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Background: Tinea capitis (TC) is a dermatophytosis of the scalp and hair, which occurs less common in infants younger than two years of age, and the data of TC in this age group are still unknown.Objectives: We aimed to reveal the epidemiological, clinical and mycological characteristics of TC in infants.Methods: We retrospectively analyzed all reported cases of TC in infants in their rst two years of life from 1991 to 2022, by searching PubMed, Embase, Web of Science, CNKI, Wanfang and Weipu databases.Results: A total of 47 articles involving 126 cases of infant TC were enrolled in this study. The sex ratio (M/F) was 1.28:1. Infants were between ten days old and two years old with a median age of three months. The main clinical manifestations were alopecic patches (40 cases, 31.7%) and scaling (39 cases, 31.0%) on the scalp, and 29 infants (23.0%) appeared kerion. The most common sources of contagion were animals (35 cases, 27.78%) and humans (31 cases, 24.60%). The leading pathogens were Microsporidium canis(64 cases, 50.79%), followed by Trichophyton violaceum (13 cases,10.32%), T. mentagrophytes complex (12 cases, 9.52%) and T. tonsurans (10 cases, 7.94%). Ninety-ve infants (75.40%) were treated with systemic antifungal drugs and 22 patients (17.46%) were only treated with topical therapy. All patients were cured after treatment. Only one infant (0.79%) relapsed after treatment with griseofulvin 20 mg/kg/d for two months and one case (0.79%) presented with gastrointestinal from griseofulvin, who got better after stopping this drug. Conclusion:The principal clinical symptoms of TC in infants were alopecic patches and scaling. The top four pathogens were M. canis, T. violaceum, T. mentagrophytes complex and T. tonsurans. Oral treatment for TC in infants had achieved good therapeutic effects, and topical therapy can be an alternative choice.
Background: Tinea capitis (TC) is a dermatophytosis of the scalp and hair, which occurs less common in infants younger than two years of age, and the data of TC in this age group are still unknown.Objectives: We aimed to reveal the epidemiological, clinical and mycological characteristics of TC in infants.Methods: We retrospectively analyzed all reported cases of TC in infants in their rst two years of life from 1991 to 2022, by searching PubMed, Embase, Web of Science, CNKI, Wanfang and Weipu databases.Results: A total of 47 articles involving 126 cases of infant TC were enrolled in this study. The sex ratio (M/F) was 1.28:1. Infants were between ten days old and two years old with a median age of three months. The main clinical manifestations were alopecic patches (40 cases, 31.7%) and scaling (39 cases, 31.0%) on the scalp, and 29 infants (23.0%) appeared kerion. The most common sources of contagion were animals (35 cases, 27.78%) and humans (31 cases, 24.60%). The leading pathogens were Microsporidium canis(64 cases, 50.79%), followed by Trichophyton violaceum (13 cases,10.32%), T. mentagrophytes complex (12 cases, 9.52%) and T. tonsurans (10 cases, 7.94%). Ninety-ve infants (75.40%) were treated with systemic antifungal drugs and 22 patients (17.46%) were only treated with topical therapy. All patients were cured after treatment. Only one infant (0.79%) relapsed after treatment with griseofulvin 20 mg/kg/d for two months and one case (0.79%) presented with gastrointestinal from griseofulvin, who got better after stopping this drug. Conclusion:The principal clinical symptoms of TC in infants were alopecic patches and scaling. The top four pathogens were M. canis, T. violaceum, T. mentagrophytes complex and T. tonsurans. Oral treatment for TC in infants had achieved good therapeutic effects, and topical therapy can be an alternative choice.
Terbinafine is an allylamine antifungal agent that has been effective and safe in the treatment of superficial and some deep mycotic infections in adults. An increasing amount of data is available where terbinafine has been used in the paediatric population to treat superficial fungal infections, in particular tinea capitis. The data suggest that terbinafine is effective and safe using treatment regimens that involve short duration therapy, leading to an increased compliance and providing a cost-effective means of treating paediatric superficial fungal infections such as tinea capitis. Terbinafine has been approved for the treatment of tinea capitis in many countries worldwide, and provides good efficacy rates for Trichophyton tinea capitis using shorter regimens than the gold standard griseofulvin. The adverse events profile for children is similar to that in adults with few adverse effects associated with its use. The evidence favours the use of terbinafine in the treatment of superficial infections in children.
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