Mtibaa Latifa, Rabhi Faten, Abderrahim Achraf, Baccouchi Nawel, Jaber Kahena, Fares Hajer, Dhaoui Abderraouf, Jemli Boutheina
Laboratoire de Parasitologie-Mycologie, Hôpital Militaire Principal d'Instruction de Tunis, 1008 Monfleury, Tunisie.
Service de Dermatologie, Hôpital Militaire Principal d´Instruction de Tunis, 1008 Monfleury, Tunisie.
Pan Afr Med J. 2022 Mar 1;41:168. doi: 10.11604/pamj.2022.41.168.29473. eCollection 2022.
Tinea capitis (TC) is the most common superficial mycosis seen in children before puberty. The distribution of these dermatophytes changes over time and varies from country to country. The purpose of this study was to investigate the epidemiological and mycological characteristics of TC in Tunis. We conducted a retrospective study, involving 474 patients referred for mycological analysis of the scalp between January 2012 and December 2020. For each patient, a Clinical Information Sheet was completed, and a mycological sample was taken. The identification of isolated dermatophytes was based on macroscopic and microscopic colony criteria. Molecular real-time Polymerase Chain Reaction (PCR) detection of 4 isolates was performed using the DermaGenius®2.0 kit. We collected 210 positive samples, reflecting a prevalence of 44.3% (n=210). Male patients were more frequently affected by TC (81%, n=170). The average age of patients was 6,2±3,4 years. Ring-shaped large patches were predominant (88%, n=184). Direct examination had a sensitivity of 87% (n=182). Microsporic ectothrix parasitism was detected in (79%, n=166) of cases and trichophytic endothrix in (7%, n=14) of cases. Culture was positive in (98%, n=207) of cases and five dermatophyte species were isolated: Microsporum canis (87%, n=182), Trichophyton violaceum (9%, n=19), Trichophyton mentagrophytes var mentagrophytes (3%, n=6), Microsporum gypsum (0.5%, n=1) and Trichophyton verrucosum (0.5%, n=1). This study reveals the occurrence of zoophilic dermatophytes, in particular M. canis. Mycological examination is essential to confirm the diagnosis, conduct epidemiological surveillance of dermatophytes in the districts and for therapeutic management.
头癣（TC）是青春期前儿童中最常见的浅表真菌病。这些皮肤癣菌的分布随时间变化，且因国家而异。本研究的目的是调查突尼斯头癣的流行病学和真菌学特征。我们进行了一项回顾性研究，纳入了2012年1月至2020年12月期间因头皮真菌学分析而转诊的474例患者。为每位患者填写了一份临床信息表，并采集了真菌学样本。分离出的皮肤癣菌的鉴定基于宏观和微观菌落标准。使用DermaGenius®2.0试剂盒对4株分离株进行了分子实时聚合酶链反应（PCR）检测。我们收集了210份阳性样本，患病率为44.3%（n = 210）。男性患者受头癣影响更为频繁（81%，n = 170）。患者的平均年龄为6.2±3.4岁。环形大片状皮损为主（88%，n = 184）。直接检查的敏感性为87%（n = 182）。在79%（n = 166）的病例中检测到小孢子菌外发癣菌寄生，在7%（n = 14）的病例中检测到毛癣菌内发癣菌。培养阳性率为98%（n = 207），分离出五种皮肤癣菌：犬小孢子菌（87%，n = 182）、紫色毛癣菌（9%，n = 19）、须癣毛癣菌须癣变种（3%，n = 6）、石膏样小孢子菌（0.5%，n = 1）和疣状毛癣菌（0.5%，n = 1）。本研究揭示了亲动物性皮肤癣菌的存在，尤其是犬小孢子菌。真菌学检查对于确诊、在各地区开展皮肤癣菌的流行病学监测以及治疗管理至关重要。
