Tinea capitis in Kwa-Zulu Natal, South Africa

Tinea capitis is the most common dermatophyte infection in children. The hair involvement can be classified as endothrix, ectothrix, or favus, and the clinical appearance is variable. The goal of this study was to determine the demography, etiology, and clinical patterns of tinea capitis in South Africa. A prospective, cross-sectional study was conducted over a 1-year period. All cases were classified clinically and subject to Wood light examination, microscopy, and culture. One hundred patients were studied. The male:female ratio was 1.4:1. The mean age was 4.6 years (range 1-11 years). Trichophyton violaceum was isolated in 90% of positive cultures. Wood light was positive in one patient with Microsporum gypseum. The most common clinical variety was the "black dot" type, seen in 50% of patients. Twenty percent of the children presented with more than one clinical type simultaneously. We concluded that the most common cause of tinea capitis in South Africa is T. violaceum. The presentation is variable.