Tinea capitis in an Adult (Microsporum canis): Tinea capitis durch Microsporum canis bei einem Erwachsenen

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<ul><li><p>mykosen 23 (11) 607-608 Eingegangen am 5 . August 1980 </p><p>0 Grosse Verlag Berlin 1980 </p><p>Tinea capitis in an Adult (Microsporum canis) Tinea capitis durch Microsporum canis bei einem Erwachsenen </p><p>E. Van Hecke and L. Meysman Department of Dermatology (Head: Prof. Dr. A. Kint) University of Ghent, Belgium </p><p>Summary: A case of tinea capitis caused by Microsporum canis is reported in a 75 year old lady. The possible role of an epithelioma of the gingival mucosa in the development of this exceptional fungal infection in an adult is discussed. Ketoconazole proved to be efficacious while griseofulvin was not. </p><p>Zusammenfassung: Tinea capitis durch Microsporum canis wird beschrieben bei einer 75jahrigen Frau. Die mogliche Verantwortlichkeit eines Epithelioms des Zahnfleisches fir die Entwicklung dieser exzeptionellen Dermatophyten-Infektion wird diskutiert. Keto- conazole gab eine rasche Abheilung, wahrend Griseofulvin die Symptome nicht beein- flui3te. </p><p>Case report </p><p>A 75 year old woman was treated 18 months prior to the present illness for an epithelioma of the gingival mucosa by radiotherapy. She consults now with an inflamed vegetating plaque in the occipital area of the scalp. Scales, crusts, pustules and broken hairs are scattered all over the plaque. the size is approximately 6 cm diameter. At distance, a few smaller plaques are seen. The patient developed these lesions in two months time. She has been treated with oral griseofulvin (125 mg tid) and tetracycline (250 mg qid) for six weeks without success. The patient has two house pets, a cat and a dog. Both had tinea in their furs. A granddaughter who often plays with the animals also had tinea capitis. The child as well as the animals were treated before the patient consulted us. </p><p>Laboratory examinations </p><p>Direct mycological examination shows ectothrix and endothrix spores in the affected hair. Mycological cultures of several hairs and pus reveal only Microsporum canis. O n histology an acanthotic epidermis and a dense inflammatory infiltrate is seen in the entire upper dermis with destruction of most hairfollicles. Some follicles are preserved and show PAS positive spores around the hairshaft. </p><p>Treatment and evolution </p><p>The patient ist treated with 200 mg ketoconazole daily. Rapid clinical improvement is noticed within 2 weeks. However, repeated cultures yield Microsporum canis during the first month of treatment. Later, the cultures stay sterile. </p><p>Keywords: Tinea capitis, Microsporum canis, Ketoconazole </p><p>mykosen 23, Heft 11 (1980) </p></li><li><p>608 E. van Hecke and L. Meysman </p><p>When the patient is seen after five months of treatment, a slightly red, atrophic and bald patch is the only remaining feature. </p><p>Discussion </p><p>Microsporum canis infection of the scalp is almost exclusively seen in prepubertal children. Invasion of hair by Microsporum canis in adolescents is infrequent and in adults even exceptional. Gauvain (1949) reports a case in a 73 year old lady. Pipkin (1 952) recovers 6 cases in a survey over the United States. All are women and 3 are over 60 years old. Gentles and OSullivan (1957) find one case, a man of 33 years old, in a survey of West Scotland. </p><p>Two possible reasons can be pointed out in the development of a Microsporum canis infection in our patient. Old age could be responsible for a decrease of the fungicidal properties of the sebum, possibly induced by an imbalance in hormonal production. Another explanation could be found in a lowered resistance due to the development of the epithelioma in the gingival mucosa and the treatment by radiotherapy. The case has an important therapeutic connotation. Indeed, while no influence on the lesions was seen after s i x weeks griseofulvin, a quick therapeutic respons followed ketoconazole therapy. </p><p>References </p><p>Gauvain, E. A. (1949): Tmea capitis in an adult (Microsporon lanosum). Archives Derm. Syph. 60, 860. Gentles, J. C., &amp; J. G. Sullivan (1957): Correlation of human and animal ringworm in West of Scotland. </p><p>Pipkin, J . L. (1952): Tinea capitis in the adult and adolescent. Archives Derm. Syph. 66, 940. Brit. Med. J. 11, 678-682. </p><p>Anschrift: Dr. E. Van Hecke und L. Meysman, Department of Dermatology, University of Ghent, Belgium. </p><p>20 Jahre Deutschsprachige Mykologische </p><p>Gesellschaft </p><p>16. Wissenschaftliche Tagung 1.J. Mai 1981 in Erlangen </p><p>Auskunft: Priv.-Doz. Dr. med. H. Hauck, Dermatologische Universitatsklinik der Friedrich- Alexander- Universitat, HartmannstraDe 14,8520 ErlangeqTel. 0 91 31/85 38 29 </p><p>mykosen 23, Heft 11 (1980) </p></li></ul>