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Tinea corporis is a fungal infection of the arms and legs, especially on glabrous skin. Common symptoms are severe itching of the scalp, dandruff, and bald patches where the fungus has rooted itself in the skin. These areas may be red or swollen (inflammed). The patient may have areas that appear bald, due to hair that has broken off. There may be small black dots on the scalp. The disease is considered to be a form of superficial mycosis or dermatophytosis. Several synonyms are used, including ringworm of the scalp and tinea tonsurans. In the United States and other regions of the world, the incidence of tinea capitis is increasing. The fungi that cause tinea infections thrive in warm, moist areas. Tinea infections are contagious. Tinea capitis is most prevalent between 3 and 7 years of age. It is common in children, tinea capitis is less frequently seen in adults.  Tinea capitis is caused by fungi of species of genera Trichophyton and Microsporum. Tinea capitis is the most common pediatric dermatophyte infection worldwide. The age predilection is believed to result from the presence of Pityrosporum orbiculare (Pityrosporum ovale), which is part of normal flora, and from the fungistatic properties of fatty acids of short and medium chains in postpubertal sebum.

Tinea capitis may result in swollen lymph glands at the sides of the back of the neck. Tinea capitis accounts for up to 92.5% of dermatophytoses in children younger than 10 years. The disease is rare in adults, although occasionally, it may be found in elderly patients. Tinea capitis is suspected if there is a combination of scale and bald patches. Tinea capitis occurrence is widespread in some urban areas in the United States. Tinea capitis occurs primarily in children and occasionally in other age groups. It is seen most commonly in children younger than 10 years. Peak age range is in patients aged 3-7 years.  Anthropophilic fungi grow preferentially on humans, and the most common type forms large conidia of approximately 3-4 mm in diameter within the hair shaft. Zoophilic fungi are acquired through direct contact with infected animals. Smaller conidia of approximately 1-3 mm in diameter typically are present, extending around the exterior of the hair shaft. Dermatophytic fungi causing tinea capitis can be divided into anthropophilic and zoophilic organisms.

Terbinafine similarly has shown promise in the treatment of tinea capitis.  Newer antifungal medications, such as ketoconazole, itraconazole, terbinafine, and fluconazole, have been reported as effective alternative therapeutic agents for tinea capitis. Avoid using topical corticosteroids during treatment of dermatophyte infections. Of these agents, itraconazole and terbinafine are used most commonly. Oral antifungal therapy is required for effective treatment, often for several months. Oral steroids may help reduce the risk for and extent of permanent alopecia in the treatment of kerion.  Treatment for the deep folliculitis seen in Majocchi granuloma is systemic oral antifungal therapy. Good general hygiene is important in the prevention and treatment of all tinea infections. The scalp should be shampooed regularly, especially after haircuts.

Treatments for Tinea Capitis Tips

1.Newer antifungal medications, such as ketoconazole, itraconazole, terbinafine, and fluconazole,as effective alternative therapeutic agents for tinea capitis.

2.Griseofulvin has been the treatment of choice in all ringworm infections of the scalp.

3.Terbinafine tablets at doses of 3-6 mg/kg/d for approximately 2-4 weeks have been used successfully for T tonsurans infections.

4.Good general hygiene is important in the prevention and treatment of all tinea infections.

5.Avoid contact with infected pets or individuals. Headgear, combs, and similar items should not be exchanged unless they are first thoroughly cleaned and dried.

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