Tinea capitis in adults: misdiagnosis or reappearance?

Background: According to the literature, tinea capitis in adults is supposed to be rare; we have recently observed a significant increase in cases.

Methods: Epidemiological, clinical and mycological features were studied in all adult tinea capitis diagnosed over 1 year in our department.

Results: Eight cases were observed: 75% of them were women, 50% never traveled and 62.5% had an underlying immunosuppressive disease. Scalp scaling and alopecia were the most frequent clinical features. A zoophilic dermatophyte was recovered in 50% of cases.

Conclusion: These cases represent 11% of all tinea capitis observed in the same period of time (higher than the 3-5% observed in the literature). Secretion of sebum and colonization by Pityrosporon orbiculare are supported to protect the scalp against dermatophytic invasion after puberty, but an immune defect may also facilitate hair invasion. The erroneous notion of the disease being uncommon and the frequent atypical clinical presentation require a high degree of clinical suspicion.