Favus of the Scalp: An Overview and Update

Abstract

Tinea capitis favosa, a chronic inflammatory dermatophyte infection of the scalp, affects over 90% of patients with anthropophilic Trichophyton schoenleinii. T. violaceum, T. verrucosum, zoophilic T. mentagrophytes (referred to as 'var. quinckeanum'), Microsporum canis, and geophilic M. gypseum have also been recovered from favic lesions. Favus is typically a childhood disease, yet adult cases are not uncommon. Interestingly, favus is less contagious than other dermatophytoses, although intrafamilial infections are reported and have been widely discussed in the literature. Clinical presentation of T. schoenleinii infections is variable: this fungus can be isolated from tinea capitis lesions that appear as gray patches, but symptom-free colonization of the scalp also occurs. Although in the past T. schoenleinii was the dominant fungus recovered from dermatophytic scalp lesions, worldwide the incidence has decreased except in China, Nigeria, and Iran. Favus of the glabrous skin and nails are reported less frequently than favus of the scalp. This review discusses the clinical features of favus, as well as the etiological agents, global epidemiology, laboratory diagnosis, and a short history of medical mycology.

In Vitro Antifungal Susceptibility Profiles of 12 Antifungal Drugs against 55 Trichophyton schoenleinii Isolates from Tinea Capitis Favosa Patients in Iran, Turkey, and China

“…avus, or tinea capitis favosa, is a chronic inflammatory dermatophytosis of the scalp, particularly diagnosed in children aged 4 to 14 years and occasionally in adults (1)(2)(3). Favus is characterized by scutulum formation and scarring atrophy (cicatricial alopecia), which can be differentiated from other clinical forms of tinea capitis, e.g., tinea capitis superficialis and kerion celsi (1,4).…”

“…Favus is characterized by scutulum formation and scarring atrophy (cicatricial alopecia), which can be differentiated from other clinical forms of tinea capitis, e.g., tinea capitis superficialis and kerion celsi (1,4).…”

“…However, in rare instances, several anthropophilic (Trichophyton violaceum), zoophilic (Trichophyton quinckeanum and Trichophyton verrucosum), and geophilic (Microsporum gypseum) dermatophytes are reported as etiological agents of favus (1,6).…”

Isolation of keratinophilic fungi from soil in Isfahan province, Iran

“…Cases of human infections caused by M. gypseum and T. ajelloi were reported, also T. terrestre as agent of dermatophytosis in humans and animals is known [3,16,18,21,25,28,29].…”

Pityriasis amiantacea-like adult tinea capitis favosa due to Trichophyton schoenleinii

“…Other species could rarely be implicated. It is the anthropophilic species, T. violaceum, zoophilic species, T. verrucosum, T. mentagrophytes and Microsporum canis and geophilic species, Microsporum gypseum (3). Favus could occur during childhood or adolescence and persists to adulthood in case of absence of treatment (3,4).…”