Tinea capitis in adults: A 14-year retrospective study in central Tunisia

Tinea capitis (TC) is a common fungal infection predominantly affecting school-aged children while being rare among adults. Few studies, particularly in Tunisia, have specifically focused on TC in adults. This retrospective study aimed to assess the epidemiological and mycological profile of adult TC in central Tunisia (North Africa).

A retrospective study of adult TC cases diagnosed at the Farhat Hached University Hospital of Sousse, in Tunisia, has been carried out over a 14-year period (2009-2022). Diagnosis was based on clinical presentation and mycological culture. Of 3711 patients examined, 41 adult patients (24 women and 17 men) were diagnosed with TC. The mean age was 43 years old. Ten patients had a history of corticosteroid therapy. Physical examination revealed associated tinea corporis in 6 cases (14.6 %), onychomycosis in 10 cases (24 %) and both those conditions concomitantly in one patient (2.4 %). Direct examination was positive in 97.5 % of cases. The most prevalent species of dermatophyte were Trichophyton violaceum (46 %) and Microsporum canis (34 %). In the majority of cases, the course of treatment was favorable.

We highlight TC as an uncommon condition in adults, with a higher prevalence observed in women, particularly postmenopausal women. Adult TC, though uncommon, should be considered in differential diagnoses for scalp lesions in elderly patients due to potential atypical presentations. Trichophyton violaceum is the most frequent species in central Tunisia. Accurate mycological diagnosis and identification of contributing factors remain crucial.