Tinea capitis in Cleveland: survey of elementary school students.
BACKGROUND
Tinea capitis, a fungal infection of the scalp, is of increasing public health importance, and Trichophyton tonsurans has become the primary causative agent in North America.


OBJECTIVE
To determine the prevalence of dermatophyte-positive scalp cultures among elementary schoolchildren in Cleveland, Ohio, describe predisposing factors, and measure the antifungal susceptibility of isolates collected.


METHODS
A total of 937 children from 8 Cleveland elementary schools were cultured for the presence of dermatophytes; 122 children (13%), all of whom were African American, had dermatophyte-positive cultures of the scalp. Sixty percent of cases were asymptomatic, indicating a carrier state. Race, scaling, and the use of anti-dandruff shampoo were associated with increased likelihood of infection. T tonsurans was the only organism isolated (except 1 Microsporum canis isolate). All isolates were susceptible to fluconazole, griseofulvin, itraconazole, and terbinafine.


CONCLUSIONS
T tonsurans was the predominant dermatophyte isolated. Further multicenter studies are needed to confirm the predominance of dermatophyte-positive scalp cultures among African American children and to determine modifiable and preventable risk factors.
Ghannoum
M
M
Center for Medical Mycology and Mycology Reference Laboratory, Department of Dermatology, University Hospitals of Cleveland and Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106-5028, USA. MAG3@PO.CWRU.edu
Isham
N
N
Hajjeh
R
R
Cano
M
M
Al-Hasawi
F
F
Yearick
D
D
Warner
J
J
Long
L
L
Jessup
C
C
Elewski
B
B
D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009820:Ohio / Q000453:epidemiology; D015995:Prevalence; D014006:Tinea Capitis / Q000188:drug therapy / Q000453:epidemiology*