title: Aspergillus niger - a possible new etiopathogenic agent in Tinea capitis? Presentation of two cases.
abstract: Tinea capitis is generally considered as the most frequent fungal infection in childhood, as it accounts for approximately 92% of all mycosis in children. The epidemiology of this disease varies widely ranging from antropophillic, zoophilic, and geophillic dermatophytes, as the main causative agent in different geographic areas, depending on several additional factors. Nowadays, the etiology is considered to vary with age, as well with gender, and general health condition. The former reported extraordinary Tinea capitis case reports have been replaced by original articles and researches dealing with progressively changing patterns in etiology and clinical manifestation of the disease. This fact is indicative that under the umbrella of the well-known disease there are facts still hidden for future revelations. Herein, we present two rare cases of Tinea capitis in children, which totally differ from the recently established pattern, in their clinical presentation, as well as in the etiological aspect, as we discuss this potential new etiological pattern of the disease, focusing on our retrospective and clinical observation. Collected data suggest that pathogenic molds should be considered as a potential source of infection in some geographic regions, which require total rationalization of the former therapeutic conception, regarding the molds' higher antimitotic resistance compared to dermatophytes. Molds-induced Tinea capitis should be also considered in clinically resistant and atypical cases, with further investigations of the antifungal susceptibility of the newest pathogens in the frame of the old disease. Further investigations are still needed to confirm or reject this proposal.
authors.affiliation: Department of Dermatology and Venereology, Medical University of Plovdiv, Plovdiv, Bulgaria. Electronic address: assia_chokoeva@abv.bg.
authors.forename: Anastasiya Atanasova
authors.initials: AA
authors.lastname: Chokoeva
authors.affiliation: Department of Dermatology and Venereology, Medical University of Plovdiv, Plovdiv, Bulgaria.
authors.forename: Liliya
authors.initials: L
authors.lastname: Zisova
authors.affiliation: University Clinic of Dermatology and Venereology, University Hospital "St. George", Medical University of Plovdiv, Plovdiv, Bulgaria.
authors.forename: Kristina
authors.initials: K
authors.lastname: Chorleva
authors.affiliation: Polyclinic for Dermatology and Venereology, University Hospital "Lozenez", Sofia, Bulgaria.
authors.forename: Georgi
authors.initials: G
authors.lastname: Tchernev
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy; D001234:Aspergillus niger / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012535:Scalp / Q000382:microbiology; D014006:Tinea Capitis / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000935:Antifungal Agents
keywords: Children; Etiology; Molds; Tinea capitis