Clinico Mycological study of Tinea Capitis

Geetha, K (2012) Clinico Mycological study of Tinea Capitis. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : Tinea capitis is also known as “Ringworm of the hair/scalp”, “Tinea tonsurans”, and “Herpes tonsurans”. It is a superficial fungal infection of the scalp and scalp hair that is caused by dermatophytes belonging to the genera Trichophyton and Microsporum. The causative fungi may vary with geography and time. Tinea capitis is predominantly an infection of children, although adult cases are also seen. It may be caused by any pathogenic dermatophyte except E.floccosum, T.concentricum and T.mentagrophytes var interdigitale1,2 . The most common cause worldwide is M.canis whereas in the United States it is T.tonsurans and it is T.violaceum in south India. In any given location, the species may change with time particularly as new organisms are introduced by immigration. Hence a study was undertaken in Rajiv Gandhi Government general Hospital, Chennai to identify the various etiological agents, various clinical types, to study the epidemiological aspects and to determine the clinicomycological correlation of tinea capitis. AIMS OF THE STUDY : 1. To study the epidemiological aspects like age, sex and socioeconomic factors related to tinea capitis. 2. To study the various clinical types of tinea capitis 3. To study the various etiological agents causing tinea capitis 4. To determine the clinico-etiological correlation of tinea capitis and to see if there is any change in trend. MATERIALS & METHODS : All new patients with tinea capitis who attended the outpatient department, mycology section, Department of Dermatology, Rajiv Gandhi Government General hospital from the period of June 1st 2010 to October 2011 were selected for the study after KOH smear positivity. Age, sex and duration of the disease were recorded. Detailed history with regard to socio economic status, tonsure/haircut, contact with pet animals, similar lesions in siblings or friends and associated systemic illness was taken. Dermatological examination was done to look for the presence of scales, patchy hair loss or boggy swelling in various areas of scalp. Associated dermatophyte infection elsewhere in the skin and nails were noted. Presence of regional cervical lymphadenopathy was recorded. Examination for other associated dermatological and systemic disorders was done. Scalp scrapings and hair root samples were analyzed by KOH wet mount. KOH positive specimens were cultured on Sabourauds dextrose agar with and without actidione. The rate of growth, colony morphology, pigment production on the reverse and microscopic examination in lactophenol cotton blue mount contributed towards confirmation of the isolates. Inclusion criteria : All patients with tinea capitis, belonging to any age group and both sexes with KOH smear positivity. Exclusion criteria : Patients who had taken topical antifungal treatment 2 weeks prior and systemic antifungal treatment 4 weeks prior to the study. CONCLUSION : Tinea capitis occurs predominantly in children, though it can occur in all age groups. • Tinea capitis was observed more in boys compared to girls. • Prevention of spread of infection can be aided by proper sterilization of instruments used for hair cut and tonsure, avoidance of sharing of combs, caps and other fomites. Intra familial and institutional infections in residential schools can be thus prevented. • Early diagnosis and treatment of dermatophyte infection elsewhere may lead to prevention of spread to scalp and thus decrease the duration of treatment. • Tinea capitis presents with varying clinical manifestations. Noninflammatory types were more commonly observed than the inflammatory types. • Grey patch was the commonest among the non-inflammatory types. Kerion was the most common type in the inflammatory group. Mixed type was also seen in a proportion of cases. • Trichophyton tonsurans, an anthropophilic dermatophyte, was the most common agent which produced non-inflammatory, inflammatory and mixed types. • Trichophyton violaceum and Trichophyton mentagrophytes were equally common following Trichophyton tonsurans. Both species caused inflammatory types in equal frequency. Among the noninflammatory group, Trichophyton violaceum was the most common causative agent in grey patch type, whereas Trichophyton mentagrophytes was the commonest agent causing glabrous type of tinea capitis. • Trichophyton rubrum was the causative agent in glabrous type and grey patch type tinea capitis. • The clinico mycological correlation reveals that a single pathogen may give rise to various clinical types. • T. violaceum was the most common agent isolated in South India, whereas T. tonsurans was isolated as the most common agent in this study. • Further studies with a larger sample size are needed to confirm this changing trend in the predominance of the organisms.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Tinea Capitis ; Clinico Mycological study.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 01 Mar 2018 16:46
Last Modified: 01 Mar 2018 16:46

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