Diagnosis of tinea capitis in adults is challenging
December 09 2019
In adults, tinea capitis is uncommon or rare. In a single centre, 17 year series from Jeonju (Korea), Dr Su-Kyung Park and colleagues describe the often subtle features in 82 patients. The typical patient was a woman in her 60’s with over 5 months of symptoms. Most (>70%) were initially mis-diagnosed. Over 25% of the patients were immunocompromised with corticosteroid or other treatments. Initial incorrect diagnoses included - bacterial folliculitis, allergic contact dermatitis, psoriasis and eczema. Alopecia was noted in 56% of patients. Microscopy for fungal hyphae was positive in 93% of cases and fungal culture in 66% of cases, when done, the most common pathogen being Microsporon canis, although animal contact was infrequent (17%). Wood’s light was also positive in 66% of cases.
- Read Park et al (2019) Tinea capitis in adults: A 18‐year retrospective, single‐centre study in Korea
Similar findings were reported from Portugal – 115 cases over 11 years, 1.5% of all tinea capitis cases, by Bruno Duarte and colleagues. Most patients were older women who were immunocompromised, although 6 of the patients were aged 18-24 years. HIV infection was a more common cause of immunosuppression. Nearly half of the patients had another fungal infection, including tinea faciei (20%) and tinea corporis (20%). Microsporum audouinii (20%) and Trichophyton rubrum (20%) were the most common fungi grown.
- Read Duarte et al (2019) Adult tinea capitis and tinea barbae in a tertiary Portuguese hospital: A 11‐year audit
Examples of adult tinea capitis from Park et al.