Tinea Capitis and Down Syndrome: A Multi-Center Retrospective Cohort Study

Area of Science:

• Dermatology
• Pediatrics
• Infectious Diseases

Background:

• Tinea capitis is a common fungal infection in children.
• Limited data exists on tinea capitis in children with Down syndrome (DS).
• This study compares tinea capitis presentation and treatment in children with and without DS.

Purpose of the Study:

• To describe and compare clinical presentation, mycological findings, and treatment response of tinea capitis in children with and without Down syndrome (DS).

Main Methods:

• Retrospective cohort study of 1320 pediatric tinea capitis cases (112 with DS) across three Jordanian dermatology centers (2015-2024).
• Multivariate regression and time-to-event analyses compared clinical symptoms, causative dermatophytes, and treatment outcomes between groups.
• Data included demographics, clinical signs, fungal species, treatment regimens, and resolution times.

Main Results:

• Children with DS had a higher incidence of inflammatory tinea capitis, particularly kerion (42.9% vs. 18.5%).
• Trichophyton violaceum was more prevalent in children with DS (58.9% vs. 42.1%), while Microsporum canis was less frequent (13.4% vs. 25.6%).
• Clinical cure rates at 8 weeks were lower in children with DS (61.6% vs. 78.9%), with a longer median resolution time (10.4 vs. 7.3 weeks). DS was an independent predictor of treatment failure and recurrence.

Conclusions:

• Tinea capitis in children with Down syndrome presents with increased inflammation and distinct mycological characteristics.
• Children with DS exhibit poorer treatment response and higher recurrence rates for tinea capitis.
• Findings aid healthcare providers in optimizing management of tinea capitis in pediatric patients with DS.