Tinea capitis in children in Northern Taiwan: An update from 2020 to 2024

Abstract Background: Tinea capitis is the most common fungal infection in children. The prevalent pathogen differs by region and shifts over time. Objectives: To investigate the current epidemiological, clinical, and mycological characteristics of tinea capitis in children in northern Taiwan. Methods: Children with tinea capitis treated at Linkou Chang Gung Memorial Hospital between January 2020 and August 2024 were retrospectively identified from the database of the Research Laboratory of Medical Mycology. Inclusion required compatible clinical features with either culture-proven scalp infection or microscopic evidence of true hair invasion. Results: Sixty-eight children with tinea capitis were enrolled. The average age was 6.0 ± 3.5 years, and most patients were female. Microsporum canis was the most common pathogen. Clinical features included hair loss, scales, and pustules. Major risk factors were animal contact and family history. Treatments included griseofulvin, terbinafine, multiple systemic antifungals, topical therapy alone, or no treatment. Overall and mycological cure rates were 100% and 44.1%, respectively. Conclusion: Tinea capitis among children in northern Taiwan was characterized by frequent isolation of zoophilic M. canis and a history of animal contact. Intrafamilial transmission of M. canis was also observed in patients without animal contact. We reported a waiting time from clinical cure to confirmed mycological cure of 4.1 ± 1.3 weeks, highlighted the presence of two asymptomatic carriers, and underscored the gap between overall and mycological cure rates. The carrier state may allow ongoing transmission and relapse, underscoring the need for follow-up mycological tests and, when indicated, prolonged antifungal therapy.