Skip to main content

Advertisement

SpringerLink
Log in

Factors in Etiology and Predisposition of Adult Tinea Capitis and Review of Published Literature

  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

Background

Tinea capitis is a common fungal infection in children but is less frequently encountered in adults, especially in immunocompromised individuals.

Objectives

To determine the incidence of tinea capitis in adults, the predisposing factors and causative species.

Methods

A retrospective study was conducted over a period of 5 years, from 2010 to 2015, on cases of tinea capitis diagnosed in the Department of Dermatology and Mycology Research Center in Tehran, Iran. The information was collected from the patients including age, gender, location of the lesions, results of direct examination and culture, cause of immunosuppression and the prescribed treatment.

Results

Twenty-five (20.6 %) patients (10 men and 15 women) with a mean age of 45.28 years were affected by tinea capitis among a total number of 121 positive cases. Most of these adults (80 %) had a grade of immunodeficiency due to the underlying syndromes or diseases, and the rest were immunocompetent. Trichophyton species were isolated from 84 % of these adult patients, indicating Trichophyton violaceum (T. violaceum) as the most common fungal agent. Treatment with oral terbinafine or itraconazole was successful in all these cases.

Conclusions

The results showed that most cases affecting the adult population were caused by species of the genus Trichophyton. T. violaceum was the most common dermatophyte of adult patients. Thus, it is important to consider tinea capitis as a differential diagnosis in immunocompromised adults, even though it is considered to be rare in adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Perez-Gonzalez M, Torres-Rodriguez JM, Martinez-Roig A, et al. Prevalence of tinea pedis, tinea unguium of toenails and tinea capitis in school children from Barcelona. Rev Iberoam Micol. 2009;26:228–32.

    Article  PubMed  Google Scholar 

  2. Oliveira ACP, Guilhermetti E, Kioshima ES, et al. Tinea capitis em Maringá, Paraná. Um estudo de 11 anos. An Bras Dermatol. 2002;77:321–8.

    Google Scholar 

  3. Artan MO, Koc AN, Baykan Z, et al. Prevalence of tinea capitis in primary school children. Int J Med Investig. 2013;1:104–10.

    Google Scholar 

  4. Khosravi AR, Shokri H, Mansouri P. Immediate hypersensitivity and serum IgE antibody responses in patients with dermatophytosis. Asian Pac J Allergy Immunol. 2012;30:40–7.

    CAS  PubMed  Google Scholar 

  5. Halgren J, Petrini B, Wahlgren C. Increasing tinea capitis prevalence in Stockholm reflects immigration. Med Mycol. 2004;42:505–9.

    Article  Google Scholar 

  6. Del Boz J, Crespo V, Rivas-Ruiz F, et al. A 30-year survey of paediatric tinea capitis in southern Spain. J Eur Acad Dermatol Venereol. 2011;25:170–4.

    Article  PubMed  Google Scholar 

  7. Brilhante RS, Cordeiro RA, Rocha MF, et al. Tinea capitis in a dermatology center in the city of Fortaleza, Brazil: the role of Trichophyton tonsurans. Int J Dermatol. 2004;43:575–9.

    Article  PubMed  Google Scholar 

  8. Mebazaa A, Oumari KE, Ghariani N, et al. Tinea capitis in adults in Tunisia. Int J Dermatol. 2010;49:513–6.

    Article  PubMed  Google Scholar 

  9. El-Khalawany M, Shaaban D, Hassan H, et al. A multicenter clinicomycological study evaluating the spectrum of adult tinea capitis in Egypt. Acta Dermatovenerol Alp Pannonica Adriat. 2013;22:77–82.

    PubMed  Google Scholar 

  10. De Hoog GS, Guarro J, Gené J, et al. Atlas of clinical fungi. 2nd ed. Utrecht: Centraalbureau voor Schimmelkultures; 2000.

    Google Scholar 

  11. Goodman JM. Tinea capitis in an adult. Arch Derm Syphilol. 1946;53:185.

    CAS  PubMed  Google Scholar 

  12. Andrews GC. Tinea capitis in an adult. Arch Derm Syphilol. 1946;54:245.

    Article  CAS  PubMed  Google Scholar 

  13. Sabzghabaee AM, Mansouri P, Mohammadi M. Safety and efficacy of terbinafine in a pediatric Iranian cohort of patients with Tinea capitis. Saudi Pharm J. 2009;17:243–8.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ziemer A, Kohl K, Schröder G. Trichophyton rubrum-induced inflammatory tinea capitis in a 63-year-old man. Mycoses. 2005;48:76–9.

    Article  CAS  PubMed  Google Scholar 

  15. Rebollo N, López-Bárcenas AP, Arenas R. Tinea capitis. Actas Dermosifiliogr. 2008;99:91–100.

    Article  CAS  PubMed  Google Scholar 

  16. Morell L, Fuente MJ, Boada A, et al. Tinea capitis in elderly women: a report of 4 cases. Actas Dermosifiliogr. 2012;103:144–8.

    Article  CAS  PubMed  Google Scholar 

  17. Pipkin JK. Tinea capitis in the adult and adolescent. Arch Dermatol Syphiliol. 1952;66:9–40.

    Article  CAS  Google Scholar 

  18. Silverberg NB, Weinberg JM, Delem VA. Tinea capitis: focus on African American women. J Am Acad Dermatol. 2002;46:S120–4.

    Article  PubMed  Google Scholar 

  19. Medina M, Padilla M, Fernández R, et al. Tiña de la cabeza en adultos: estudio clínico, micológico y epidemiológico de 30 casos en la ciudad de México. Piel. 2003;18:403–8.

    Article  Google Scholar 

  20. Cervetti O, Albini P, Arese V, Ibba F, Novarino M, Panzone M. Tinea capitis in adults. Adv Microbiol. 2014;4:12–4.

    Article  Google Scholar 

  21. Devliotou-Panagliotidou D, Koussidou-Eremondi T, Chaidemenos GC, et al. Tinea capitis in adults during 1981–95 in northern Greece. Mycoses. 2001;44:398–400.

    Article  CAS  PubMed  Google Scholar 

  22. Cremer G, Bournerias I, Vandemeleubroucke E, et al. Tinea capitis in adults: misdiagnosis or reappearance? Dermatology. 1997;194:8–11.

    Article  CAS  PubMed  Google Scholar 

  23. Lova-Navarro M, Gómez-Moyano E, Pilar LM, et al. Tinea capitis in adults in southern Spain. A 17-year epidemiological study. Rev Iberoam Micol. 2016;33. doi:10.1016/j.riam.2015.02.007.

  24. Lee JY, Hsu ML. Tinea capitis in adults in southern Taiwan. Int J Dermatol. 1991;30:572–5.

    Article  CAS  PubMed  Google Scholar 

  25. Yu J, Chen W, Wan Z, et al. Adult tinea capitis due to Trichophyton violaceum in China. Mycopathologia. 2004;157:49–52.

    Article  PubMed  Google Scholar 

  26. Zaki SM, Ibrahim N, Aoyama K, et al. Dermato-phyte infections in Cairo, Egypt. Mycopathologia. 2009;167:133–7.

    Article  CAS  PubMed  Google Scholar 

  27. Frangoulis E, Papadogeorgakis H, Athanasopoulou B, et al. Superficial mycoses due to Trichophyton violaceum in Athens, Greece: a 15-year retrospective study. Mycoses. 2005;48:425–9.

    Article  CAS  PubMed  Google Scholar 

  28. Saghrouni F, Bougmiza I, Gheith S, et al. Mycological and epidemiological aspects of tinea capitis in the Sousse region of Tunisia. Ann Dermatol Venereol. 2011;138:557–63.

    Article  CAS  PubMed  Google Scholar 

  29. Elmaataoui A, Zeroual Z, Lyagoubi M, et al. Tinea capitis etiology in Ibn Sina Hospital in Rabat (Morocco). J Mycol Med. 2012;22:261–4.

    Article  CAS  PubMed  Google Scholar 

  30. Barlow D, Saxe N. Tinea capitis in adults. Int J Dermatol. 1988;27:388–90.

    Article  CAS  PubMed  Google Scholar 

  31. Hussain I, Aman S, Haroon TS, et al. Tinea capitis in Lahore, Pakistan. Int J Dermatol. 1994;33:255–7.

    Article  CAS  PubMed  Google Scholar 

  32. Rudolph AH. The diagnosis and treatment of tinea capitis due to Trichophyton tonsurans. Int J Dermatol. 1985;24:426–31.

    Article  CAS  PubMed  Google Scholar 

  33. Keisham C, Sarkar R, Khurana N, et al. Black dot tinea capitis caused by Trichophyton rubrum in an adult female presenting with cicatricial alopecia. Indian J Dermatol Venereol Leprol. 2015;81:224.

    Article  PubMed  Google Scholar 

  34. Buckley DA, Fuller LC, Higgins EM, et al. Tinea capitis in adults. Br Med J. 2000;320:1389–90.

    Article  CAS  Google Scholar 

  35. Gianni C, Betti R, Perotta E, et al. Tinea capitis in adults. Mycoses. 1995;38:329–31.

    Article  CAS  PubMed  Google Scholar 

  36. Aste N, Pau M. Tinea capitis caused by Microsporum canis treated with terbinafine. Mycoses. 2004;47:428–30.

    Article  CAS  PubMed  Google Scholar 

  37. Zaraa I, Hawilo A, Aounallah A, et al. Inflammatory tinea capitis: a 12-year study and a review of the literature. Mycoses. 2013;56:110–6.

    Article  PubMed  Google Scholar 

  38. Morán MD, Tarango-Martínez VM, González Treviño LA, et al. Tinea capitis in an adult. Case report. Rev Iberoam Micol. 2005;22:54–6.

    Article  Google Scholar 

  39. Blasco Melguizo J, Ruiz Villaverde R, Delgado Florencio V, et al. Tinea capitis by Trichophyton violaceum in immunosuppressed elderly man. J Eur Acad Dermatol Venereol. 2004;18:100–2.

    Article  CAS  PubMed  Google Scholar 

  40. Ooka S, Kashima M, Kubota Y, et al. A case of black dot ringworm with a review of Japanese cases. J Dermatol. 2000;27:658–63.

    Article  CAS  PubMed  Google Scholar 

  41. Atzori L, Aste N, Pau M. Tinea capitis in adults. J Symptoms Signs. 2014;3:392–8.

    Google Scholar 

  42. Koga T, Shimizu A, Kubota Y, et al. Tinea manus during interferon-alpha therapy for chronic hepatitis C. Eur J Dermatol. 2000;10:565–6.

    CAS  PubMed  Google Scholar 

  43. Finielz P. Tinea capitis in adult renal transplant recipient. Nephron. 1999;82:86.

    Article  CAS  PubMed  Google Scholar 

  44. Lateur N, Andre J, Maubeuge JD, et al. Tinea capitis in two black African adults with HIV infection. Br J Dermatol. 1999;140:722–4.

    Article  CAS  PubMed  Google Scholar 

  45. Haroon TS, Hussain I, Aman S, et al. A randomized double-blind comparative study of terbinafine for 1, 2 and 4 weeks in tinea capitis. Br J Dermatol. 1996;135:86–8.

    Article  CAS  PubMed  Google Scholar 

  46. Dragos V, Lunder M. Lack of efficacy of 6-week treatment with oral terbinafine for tinea capitis due to Microsporum canis in children. Pediatr Dermatol. 1997;14:46–8.

    Article  CAS  PubMed  Google Scholar 

  47. López-Gómez S, Del Palacio A, Van Cutsem J, et al. Itraconazole versus griseofulvin in the treatment of tinea capitis: a double-blind randomized study in children. Int J Dermatol. 1994;33:743–7.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the Research Council of the University of Tehran, Tehran, Iran.

Author information

Authors and Affiliations

  1. Mycology Research Center, Faculty of Veterinary Medicine, University of Tehran, Azadi St., Tehran, Iran

    Ali Reza Khosravi & Ghasem Vahedi

  2. Faculty of Veterinary Medicine, Amol University of Special Modern Technologies, Amol, Iran

    Hojjatollah Shokri

Authors
  1. Ali Reza Khosravi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hojjatollah Shokri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ghasem Vahedi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ali Reza Khosravi.

Ethics declarations

Conflicts of interest

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Khosravi, A.R., Shokri, H. & Vahedi, G. Factors in Etiology and Predisposition of Adult Tinea Capitis and Review of Published Literature. Mycopathologia 181, 371–378 (2016). https://doi.org/10.1007/s11046-016-0004-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11046-016-0004-9

Keywords

Search

Navigation