Tinea capitis in infants younger than two years old: a retrospective study and treatment recommendations

Abstract

Abstract Background: Tinea capitis (TC) is a dermatophytosis of the scalp and hair, which occurs less common in infants younger than two years of age, and the data of TC in this age group are still unknown. Objectives: We aimed to reveal the epidemiological, clinical and mycological characteristics of TC in infants. Methods: We retrospectively analyzed all reported cases of TC in infants in their first two years of life from 1991 to 2022, by searching PubMed, Embase, Web of Science, CNKI, Wanfang and Weipu databases. Results: A total of 47 articles involving 126 cases of infant TC were enrolled in this study. The sex ratio (M/F) was 1.28:1. Infants were between ten days old and two years old with a median age of three months. The main clinical manifestations were alopecic patches (40 cases, 31.7%) and scaling (39 cases, 31.0%) on the scalp, and 29 infants (23.0%) appeared kerion. The most common sources of contagion were animals (35 cases, 27.78%) and humans (31 cases, 24.60%). The leading pathogens were Microsporidium canis(64 cases, 50.79%), followed by Trichophyton violaceum (13 cases,10.32%), T. mentagrophytes complex (12 cases, 9.52%) and T. tonsurans (10 cases, 7.94%). Ninety-five infants (75.40%) were treated with systemic antifungal drugs and 22 patients (17.46%) were only treated with topical therapy. All patients were cured after treatment. Only one infant (0.79%) relapsed after treatment with griseofulvin 20 mg/kg/d for two months and one case (0.79%) presented with gastrointestinal from griseofulvin, who got better after stopping this drug. Conclusion: The principal clinical symptoms of TC in infants were alopecic patches and scaling. The top four pathogens were M. canis, T. violaceum, T. mentagrophytes complex and T. tonsurans. Oral treatment for TC in infants had achieved good therapeutic effects, and topical therapy can be an alternative choice.