Original article
Outbreak of Dermatophyte Infections on the Head and Neck Related to Shave Haircuts: Description of a Multicenter Case Series
Brote de dermatofitosis en región de cabeza y cuello asociadas al rasurado en peluquerías: estudio descriptivo multicéntrico de una serie de casos
L. Bascóna, J.I. Galvañb, I. López-Riquelmec, P.J. Navarro-Guillamónd, J.M. Moróne, J.A. Llamasc, M. Ballesterosf, A. Tejera-Vaquerizog, A.G. Anguloh, A. Guilaberta, J. Romanía,
, on behalf of the study group TCP (Tinea Capitis in Hairdressing) ◊
Corresponding author
a Hospital General de Granollers, Granollers, Barcelona, Spain
b Práctica Privada, Málaga, Spain
c Hospital Regional Universitario de Málaga, Málaga, Spain
d Hospital Universitario Virgen de la Victoria, Málaga, Spain
e Hospital Nuestra Señora de Valme, Sevilla, Spain
f Hospital Clínico Universitario de Valencia, Valencia, España
g Instituto Dermatológico Globalderma, Palma del Río, Córdoba, España
h Serveis Mèdics Penedés, Barcelona, España
Read
3821
Timeswas read the article
1020
Total PDF
2801
Total HTML
Share statistics
array:24 [ "pii" => "S0001731023002934" "issn" => "00017310" "doi" => "10.1016/j.ad.2023.04.014" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "3455" "copyright" => "AEDV" "copyrightAnyo" => "2023" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2023;114:T371-T376" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0001731023001539" "issn" => "00017310" "doi" => "10.1016/j.ad.2023.02.004" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "3399" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2023;114:377-81" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Contact Allergy to Shellac. Retrospective Cross-Sectional Study With Data From the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy (REIDAC)" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:3 [ 0 => "en" 1 => "en" 2 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "377" "paginaFinal" => "381" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Alergia de contacto a shellac. Estudio transversal retrospectivo con datos del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea (REIDAC)" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0005" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 701 "Ancho" => 1333 "Tamanyo" => 54046 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. Mercader-García, I. Ruiz-Gonzalez, R. Gonzalez-Perez, T. Sanz-Sanchez, J. Sanchez-Pérez, L. Borrego" "autores" => array:7 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Mercader-García" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Ruiz-Gonzalez" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Gonzalez-Perez" ] 3 => array:2 [ "nombre" => "T." "apellidos" => "Sanz-Sanchez" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Sanchez-Pérez" ] 5 => array:2 [ "nombre" => "L." "apellidos" => "Borrego" ] 6 => array:1 [ "colaborador" => "on behalf of the REIDAC" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0005"></elsevierMultimedia></p></span>" ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023001539?idApp=UINPBA000044" "url" => "/00017310/0000011400000005/v2_202306061222/S0001731023001539/v2_202306061222/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S000173102300090X" "issn" => "00017310" "doi" => "10.1016/j.ad.2023.02.001" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "3389" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2023;114:371-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Brote de dermatofitosis en región de cabeza y cuello asociadas al rasurado en peluquerías: estudio descriptivo multicéntrico de una serie de casos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:3 [ 0 => "es" 1 => "es" 2 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "371" "paginaFinal" => "376" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Outbreak of Dermatophyte Infections on the Head and Neck Related to Shave Haircuts: Description of a Multicenter Case Series" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0030" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 475 "Ancho" => 1333 "Tamanyo" => 103710 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Bascón, J.I. Galvañ, I. López-Riquelme, P.J. Navarro-Guillamón, J.M. Morón, J.A. Llamas, M. Ballesteros, A. Tejera-Vaquerizo, A.G. Angulo, A. Guilabert, J. Romaní" "autores" => array:12 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Bascón" ] 1 => array:2 [ "nombre" => "J.I." "apellidos" => "Galvañ" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "López-Riquelme" ] 3 => array:2 [ "nombre" => "P.J." "apellidos" => "Navarro-Guillamón" ] 4 => array:2 [ "nombre" => "J.M." "apellidos" => "Morón" ] 5 => array:2 [ "nombre" => "J.A." "apellidos" => "Llamas" ] 6 => array:2 [ "nombre" => "M." "apellidos" => "Ballesteros" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Tejera-Vaquerizo" ] 8 => array:2 [ "nombre" => "A.G." "apellidos" => "Angulo" ] 9 => array:2 [ "nombre" => "A." "apellidos" => "Guilabert" ] 10 => array:2 [ "nombre" => "J." "apellidos" => "Romaní" ] 11 => array:1 [ "colaborador" => "en representación del grupo de estudio TCP (Tinea Capitis en Peluquería)" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0030"></elsevierMultimedia></p></span>" ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173102300090X?idApp=UINPBA000044" "url" => "/00017310/0000011400000005/v2_202306061222/S000173102300090X/v2_202306061222/es/main.assets" ] "asociados" => array:1 [ 0 => array:18 [ "pii" => "S000173102300090X" "issn" => "00017310" "doi" => "10.1016/j.ad.2023.02.001" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "3389" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2023;114:371-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Brote de dermatofitosis en región de cabeza y cuello asociadas al rasurado en peluquerías: estudio descriptivo multicéntrico de una serie de casos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:3 [ 0 => "es" 1 => "es" 2 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "371" "paginaFinal" => "376" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Outbreak of Dermatophyte Infections on the Head and Neck Related to Shave Haircuts: Description of a Multicenter Case Series" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0030" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 475 "Ancho" => 1333 "Tamanyo" => 103710 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Bascón, J.I. Galvañ, I. López-Riquelme, P.J. Navarro-Guillamón, J.M. Morón, J.A. Llamas, M. Ballesteros, A. Tejera-Vaquerizo, A.G. Angulo, A. Guilabert, J. Romaní" "autores" => array:12 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Bascón" ] 1 => array:2 [ "nombre" => "J.I." "apellidos" => "Galvañ" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "López-Riquelme" ] 3 => array:2 [ "nombre" => "P.J." "apellidos" => "Navarro-Guillamón" ] 4 => array:2 [ "nombre" => "J.M." "apellidos" => "Morón" ] 5 => array:2 [ "nombre" => "J.A." "apellidos" => "Llamas" ] 6 => array:2 [ "nombre" => "M." "apellidos" => "Ballesteros" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Tejera-Vaquerizo" ] 8 => array:2 [ "nombre" => "A.G." "apellidos" => "Angulo" ] 9 => array:2 [ "nombre" => "A." "apellidos" => "Guilabert" ] 10 => array:2 [ "nombre" => "J." "apellidos" => "Romaní" ] 11 => array:1 [ "colaborador" => "en representación del grupo de estudio TCP (Tinea Capitis en Peluquería)" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0030"></elsevierMultimedia></p></span>" ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173102300090X?idApp=UINPBA000044" "url" => "/00017310/0000011400000005/v2_202306061222/S000173102300090X/v2_202306061222/es/main.assets" ] ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => " Outbreak of Dermatophyte Infections on the Head and Neck Related to Shave Haircuts: Description of a Multicenter Case Series" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "T371" "paginaFinal" => "T376" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L. Bascón, J.I. Galvañ, I. López-Riquelme, P.J. Navarro-Guillamón, J.M. Morón, J.A. Llamas, M. Ballesteros, A. Tejera-Vaquerizo, A.G. Angulo, A. Guilabert, J. Romaní" "autores" => array:12 [ 0 => array:3 [ "nombre" => "L." "apellidos" => "Bascón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "J.I." "apellidos" => "Galvañ" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "I." "apellidos" => "López-Riquelme" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "P.J." "apellidos" => "Navarro-Guillamón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "J.M." "apellidos" => "Morón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 5 => array:3 [ "nombre" => "J.A." "apellidos" => "Llamas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 6 => array:3 [ "nombre" => "M." "apellidos" => "Ballesteros" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 7 => array:3 [ "nombre" => "A." "apellidos" => "Tejera-Vaquerizo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] 8 => array:3 [ "nombre" => "A.G." "apellidos" => "Angulo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">h</span>" "identificador" => "aff0040" ] ] ] 9 => array:3 [ "nombre" => "A." "apellidos" => "Guilabert" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 10 => array:4 [ "nombre" => "J." "apellidos" => "Romaní" "email" => array:1 [ 0 => "xurxoromani@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 11 => array:2 [ "colaborador" => "on behalf of the study group TCP (Tinea Capitis in Hairdressing)" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">◊</span>" "identificador" => "fn0005" ] ] ] ] "afiliaciones" => array:8 [ 0 => array:3 [ "entidad" => "Hospital General de Granollers, Granollers, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Práctica Privada, Málaga, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital Regional Universitario de Málaga, Málaga, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Hospital Universitario Virgen de la Victoria, Málaga, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Hospital Nuestra Señora de Valme, Sevilla, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Hospital Clínico Universitario de Valencia, Valencia, España" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Instituto Dermatológico Globalderma, Palma del Río, Córdoba, España" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Serveis Mèdics Penedés, Barcelona, España" "etiqueta" => "h" "identificador" => "aff0040" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Brote de dermatofitosis en región de cabeza y cuello asociadas al rasurado en peluquerías: estudio descriptivo multicéntrico de una serie de casos" ] ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0030" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 475 "Ancho" => 1333 "Tamanyo" => 91754 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Ringworm of the scalp, or tinea capitis, is a highly infectious disease that mainly affects children between 6 months and 12 years of age,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> with a slight predominance in boys.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">2</span></a> Depending on the route of transmission of the causative fungus of tinea capitis, we can distinguish 3 types of dermatophyte<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">3</span></a>: anthropophilic (including <span class="elsevierStyleItalic">Trichophyton tonsurans</span>, <span class="elsevierStyleItalic">Trichophyton</span><span class="elsevierStyleItalic">rubrum, Trichophyton interdigitale</span>, <span class="elsevierStyleItalic">Trichophyton violaceum</span>, and <span class="elsevierStyleItalic">Microsporum audouinii</span>), which generally cause noninflammatory clinical forms; zoophilic (mainly <span class="elsevierStyleItalic">Trichophyton mentagrophytes</span>, <span class="elsevierStyleItalic">Trichophyton verrucosum</span>, and <span class="elsevierStyleItalic">Microsporum canis</span>), which usually cause inflammatory forms, and geophilic (<span class="elsevierStyleItalic">Microsporum gypseum</span>), causing moderate inflammation.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The pathogens responsible for tinea capitis vary over time and by geographic region studied. During 19th century and through to the middle of the 20th century, the dominant pathogen in Europe and the United States was the anthropophilic <span class="elsevierStyleItalic">Microsporum audouinii</span>,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> endemic in Africa,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a> followed by the zoophilic <span class="elsevierStyleItalic">M. canis.</span><a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a> The use of griseofulvin, along with campaigns to identify and treat infection led to an increase in the prevalence of anthropophilic fungi from the middle of the 20th century, with less infections showing fewer clinical symptoms. Such fungi include <span class="elsevierStyleItalic">T. tonsurans</span>, which was endemic originally in Southeast Asia and Australia, before spreading to Central and South America, and from there to Europe and the United States.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> Currently, in the United States, this fungus is responsible for more than 90% of cases of tinea capitis, with a predilection for people of African origin, with <span class="elsevierStyleItalic">M. canis</span> being the second most common causative agent.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In urban areas in Europe, the most common causative agents of tinea capitis are the anthropophilic species (in countries such as Spain, Belgium, or Poland), whereas other areas still have a predominance of zoophilic species, particularly <span class="elsevierStyleItalic">M. canis</span> (in countries such as Greece or Germany).<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a> Other studies, such as the one conducted in 2016 in Würzburg, Germany,<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">9</span></a> showed that although <span class="elsevierStyleItalic">M. canis</span> remained the most frequent causative agent of ringworm of the scalp in that region, other anthropophilic fungi were gaining ground, most notably <span class="elsevierStyleItalic">T. interdigitale</span>.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Among the studies that report a high current prevalence of <span class="elsevierStyleItalic">T. tonsurans</span> in European countries and the Mediterranean basin, there are some conducted in Israel,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> and one published by Müller et al.,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> in which 18 young males had tinea capitis or tinea barbae caused by this dermatophyte up to 2 weeks after having had their haircut. We have also observed an increase in cases of ringworm caused by <span class="elsevierStyleItalic">T. tonsurans</span> in different parts of Spain in adolescent patients in our clinical practice since 2001. This apparent grouping of cases in time coincides with a new fashion among young Spaniards of shaving their head in the occipital and temporal area every week or twice a month. In light of this clinical observation, we decided to perform a study at the national level to analyze a series of cases of ringworm of the scalp associated with this new social trend.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patients and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This was an observational, retrospective, multicenter study of cases of dermatophyte infections of the head after a shave haircut at the hairdressers. The study was approved by the Ethics Committee for Drug Research of the Hospital General in Granollers (Barcelona, Spain) (number 2022.042). The cases were reported by dermatologists belonging to the Spanish Academy for Dermatology and Venereology during December 2022, after a call for participation via Dermachat.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">10</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The inclusion criteria were microbiological confirmation by direct examination with KOH and/or culture, performed by obtaining sample by skin scraping in the dermatology clinic, and receipt of a shave haircut in a public hairdresser in the 2 weeks prior to the first visit to the clinic. Cases were identified from January 1, 2021, through December 31, 2022.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The variables collected were age, sex, site of initial lesion (back of the head/occipital, temporal/retroauricular, preauricular, facial, and others), spread to other areas, inflammatory versus noninflammatory ringworm, availability of direct examination and/or culture and corresponding result, accompanying clinical symptoms (swollen lymph nodes, fever, pain, others), prior treatments, treatments prescribed, and presence of subsequent indirect contagion.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">Of the 883 dermatologists contacted, 44 responded and provided data on cases. In total, 107 patients were included, 106 of whom were male. The mean age of the patients was 19 years (range 5–40 years). The initial site, with more than one possible at the same time, was back of the head/occipital in 90 cases (84%), temporal/retroauricular in 17 cases (15.8%), facial in 4 (3.7%), periauricular in 2 (1.8%), back in 1 (1%), and not specified in 2 (1.8%) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a). In the majority of cases (65 [60.7%]), infection had not spread to other areas; when it had, the most affected areas are those shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Inflammatory forms were reported in 29 patients (21.1%) compared with 78 (72.9%) that were not inflammatory. The most frequently reported causative agent in the series was <span class="elsevierStyleItalic">T. tonsurans</span>, with 81 confirmed cases (75.7%), followed by <span class="elsevierStyleItalic">T. rubrum</span>, <span class="elsevierStyleItalic">T. mentagrophytes</span> and <span class="elsevierStyleItalic">T. verrucosum</span>, <span class="elsevierStyleItalic">M. canis</span>, and <span class="elsevierStyleItalic">M. audouinii</span> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Of the total 81 cases of ringworm caused by <span class="elsevierStyleItalic">T. tonsurans</span>, 22 (27.1%) were inflammatory. Of the total 29 cases of inflammatory ringworm, 21 (72.4%) were caused by <span class="elsevierStyleItalic">T. tonsurans</span>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Culture was not done in 8 cases (7.4%), while 5 (47%) yielded a negative result. The most common accompanying clinical symptoms were swollen lymph nodes in 25 cases (23.3%), fever in 5 (4.6%), and pain 2 (1.8%). In 16 cases (15%), subsequent indirect contagion to family members or partners of the index cases was reported.</p><p id="par0055" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a> show different images of the inflammatory and noninflammatory forms reported in the present study. <a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a> shows typical trichoscopic findings of black dots and corkscrew hair, indicative of noninflammatory forms. <a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>a shows typical trichophytic patterns on direct examination with KOH, and <a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>b an image of an isolate of <span class="elsevierStyleItalic">T. tonsurans</span>.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The most widely used treatment was oral terbinafine (250<span class="elsevierStyleHsp" style=""></span>mg/d) in 92 cases (86%), with a median duration of 2 months (range 1–3 months). Griseofulvin was used in 8 patients (7.4%) and 23 patients (21.4%) also received topical treatment in addition to systemic treatment. Response to treatment was favorable, with complete cure in all cases without any reports of relapse.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Fifty-two patients had not received any prior treatment; 17 (15.8%) had applied topical corticosteroids, either on their own initiative or following prescription by the primary care physician, 16 (15%) applied topical antifungal agents, and 5 (5.6%) took systemic antibiotics. There was a relationship between inflammatory forms and previous corticosteroids use.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">The present study is the most extensive one of cases of ringworm of the scalp associated with a visit to the hairdressers published to date. The design was retrospective and with a limited number of participating dermatologists. Its objective was not to obtain an estimate of the total number of cases in Spain nor the geographic distribution but rather provide a sufficiently representative sample of cases to define the clinical pattern, etiology, and response to treatment. The outbreak affects almost exclusively young males who frequently shave the back of the head and temporal area in hairdressers, often every week or twice a month, generally on Fridays, to prepare for going out on the weekend. This fashion seems to be a response to the haircuts of certain footballers, Tiktokers, or DJs.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">11</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">The observation that supports this practice as the cause of the outbreak is the area of the body where the initial lesion appears, which coincides with the most closely shaved hair, and therefore, the greatest contact between the razor and skin. We observed a frequent delay in diagnosis, as well as application of ineffective treatments, including topical corticosteroids, which may lead to rapid dissemination of fungal infection to other areas.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The most frequently isolated agent was <span class="elsevierStyleItalic">T. tonsurans</span>, in line with the increasing incidence of this dermatophyte infection in Europe.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> The cause of the increase in prevalence of ringworm of the scalp due to <span class="elsevierStyleItalic">T. tonsurans</span> has not yet been determined. One reason could be that griseofulvin, the only systemic antimycotic agent approved in children, is not as effective as terbinafine in the treatment of trichophyton infection, such as that caused by <span class="elsevierStyleItalic">T. tonsurans</span>. As a result, inappropriate therapy could lead to spread of infection. Only around half of all mycoses caused by <span class="elsevierStyleItalic">T. tonsurans</span> have been successfully treated by applying griseofluvin, as terbinafine would be the treatment of choice. In those caused by <span class="elsevierStyleItalic">T. tonsurans</span> and <span class="elsevierStyleItalic">T. schoenleinii</span>, much longer courses of treatment may be needed and, at times, with full doses (20<span class="elsevierStyleHsp" style=""></span>mg/kg/d) of griseofulvin.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Although noninflammatory ringworm predominates, as expected when <span class="elsevierStyleItalic">T. tonsurans</span> is the causative agent, more than one fourth of ringworm infections caused by <span class="elsevierStyleItalic">T. tonsurans</span> in our series were inflammatory, a significant number and in line with that reported for the German outbreak.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> One possible explanation would that microtraumas during shaving could be associated with more extensive invasion, and therefore, a greater host immune response.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Detailed medical history usually provides important information on the possible origin of the disease in those outbreaks transmitted by contaminated hairdressing utensils. To interrupt the chain of infection, mycological study is urgently indicated for contacts of the index case, as well as antimycotic therapy for asymptomatic carriers of the fungus, who would need to be identified by microbiological tests. In addition, appropriate and constant hygiene measures should be taken with the hairdressing utensils of common use in accordance with the current guidelines that indicate that parts in contact with the skin should be disposable or sterilized in an autoclave.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">12</span></a> Spores from dermatophytes can persist on inanimate objects (including brushes, towels, cushions, and electric razors). There have even been reports of asymptomatic carriers who have spores in the scalp and who do not develop the disease, but they can transmit the pathogen. In fact, <span class="elsevierStyleItalic">T. tonsurans</span> is the dermatophyte species associated with asymptomatic carriers.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">13</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">In conclusion, the present study describes an emerging epidemiologic situation for which a deeper understanding is necessary with future studies that include information on patients and their contacts, hairdressers, and their hygiene habits, as well as field studies with mycological cultures of material from shaving, and other pertinent actions, in particular, public health education. The high number of cases supposedly transmitted by hairdressing utensils should be taken into account by the corresponding public health bodies, who need to ensure compliance with the established guidelines for disinfection.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1908366" "titulo" => "Graphical abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:3 [ "identificador" => "xres1908365" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0015" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] 2 => array:2 [ "identificador" => "xpalclavsec1648592" "titulo" => "Keywords" ] 3 => array:3 [ "identificador" => "xres1908364" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Conclusiones" ] ] ] 4 => array:2 [ "identificador" => "xpalclavsec1648591" "titulo" => "Palabras clave" ] 5 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 6 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and methods" ] 7 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 8 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-01-17" "fechaAceptado" => "2023-02-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1648592" "palabras" => array:5 [ 0 => "<span class="elsevierStyleItalic">Tinea capitis</span>" 1 => "<span class="elsevierStyleItalic">Trichophyton tonsurans</span>" 2 => "Outbreak" 3 => "Hairdresser" 4 => "Shaving" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1648591" "palabras" => array:5 [ 0 => "<span class="elsevierStyleItalic">Tinea capitis</span>" 1 => "<span class="elsevierStyleItalic">Trichophyton tonsurans</span>" 2 => "Brote" 3 => "Peluquerías" 4 => "Rasurado" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Since 2021, an increase in cases of <span class="elsevierStyleItalic">tinea capitis</span> has been detected in adolescents who shave their hair with fade haircut.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Patients and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Multicenter retrospective observational study of cases of cephalic pole dermatophytosis with a history of having been acquired after frequent shaving in hairdressing. A call was made to dermatologists from the Spanish Academy of Dermatology and Venereology (AEDV) to provide cases observed between January 2021 and December 2022. Patients with microbiological confirmation by culture or direct examination with KOH were included.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">107 cases were collected, 106 of which were male. 78 non-inflammatory forms were observed, compared to 29 inflammatory. The most frequently isolated fungus was <span class="elsevierStyleItalic">Trichophyton tonsurans</span> (75.7% of cases). The lesions appeared predominantly on the nape of the neck and temporal area.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The distribution by sex, age and lesional location seems to indicate that a new social trend, in which male adolescents regularly go to hairdressers to shave the occipital and temporal areas, would be the cause of this grouping of cases of ringworm of the scalp. The most frequent microorganism in our study (<span class="elsevierStyleItalic">T. tonsurans</span>) coincides with the most prevalent in our environment. This study shows an accumulation of cases that can be taken into account by competent Public Health agencies, which are responsible for ensuring compliance with the rules of disinfection of the material used for shaving.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0015" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducción</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Desde 2021 se ha detectado un aumento de casos de tiñas del cuero cabelludo en adolescentes que se cortan el pelo mediante rasurado o degradado.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Pacientes y métodos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional retrospectivo multicéntrico de casos de dermatofitosis del polo cefálico con el antecedente de haber sido contraídas tras el rasurado frecuente en peluquería. Se realizó una llamada a dermatólogos de la Academia Española de Dermatología y Venereología (AEDV) para que aportaran casos observados entre enero de 2021 y diciembre de 2022. Se incluyeron pacientes con confirmación microbiológica mediante cultivo o examen directo con KOH.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se recogieron 107 casos, siendo 106 pacientes varones. Se observaron 78 formas no inflamatorias frente a 29 inflamatorias. El hongo aislado con mayor frecuencia fue <span class="elsevierStyleItalic">Trichophyton tonsurans</span> (75,7% de los casos). Las lesiones aparecieron predominantemente en la nuca y en el área temporal.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La distribución por sexo, edad y localización lesional parece apuntar a que una nueva tendencia social, en la que adolescentes varones acuden asiduamente a peluquerías para el afeitado de las zonas occipital y temporal, sería la causante de esta agrupación de casos de tiña del cuero cabelludo. El microorganismo más frecuente en nuestro estudio <span class="elsevierStyleItalic">(T.</span><span class="elsevierStyleItalic">tonsurans)</span> coincide con el más prevalente en nuestro medio. Con el presente estudio se evidencia un acúmulo de casos susceptible de ser tenido en cuenta por organismos competentes de salud pública, a los cuales corresponde velar por el cumplimiento de las normas de desinfección del material empleado para el rasurado.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "◊" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Members of the TCP (Tinea Capitis in Hairdressing) study group present themselves at the <a class="elsevierStyleCrossRef" href="#sec0030">Annex 1</a>.</p>" "identificador" => "fn0005" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0105" class="elsevierStylePara elsevierViewall">Vicent Alonso, Salomé Álvarez, Asunción Arregui, Belén Civico, Víctor Dios, Patricia Eguino, Andrea Estébanez, Vicente Expósito, Santiago Férnández de Piérola, Patricia Garbayo, Elisabeth Gómez, M. Rosario González-Hermosa, José Herrerías, Helena Iznardo, Ane Jaka, Mar Llamas, Irene López, Miren Marquina, Júlia Mercader, Joan F. Mir, Juan A. Moreno, Juan M. Morón, Carolina Ortuño, Nasser Porras, Liliana Randazzo, Amparo Sánchez, Júlia Sánchez-Schmidt, Jesús Tercedor, Tomás Toledo, Anna Tuneu, Pedro Vilas, Susana Vildósola, Jorge Adsuar.</p>" "etiqueta" => "Annex" "titulo" => "Remaining members of the TPC (Tinea capitis in hairdressers)" "identificador" => "sec0030" ] ] ] ] "multimedia" => array:7 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 936 "Ancho" => 2337 "Tamanyo" => 118870 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">(A) Initial site of lesions of tinea capitis recorded in the present study, marked with red dots. Note the predominance of areas that are shaved (back of the head and temporal area). (B) Spread to other sites in the present series, marked with blue dots.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 713 "Ancho" => 2009 "Tamanyo" => 200188 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">(A, B) Noninflammatory forms. (C) Spread to areas away from the initial site.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1024 "Ancho" => 2341 "Tamanyo" => 350956 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Inflammatory forms.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 503 "Ancho" => 752 "Tamanyo" => 58438 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Trichoscopic image of corkscrew hairs, typical of black dot ringworm caused by <span class="elsevierStyleItalic">T. tonsurans</span>.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 969 "Ancho" => 2337 "Tamanyo" => 304560 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">(A) Parasitization in the KOH examination. (B) Septate hyphae and arthroconidia in the KOH examination. (C) Isolate of <span class="elsevierStyleItalic">T. tonsurans</span> in glycosylated Sabouraud agar with actidione.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sex \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male 106 (99.06%)Female 1 (0.9%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.93 years \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Site of initial lesion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Back of the head/occipital 90 (84%)Temporal–retroauricular 17 (15.8%)Facial 4 (3.7%)Back 3 (2.8%)Preauricular 2 (1.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Spread to other areas \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No 65 (60.7%)Yes 42 (39.3%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inflammatory/noninflammatory ringworm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Noninflammatory 78 (72.9%)Inflammatory 29 (27.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Direct vision \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Positive 57 (53.2%)No done 46 (42.9%)Negative 4 (3.7%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Culture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">T. tonsurans</span> 81 (75.7%)<span class="elsevierStyleItalic">T. rubrum</span> 2 (1.9%)<span class="elsevierStyleItalic">T. mentagrophytes</span> 2 (1.8%)<span class="elsevierStyleItalic">T. verrucosum</span> 2 (1.9%)<span class="elsevierStyleItalic">M. canis</span> 1 (0.9%)<span class="elsevierStyleItalic">M. audiouinii</span> 1 (0.9%)Not done 8 (7.4%)Negative 5 (4.7%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Accompanying symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">None 75 (77.3%)Swollen lymph nodes 25 (23.3%)Fever 5 (4.6%)Pain 2 (1.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prior treatments (yes/no) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No 52 (48.5%)Not reported 38 (35.5%)Yes 17 (15.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Treatment prescribed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Terbinafine 92 (86%)Griseofulvin 8 (7.4%)Not reported 7 (6.5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Subsequent indirect infection (yes/no) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No 91 (85%)Yes 16 (15%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3185355.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Results.</p>" ] ] 6 => array:5 [ "identificador" => "fig0030" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 475 "Ancho" => 1333 "Tamanyo" => 91754 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib0070" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Tinea capitis</span>: current status" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.J. Hay" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11046-016-0058-8" "Revista" => array:6 [ "tituloSerie" => "Mycopathologia" "fecha" => "2017" "volumen" => "182" "paginaInicial" => "87" "paginaFinal" => "93" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27599708" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0075" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiologic trends in pediatric <span class="elsevierStyleItalic">Tinea capitis</span>: a population-based study from Kaiser Permanente Northern California" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Mirmirani" 1 => "L.Y. Tucker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2013.08.031" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2013" "volumen" => "69" "paginaInicial" => "916" "paginaFinal" => "921" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24094452" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0080" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermatología" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.L. Bolognia" 1 => "J.V. Schaffer" 2 => "L. Cerroni" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "4th ed." "fecha" => "2018" "editorial" => "Elsevier" "editorialLocalizacion" => "Philadelphia" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0085" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical clues and trends in epidemiology and pathogens in paediatric <span class="elsevierStyleItalic">Tinea capitis</span>: a retrospective cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Friedland" 1 => "S. Reiss-Huss" 2 => "F. Sabbah" 3 => "D. Ben Amitai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ced.14831" "Revista" => array:5 [ "tituloSerie" => "Clin Exp Dermatol" "fecha" => "2022" "volumen" => "47" "paginaInicial" => "50" "paginaFinal" => "56" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0090" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "<span class="elsevierStyleItalic">Microsporum audouinii</span>: re-emergence of ringworm due to the dermatophyte" "tituloTraducido" => "<span class="elsevierStyleItalic">Microsporum audouinii</span>: un dermatofito causante de una tiña reemergente" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Lozano-Masdemont" 1 => "B. Carrasco-Fernández" 2 => "I. Polimón-Olabarrieta" 3 => "M.T. Durán-Valle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2018.11.008" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr (Engl Ed)" "fecha" => "2019" "volumen" => "110" "paginaInicial" => "785" "paginaFinal" => "787" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31153545" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0095" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pediatric <span class="elsevierStyleItalic">Tinea capitis</span> caused by <span class="elsevierStyleItalic">Trichophyton violaceum</span> and <span class="elsevierStyleItalic">Trichophyton soudanense</span> in Rochester, Minnesota, United States" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.V. Grigoryan" 1 => "M.M. Tollefson" 2 => "M.A. Olson" 3 => "C.C. Newman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ijd.14352" "Revista" => array:7 [ "tituloSerie" => "Int J Dermatol" "fecha" => "2019" "volumen" => "58" "paginaInicial" => "912" "paginaFinal" => "915" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30548845" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0090825811006998" "estado" => "S300" "issn" => "00908258" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0100" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Tinea capitis</span> et barbae caused by <span class="elsevierStyleItalic">Trichophyton tonsurans</span>: a retrospective cohort study of an infection chain after shavings in barber shops" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V.L. Müller" 1 => "K. Kappa-Markovi" 2 => "J. Hyun" 3 => "D. Georgas" 4 => "G. Silberfarb" 5 => "U. Paasch" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/myc.13231" "Revista" => array:7 [ "tituloSerie" => "Mycoses" "fecha" => "2021" "volumen" => "64" "paginaInicial" => "428" "paginaFinal" => "436" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33341968" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1470204503010878" "estado" => "S300" "issn" => "14702045" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0105" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of dermatomycoses and onychomycoses in Ireland (2001–2020): a single-institution review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Powell" 1 => "E. Porter" 2 => "S. Field" 3 => "N.H. O’Connell" 4 => "K. Carty" 5 => "C.P. Dunne" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/myc.13473" "Revista" => array:6 [ "tituloSerie" => "Mycoses" "fecha" => "2022" "volumen" => "65" "paginaInicial" => "770" "paginaFinal" => "779" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35598177" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0110" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Tinea capitis</span>: temporal shift in pathogens and epidemiology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W. Ziegler" 1 => "S. Lempert" 2 => "M. Goebeler" 3 => "A. Kolb-Mäurer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ddg.12885" "Revista" => array:7 [ "tituloSerie" => "J Dtsch Dermatol Ges" "fecha" => "2016" "volumen" => "14" "paginaInicial" => "818" "paginaFinal" => "825" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27509419" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0090825819311850" "estado" => "S300" "issn" => "00908258" ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0115" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congreso virtual de dermatología realizado a través de Telegram® durante el confinamiento de la COVID-19: organización y evaluación" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Martín-Gorgojo" 1 => "J. Bernabeu-Wittel" 2 => "M. Linares-Barrios" 3 => "F. Russo-de la Torre" 4 => "I. García-Doval" 5 => "E. Del Río-de la Torre" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2020.08.009" "Revista" => array:7 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2020" "volumen" => "111" "paginaInicial" => "852" "paginaFinal" => "860" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32946805" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0090825814010774" "estado" => "S300" "issn" => "00908258" ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0120" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "La nueva costumbre masculina: retoque cada viernes por la tarde en la barbería. <span class="elsevierStyleItalic">El País</span>, edición nacional, 2022. Available from: <a target="_blank" href="https://elpais.com/espana/madrid/2022-09-04/viernes-tarde-hora-punta-en-la-barberia.html">https://elpais.com/espana/madrid/2022-09-04/viernes-tarde-hora-punta-en-la-barberia.html</a> [consulted 11.1.23]." ] ] ] 11 => array:3 [ "identificador" => "bib0125" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ordenanza Reguladora de las Condiciones Higiénico Sanitarias y Técnicas de Peluquerías, Institutos de Belleza y otros Servicios de Estética. BO Comunidad de Madrid, 2000. Available from: <a target="_blank" href="https://sede.madrid.es/portal/site/tramites/menuitem.5dd4485239c96e10f7a72106a8a409a0/?vgnextoid=c2e49d2e3fd4f010VgnVCM1000009b25680aRCRD%26vgnextchannel=b49ca38813180210VgnVCM100000c90da8c0RCRD%26vgnextfmt=pda">https://sede.madrid.es/portal/site/tramites/menuitem.5dd4485239c96e10f7a72106a8a409a0/?vgnextoid=c2e49d2e3fd4f010VgnVCM1000009b25680aRCRD&vgnextchannel=b49ca38813180210VgnVCM100000c90da8c0RCRD&vgnextfmt=pda</a> [consulted 11.1.23]." ] ] ] 12 => array:3 [ "identificador" => "bib0130" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clonal outbreak of <span class="elsevierStyleItalic">Trichophyton tonsurans</span> tinea capitis gladiatorum among wrestlers in Adana, Turkey" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Ilkit" 1 => "M. Ali Saracli" 2 => "H. Kurdak" 3 => "A. Turac-Bicer" 4 => "T. Yuksel" 5 => "M. Karakas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/13693780903278051" "Revista" => array:6 [ "tituloSerie" => "Med Mycol" "fecha" => "2010" "volumen" => "48" "paginaInicial" => "480" "paginaFinal" => "485" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19824879" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00017310/0000011400000005/v2_202306061222/S0001731023002934/v2_202306061222/en/main.assets" "Apartado" => array:4 [ "identificador" => "6163" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011400000005/v2_202306061222/S0001731023002934/v2_202306061222/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023002934?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 16 | 14 | 30 |
| 2024 October | 138 | 81 | 219 |
| 2024 September | 187 | 43 | 230 |
| 2024 August | 175 | 97 | 272 |
| 2024 July | 133 | 78 | 211 |
| 2024 June | 145 | 81 | 226 |
| 2024 May | 113 | 47 | 160 |
| 2024 April | 90 | 30 | 120 |
| 2024 March | 85 | 52 | 137 |
| 2024 February | 74 | 47 | 121 |
| 2024 January | 141 | 30 | 171 |
| 2023 December | 162 | 21 | 183 |
| 2023 November | 142 | 41 | 183 |
| 2023 October | 232 | 54 | 286 |
| 2023 September | 145 | 49 | 194 |
| 2023 August | 149 | 28 | 177 |
| 2023 July | 206 | 68 | 274 |
| 2023 June | 161 | 59 | 220 |
| 2023 May | 230 | 57 | 287 |
| 2023 April | 77 | 43 | 120 |
Show all
