Tinea Capitis in Children Younger than Two Years Old: A Retrospective Study and Treatment Recommendations

Abstract

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.

Successful treatment of fungal ball‐associated tinea capitis in a healthy infant: An unusual presentation

“…20 Tinea capitis and kerion can lead to long-term complications such as permanent scarring alopecia. 5 Arenas et al studied 19 patients with kerion and five showed scarring alopecia. 21 Also, other cases reported this due to delayed diagnosis and treatment.…”

“…Scalp dermatophytosis, with or without abscess formation, should be considered as a differential diagnosis for any hair loss patches, particularly those with epidermal changes. Any delay in diagnosis and treatment may result in more extensive scalp involvement and lead to complications such as permanent hair loss 4,5 …”

“…4 Clinical manifestations of tinea capitis are various in infants, including alopecic patches, | 3 of 4 ABTAHI-NAEINI et scaling, annular erythema, broken hairs, or even kerion and favus. 4,5 Scalp dermatophytosis, with or without abscess formation, should be considered as a differential diagnosis for any hair loss patches, particularly those with epidermal changes. Any delay in diagnosis and treatment may result in more extensive scalp involvement and lead to complications such as permanent hair loss.…”

“…Any delay in diagnosis and treatment may result in more extensive scalp involvement and lead to complications such as permanent hair loss. 4,5 Low socioeconomic conditions, contact with farm animals, 8 and also positive family history 9 can increase the risk of tinea capitis. As mentioned, our case had a close contact with domestic animals with a positive family history that were risk factors in this case.…”

“…Therefore, the epidemiological characteristics of tinea capitis in this age group are still unknown. 5 Tinea capitis is relatively rare among infants. Therefore, many aspects of the disease are still unknown in this group of age.…”