Terbanafine effective against Tinea capitis due to Trichophyton tonsurans

Occipital scaly plaques and papules with concomitant non-scalp lesions are the most common clinical presentation of T. tonsurans tinea capitis. Oral terbinafine can be effectively used for the management of this condition. The clinical manifestations and treatment outcomes were published in the journal Mycoses. 

There is an increasing epidemiological concern about Trichophyton tonsurans tinea capitis. Very few studies have described the clinical manifestations and treatment response among adults. Hence researchers conducted a study to assess the clinical manifestations and treatment outcomes of T. tonsurans tinea capitis among adults. 

A retrospective cohort study was carried out among 111 adults with T. tonsurans tinea capitis. Fungal culture or polymerase chain reaction was used to confirm the diagnosis. Examinees' demographics, disease characteristics, and treatment response were measured and the risk factors for the treatment failure were evaluated. 

Results

• The mean age was 20.1 years (±3.1), with men (98.2%) outnumbering women.
• The follow-up lasted 12.2 months (±5.6).
• The occipital area (87.6%) was the major scalp area where T. tonsurans tinea capitis was seen.
• In 78.9% of the cases, the scalp manifestation was non-inflammatory with scaly plaques and papules seen in 76.1% and seborrhoea-like manifestations seen in 2.8%. 
• 21.1% of cases presented with inflammatory tinea capitis with 10.1% as Kerion and 11% as pustular forms. 
• Other than scalp areas were concomitantly involved. Tinea corporis was seen in 38.7% of the cases; tinea faciei and barbae in 24.3%; nape and anterior neck in 76.6% and 2.7% of the cases, respectively. 
• There was an 83.2% clinical cure rate with an adequate treatment course of oral terbinafine.
• Treatment failure was significantly associated with concomitant tinea corporis (odds ratio 3.9; 95% confidence interval 1.3–12.1, p-Value< .02). 

T. tonsurans tinea capitis included occipital scaly plaques and papules with concomitant non-scalp lesions and was effectively managed by Oral terbinafine but concomitant tinea corporis increased the risk for treatment failure. 

Further reading: Galili E, Goldsmith T, Khanimov I, et al. Tinea capitis caused by Trichophyton tonsurans among adults: Clinical characteristics and treatment response [published online ahead of print, 2022 Oct 11]. Mycoses. 2022;10.1111/myc.13536. doi:10.1111/myc.13536