We examined the epidemiological trends in 23 cases of tinea capitis encountered at the Department of Dermatology, Kanazawa Medical University Hospital, from 1998 to 2007. The patients were 11 males and 12 females, aged from 1 y.o. to 81 y.o. (mean 34.2 y.o.). KOH examination for dermatophytes and fungal culture of hair shafts from all patients gave positive results. The distribution of clinical types was black dot ringworm (BDR) (14 cases), kerion celsi (6 cases) and gray patch (3 cases). The predominant causative agent was
Trichophyton (
T.)
tonsurans (8 cases), followed by
Microsporum canis (5 cases),
T. violaceum (5 cases),
T. rubrum (4 cases), and
T. glabrum (1 case).
T. tonsurans has been detected since 2002, and it was isolated only from adolescent patients doing contact sports such as judo or wrestling.
T. violaceum was identified from two different families. In one family, a boy developed BDR three years after the two other siblings who had been cured. All the patients were treated with oral antimyicotic agents; terbinafine (TBF) in 10 cases, griseofulvin (GRF) in 9 cases, itraconazole in 1 case, and sequential administration of GRF and TBF in 3 cases. The treatment period with TBF was shorter compared with GRF; mean 46.4 days and 54.3 days, respectively. Topical application of antimycotics or antibiotics was also prescribed for 15 patients. It did not aggravate any of the cutaneous lesions.
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