Song Ge, Zhang Meijie, Kong Xue, Liu Weida, Liang Guanzhao
Department of Medical Mycology, Institute of Dermatology and Hospital for Skin Diseases, Chinese Academy of Medical Science & Peking Union Medical College, Nanjing, 210042, China.
CAMS Collection Center of Pathogen Microorganisms-D (CAMS-CCPM-D), Nanjing, 210042, China.
Mycopathologia. 2023 Oct;188(5):461-478. doi: 10.1007/s11046-022-00703-z. Epub 2022 Dec 30.
Tinea capitis (TC) is a dermatophytosis of the scalp and hair, which occurs less common in children younger than two years of age, and the data of TC in this age group are still unknown.
We aimed to reveal the epidemiological, clinical and mycological characteristics of TC in children under two years old.
We retrospectively analyzed all reported cases of TC in children in their first two years of life from 1991 to 2022, by searching PubMed, Embase, Web of Science, CNKI, Wanfang and Weipu databases.
A total of 47 articles involving 126 cases of pediatric TC were enrolled in this study. The sex ratio (M/F) was 1.28:1. The age of the children ranged from ten days old to 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 children (75.40%) were treated with systemic antifungal drugs and 22 patients (17.46%) were only treated with topical therapy. Except for 10 patients with unknown final prognosis, all the other cases were cured after treatment. There was one child (0.79%) relapsed after treatment with griseofulvin and one case (0.79%) presented with gastrointestinal symptoms from griseofulvin.
The principal clinical symptoms of TC in children less than two years old were alopecic patches and scaling. The top four pathogens were M. canis, T. violaceum, T. mentagrophytes complex and T. tonsurans. Oral treatment for pediatric TC had achieved good therapeutic effects, and topical therapy can be an alternative choice.
头癣（TC）是一种头皮和毛发的皮肤癣菌病，在两岁以下儿童中较少见，该年龄组头癣的数据仍不明确。
我们旨在揭示两岁以下儿童头癣的流行病学、临床和真菌学特征。
通过检索PubMed、Embase、Web of Science、中国知网、万方和维普数据库，我们回顾性分析了1991年至2022年期间所有报道的两岁以内儿童头癣病例。
本研究共纳入47篇涉及126例儿童头癣病例的文章。男女比例（男/女）为1.28:1。儿童年龄从10天至2岁不等，中位年龄为3个月。主要临床表现为头皮斑秃（40例，31.7%）和脱屑（39例，31.0%），29例婴儿（23.0%）出现脓癣。最常见的传染来源是动物（35例，27.78%）和人（31例，24.60%）。主要病原体是犬小孢子菌（64例，50.79%），其次是紫色毛癣菌（13例，10.32%）、须癣毛癣菌复合体（12例，9.52%）和断发毛癣菌（10例，7.94%）。95名儿童（75.40%）接受了全身抗真菌药物治疗，22例患者（17.46%）仅接受了局部治疗。除10例最终预后不明的患者外，所有其他病例治疗后均治愈。有1名儿童（0.79%）在接受灰黄霉素治疗后复发，1例（0.79%）出现灰黄霉素引起的胃肠道症状。
两岁以下儿童头癣的主要临床症状是斑秃和脱屑。前四位病原体是犬小孢子菌、紫色毛癣菌、须癣毛癣菌复合体和断发毛癣菌。儿童头癣的口服治疗取得了良好的治疗效果，局部治疗也可作为一种替代选择。
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