Évolution des teignes du cuir chevelu à Microsporum canis et à Trichophyton violaceum à Tunis

Epidemiology of scalp ringworms and superficial fungal infections in schools in Mauritania

INTRODUCTION

Scalp Tinea is the most common mycosis in children and adolescents. The objective of this work was to determine the epidemiological and etiological profile of Scalp Tinea in schoolchildren in Mauritania, during the year 2019.

METHODS

This is a descriptive cross-sectional study lasting four months, from May to September 2019, in a sample of schoolchildren from Nouakchott, included following a random survey at three levels, having benefited from a clinical examination, mycological and culture samples.

RESULTS

A total of 228 children out of the 434 included (52,5%) were detected as carriers of Scalp Tinea, after fungal culture, i.e. rates of 54% in boys and 46% in girls. The most affected age group was 9-12 years (49%). Public schools were the most affected (37,7%), followed by private schools (32%) and traditional schools (30,3%), (p<0,05). Trichophyton sudanense represented 23,5% (n=102) followed by Trichophyton rubrum (15,4%, n=67) and Microsporum langeronii 8,1% (n=35). The type of habitat, the humidity of the environment and walking with bare feet did not significantly influence the presence of ringworms, unlike overcrowding (sleeping with more than two people). The prevalence of scalp ringworms increased from 1,3% for children sleeping on single beds to 22,8% in children sharing their beds and to 75,9% in students sleeping together on the same bed (p˂0,05).

CONCLUSION

The results of this survey, conducted in 2019, confirmed the changes in the epidemiological and ecological trend of the mycological profile of Scalp Tinea, in Mauritania. It is necessary to strengthen these results with the molecular characterization of fungal strains circulating in our country.

[Tinea capitis: Main mycosis child. Epidemiological study on 10years]

Despite the changes in their epidemiology, and the improving level of hygiene of the population, tinea capitis is still considered a public health problem in our country, and is the most common type of dermatophytosis in our country. The aim of our study was to evaluate the epidemiological, clinical and mycological features of tinea capitis in children encountered in the Tunis region. A retrospective study concerned 1600 children aged 6 months to 15 years suspected to have tinea capitis was conducted in Parasitology-Mycology laboratory, Rabta hospital, over a 10-years period (2005-2014). Dermatophyte infections were confirmed using scalp scrapings examinated with direct microscopy using potash at 30% and/or culture on Sabouraud medium agar. Tinea capitis diagnosis was confirmed in 947 cases (59.18%). The sex ratio was 2.61 and the average age of 6.28 years with predominance in the age group of 4 to 8 years (52.27%). The most common clinical presentation was ringworm (87.65%). Ringworm large plaque was predominant (65.9%). Direct examination was positive in 884 cases (93.35%). Microsporic tinea was the most frequent (63.25%) followed by trichophytic tinea (29.78%). Positive cultures of dermatophytes were obtained in 912 cases (96.30%). The following dermatophyte species were isolated: Microsporum canis (67%), Trichophyton violaceum (31.68%), Trichophyton mentagrophytes (0.66%), Microsporum audouinii (0.22%), Trichophyton schoenleinii (0.22%) and Microsporum gypseum (0.22%). M. canis is currently the most frequently incriminated species in tinea capitis in Tunisia. This change is related to a change in behavior of our population, in fact the cat; main reservoir of M. canis cohabiting increasingly with Tunisian families.

[Evolution of tinea capitis observed in mycology laboratory of institute Pasteur of Algeria from1995 to 2015]

Tinea capitis are common in Algeria and are a frequent reason for consultation. This mycosis affects children and rarely adults. This is a retrospective study over a period of 20 years from 1995 to 2015 at the mycology laboratory of the Pasteur institute of Algeria.

OBJECTIVE OF THE STUDY

Observe the evolution of these tinea over the years, to study the epidemiological aspects and identify the responsible agents.

PATIENTS

This study concerned patients of all ages and sexes living in the region of Algiers and the environs, consultant for various scalp lesions.

MATERIALS AND METHODS

For each patient, a completed information sheet is developed in insisting on the presence of animals and people with similar lesions. For each sampling, direct examination and culture on Sabouraud medium and antibiotics are utilized. The cultures are put at T° 27 to 28°C and controlled regularly during 3 to 4 weeks.

RESULTS

A total of 2664 samples were collected, 892 examinations were positive corresponding to a frequency of 33.48%. The age group 0-10 years is the most affected 710 cases (79.60%), with a slight predominance for male sex 502 cases (56.27%) and 390 cases (43.72%) for female sex. Eight hundred and fifty-five dermatophytes strains were isolated. Among the species found, Trichophyton violaceum is the most species isolated (59.41%), followed by Microsporum canis to 35.08%. In our series, the number of cases of tinea has increased slightly over the years, the rate of 26% in 2001 has progressed to 41.02% in 2015. From 1995 to 2011, T. violaceum was the predominant species, but from the year 2011 we see an increase of M. canis and decreased of T. violaceum.

CONCLUSION

Tinea capitis remains frequent in Algeria and affects preferentially the children. T. violaceum and M. canis dominate the dermatophytic flora. Tinea trichophytic anthropophiles have progressively decreased in favor of tinea microsporic zoophiles who saw their number increased.

Tinea capitis favosa misdiagnosed as tinea amiantacea

INTRODUCTION

Favus of the scalp or tinea capitis favosa is a chronic dermatophyte infection of the scalp. In almost cases, favus is caused by Trichophyton schoenleinii, anthropophilic dermatophyte. It is characterized by the presence of scutula and severe alopecia. Besides the classic clinical type of tinea capitis favosa, there are many variant of clinical form which may persist undiagnosed for many years. In this work, we report an atypical form of favus to Trichophyton schoenleinii which was misdiagnosed as tinea amiantacea.

CASE-REPORT

An 11-year old girl came to the outpatient department of dermatology (day 0) with history of tinea amiantacea treated unsuccessfully with keratolytic shampoo (day - 730). She presented a diffuse scaling of the scalp with thick scaly patches and without scutula or alopecia. A diagnosis of tinea favosa by T. schoenleinii was made by mycological examination. She was treated with griseofulvin and ketoconazole in the form of foaming gel for twelve weeks. Despite treatment, clinical evolution was marked by appearance of permanent alopecia patches. The follow-up mycological examination was negative.

CONCLUSION

Because of ultimate evolution of favus into alopecia, we emphasize the importance of mycological examination in case of diffuse scaling.

Clinical and mycological features of onychomycosis in central Tunisia: a 22 years retrospective study (1986-2007)

Onychomycosis is the most frequently encountered nail disease and may be difficult to diagnose and treat. The objective of this study was to determine the prevalence, the clinical and mycological characteristics of onychomycosis in central Tunisia. It is a retrospective study performed over a 22-year period (1986-2007). It included 7151 patients (4709 women and 2442 men) with suspected fingernails and/or toenails onychomycosis. The patients were referred to the Mycology-Parasitology Laboratory of Farhat Hached hospital in Sousse for mycological examination. Both direct microscopy and culture of the nail material were performed to diagnose and identify the causative fungal species. Onychomycosis was confirmed in 78.6% of investigated patients (5624/7151). The positivity rate was higher in women as compared with men. In both men and women, fingernails were most frequently involved than toenails. No significant relation was found between gender and toenails onychomycosis, whereas fingernails were frequently involved in women. As far as aetiological agents are considered, dermatophytes, yeast and moulds were responsible for 49.9%, 47.4% and 2.7% of onyxis cases respectively. In fingernail infections, yeast were the most frequent fungi (83.6%), Candida albicans being the leading species (51.6%). In contrast, in toenail infections, dermatophytes were more frequent (74.1%). Trichophyton rubrum was by far the dominant species (88.1%). Yeast were observed more frequently in women whereas dermatophytes were more common in men. Moulds were involved in 4.2% of cases. The most frequent species were Aspergillus sp. and Chrysosporium sp. Onychomycosis is a frequent disease in central Tunisia. T. rubrum is the predominant agent in toenails infection and yeast, mainly C. albicans, in fingernails onychomycosis.

Inflammatory Tinea capitis: a 12-year study and a review of the literature

Inflammatory Tinea capitis (TC) is a rare form of TC. The aim of this study was to review epidemiological, clinical and mycological profile of inflammatory TC. We present a retrospective study (1999-2010), enrolled all the cases of inflammatory TC observed at a referral hospital in the northern Tunisia. One hundred and twenty-one patients with inflammatory TC, 83 male patients (68.6%) and 38 female patients (31.4%) were enrolled. The mean age was about 8 years. A majority of TC (71.9%) were in patients lesser than 10 years of age. Positive family history and contact with animals were noted in seven and 35 cases respectively. Direct examination was positive in 110 cases (59 ectothrix, 51 endothrix) and positive cultures were obtained in 105 patients (49 Trichophyton violaceum, 31 Microsporum canis, 13 Trichophyton interdigitale complex, 12 Trichophyton verrucosum). Systemic treatment was carried out in 115 patients with griseofulvin, in one with terbinafine. A complete recovery was noted in 88 cases; and persistent alopecia in 28 cases. The inflammatory TC is rare, but more common in rural families. The disease mostly affected male genders (68.6%) and T. violaceum remains the common pathogen of inflammatory TC in northern Tunisia.

Epidemiology of dermatophytoses in Sfax, Tunisia

The distribution of dermatophytes varies in different countries and geographical areas depending on several factors. To determine the frequency of aetiological agents and the clinical variants of dermatophytoses, we carried out a study between 1998 and 2007. Out of 25 432 subjects suspected to have superficial mycoses, 9960 (39.2%) were affected with dermatophytoses; 14957 positive samples were obtained. The mean age was 35.7 years (range: 21 days to 97 years). Sex ratio was 0.9. Our patients were from urban regions in 81.9% of cases. The most common type of infection was onychomycosis (30.3%), followed by tinea pedis (24.8%), intertrigo (21.7%), tinea corporis (11.4%) and tinea capitis (9.6%). Fifteen patients had generalised dermatophytosis. Hadida and Schousboe disease was diagnosed in one case with lethal evolution. The most isolated dermatophyte was Trichophyton rubrum (74.5%), followed by T. violaceum (7.9%), T. mentagrophytes (7.5%), Microsporum canis (3.8%), Epidermophyton floccosum (0.7%) and T. verrucosum (0.54%). Other species were occasionally isolated: T. schoenleinii, T. tonsurans, M. audouinii and M. ferrugineum. The prevalence of dermatophytoses remains high in our country (996 cases/year). Trichophyton rubrum is the predominant causal agent. However, zoophilic agents become more prevalent. Epidemiological surveys are an essential tool for developing strategies for infection control.