Tinea Capitis in the Paediatric Population in Milan, Italy: The Emergence of Trichophyton violaceum

Abstract

Tinea capitis (TC) is the most common type of dermatophytosis in children. The epidemiology of TC depends on the geographical areas, and it changes over time. The aim of the study is to determine the incidence of TC and to identify the causative species in children observed at Dermatology Outpatient Department of the University of Milan, Italy, between January 2004 and December 2011. Four hundred and eighty-six children with suspected dermatomycosis were observed; TC was the most prevalent dermatomycoses with 86 cases. The most common isolated dermatophyte in scalp lesions was Trichophyton violaceum with 33 cases. The most recent epidemiological Italian studies still show zoophilic fungi as primary cause of TC. We are the first medical team in Italy to demonstrate a dominance of anthropophilic fungi, in particular T. violaceum.

Tinea capitis and tinea faciei in the Zurich area – an 8‐year survey of trends in the epidemiology and treatment patterns

“…While in Central, Eastern and most Mediterranean European countries M. canis is still considered the most common causative agent, a shift towards anthropophilic species, such as T. violaceum , T. tonsurans or M. audouinii has been observed mainly in urban areas of Europe, e.g. United Kingdom, France, Sweden, Denmark and recently in Italy . This observation is consistent with the results presented here, where anthropophilic fungi accounted for 75.6% of tinea capitis cases.…”

“…As demonstrated in other studies on tinea capitis, male patients were more often affected than females and most of the patients were younger than 14 years old with a peak incidence at 4–8 years …”

“…T. violaceum now has the highest incidence in Belgium and the Netherlands, Sweden and Turkey. Although M. canis was reported as the predominant agent across Italy, a recent study showed T. violaceum to be the most common species . Around Paris, a rise in the number of anthropophilic tinea capitis with T. tonsurans , T. soudanense and M. audouinii has been noted .…”

Dermatophytosis, Trends in Epidemiology and Diagnostic Approach

“…In a study in Milan during the period 2004 to 2011 including adults and children under the age of 16 years suffering from dermatomycosis, TC was found in 86 patients [69]. Among 70 infections with a positive culture, the majority (47.2 %) were due to T. violaceum, followed by M. canis (37.1 %).…”

“…However, a great change in the epidemiology of TC has been reported throughout Europe. For example, in Italy the re-emergence of previously eradicated anthropophilic dermatophytes such as M. audouinii, T. violaceum and T. tonsurans has been recorded over the last two decades [69]. Indeed, in the 1980s, M. canis was the main dermatophyte isolated in dermatophytosis in Italy causing tinea corporis and TC.…”