Tinea capitis et barbae caused by Trichophyton tonsurans: A retrospective cohort study of an infection chain after shavings in barber shops

Mycoses. 2021 Apr;64(4):428-436. doi: 10.1111/myc.13231. Epub 2020 Dec 28.

Abstract

Background: Tinea capitis is a highly contagious infectious disease caused by dermatophytes. In Central Europe, it is mainly caused by zoophilic dermatophytes, as, for example Microsporum (M) canis or Trichophyton (T) mentagrophytes and increasingly by anthropophilic fungi. T tonsurans was commonly related to the Tinea gladiatorum, where transmission occurred between infected persons or via contaminated floors.

Objective: Reporting the transmission of this highly contagious dermatophyte for the first time via beard shaving and hairdressing in barber shops in Germany.

Patients and methods: 18 young male patients developed tinea capitis and/or barbae shortly after shavings of the beard and/or hair in a barber shop. Native, cultural and molecular diagnostics as well as tissue biopsies and resistance tests were performed of skin and hair samples.

Results: In all samples, T tonsurans could be identified. The medical history and the clinical picture suggest a transmission through contaminated hairdressing tools. The patients were treated with terbinafine or itraconazole in combination with or exclusively with topical antimycotics.

Conclusion: The transmission and a resulting increase in the incidence of infections with T tonsurans may be due to shavings with direct skin contact of insufficiently disinfected hairdressing tools. This path of infection has already been observed in Africa and is now being described for the first time in Germany. Knowledge of the pathogen and its transmission ways are essential to interrupt the chain of infection.

Keywords: barber shop; dermatophyte carriage; dermatophytosis; infection chain; tinea barbae; tinea capitis.

MeSH terms

  • Adolescent
  • Antifungal Agents / therapeutic use
  • Barbering*
  • Chain of Infection*
  • Child
  • Child, Preschool
  • Floors and Floorcoverings*
  • Germany
  • Hair / microbiology
  • Humans
  • Incidence
  • Male
  • Retrospective Studies
  • Skin / microbiology
  • Skin / pathology
  • Tinea / drug therapy
  • Tinea / microbiology
  • Tinea / transmission*
  • Trichophyton / drug effects
  • Trichophyton / genetics
  • Trichophyton / pathogenicity*
  • Young Adult

Substances

  • Antifungal Agents