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A single-centre, retrospective cohort study of paediatric tinea capitis in the United Kingdom
Elliot Herd1, Louis Gardner2, Suzy Leech2
1School of Medicine, Newcastle University, Newcastle upon Tyne, UK.
Background:
Contemporary understanding of the epidemiology and clinical spectrum of paediatric tinea capitis in the UK is limited, with implications for both clinical management and public health interventions.
Objectives:
To examine recent trends in the incidence, clinical presentation and microbiological profiles of paediatric tinea capitis, and to explore the implications for quality of care and infection prevention.
Methods:
A single-centre retrospective cohort study was conducted of all patients aged < 18 years with microbiologically confirmed tinea capitis during two 3-year intervals: 2016-19 and 2022-25. Clinical records were reviewed for demographic features, clinical presentation, organisms identified and transmission sources, with a focus on practice standards and preventive strategies influencing quality of care.
Results:
A total of 102 patients were identified: 32 from 2016-19 and 70 from 2022-25, representing a 118.8% increase in cases. Severe inflammatory presentations (kerion) rose from 19% (n = 6/32) in 2016-19 to 36% (n = 25/70) in 2022-25. Trichophyton tonsurans remained the predominant organism in both cohorts (72% vs. 74% of cultured organisms), but Trichophyton mentagrophytes newly emerged as the second most common pathogen (9% in 2022-25), having been absent in 2016-19. Barber-associated transmission was only reported in 2022-25 (n = 22), exclusively among relatively older boys, who also had a higher rate of kerion (41%). A shift in preferred oral antifungal therapy from griseofulvin to terbinafine was observed with the changing microbiological profile.
Conclusions:
Our findings demonstrate a significant rise in paediatric tinea capitis, with a disproportionate increase in inflammatory cases and a shift in causative organisms. The emergence of barber-associated transmission and T. mentagrophytes highlights evolving risk factors and the need to adapt practice standards and preventive measures to influence quality of care. Enhanced surveillance targeted educational interventions for practitioners and public, and routine practice measures to moni-tor infection sources are warranted to improve the quality of care and patient outcomes.