency: Microsporum langeronii (39.34%), Trichophyton soudanense (28.69%), Trichophyton violaceum (18.03%) and Trichophyton tonsurans (3.28%). Conclusion: The responsible pathogens reflect immigration flows originating mostly from Black and North Africa. Precise recommendations for each visit are detailed.

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The authors studied in vitro and in vivo the invasion of the nail keratin by saprophytes. This invasion takes place in the same way in both cases: mycelian filaments and spores penetrate in the hyponychium, filaments penetrate in the upper part of the tablet, filaments and, as far as some saprophytes are concerned, ‘boring hyphae’ penetrate in the lower part of the tablet. Those ways of invasion are responsible for the clinical pictures (onychomycosis, pachyonychia, leuconychomycosis). Electron microscopically the mycelian filaments appear to be both intercellular and intracellular. The authors insist on the importance of the criteria of evaluation which allow us to establish the saprophytic origin of onychomycosis.

the effects of the used drugs. For this purpose we have investigated several drugs which were produced from natural sources.The fungicidal as well as the inhibitory effects were examined. The tests were done on human pathogenic yeast such as Candida albicans, Candida krusei, Candida glabrata and others.The fungicidal effects were tested by determining the decrease of CFU (Colony Forming Units) in time and concentrations in water solution. The development of the colonies were tested in Sabouraud glucose agar in Petri dishes. In the case of oils (eg. tea-plant oil, etc.) or volatile oil (e.g. thymol) first an alcoholic mixture was made which was diluted by water or physiological NaCI. The end-concentration of the natural agencies were 5 0 0 0~ or 5 0 0~. In these experiments the product which was a composition of natural plant volatile oils used in foraging and veterinary medicine showed a very high fungicidal effect.In further examinations grapefruit-seed extract, lavender-oil, tea-plant-oil, geranium-oil, rosemary-oil, orange-peel extract were tested. Three of them: tea-plantoil, geranium-oil and orange-peel extract showed fungicidal effect, others had no effect on fungi.The fungistatic effects were also tested by the reduced growing of the species in growing media containing acid/alcalic indicators. The effects were visualised by colour changing depending on the produced amounts of acid(s) by yeast species.According to the in vitro results some natural drugs may be a helpful supplement in certain cases. Service de Dermatologic CHU Saint Pierre, Brugmann et HUDERF ULB, Brussels, BelgiumWe report the cure of 4 cases of tinea capitis due to different anthropophilic pathogens. One case was due to Microsporum langeroni, the three others to Trichophyton species: T soudanense, T violaceum and T tonsurans. All patients were under the weight of 16 kg and Black Africans. They were treated with fluconazole oral solution at the dosage of 5-6 mg/kg daily and kept away from the crhche. They were assessed clinically and mycologically 3 weeks later. Even if the child looked clinically cured at the first check, treatment was only discontinued at week 6, when the result of a negative culture became available. The parents reported no adverse events.In cities, anthropophilic tinea capitis seem to become predominant, the identified fungi reflecting the current migration movements. In Belgium our two main anthropophilic pathogens are M. langeroni and T violaceurn, T soudanense ranks third, and T tonsurans is only rarely involved. Treating children under the weight of 16 kg, we were confronted with the problem of the compliance of the patient.Fluconazole oral solution, at the dose of 5-6 mg/kg daily, is both an effective and safe treatment for anthropophilic tinea capitis in children under the age of two or the weight of 16 kg. Although clinical cure can be observed in as little as 3 weeks of therapy, the treatment should not be discontinued before a negative culture becomes available. SENSITISATION TO CANDZDA ALBZCANS IN PATIENTS WIT...