Clinical, Dermoscopic, and Mycological Characteristics of Tinea Capitis in Children

September 1, 2026 updated by: Walaa Hemdan Aboelhasan, Sohag University

Clinical, Dermoscopic, and Mycological Characteristics of Tinea Capitis in Children: A Cross-sectional Study

Tinea capitis is a common dermatophyte infection of the scalp in children aged 0-9 years .The prevalence of tinea capitis in Egypt is 0.4% and higher in public than private schools, Boys were more affected than girls according to children by 5:1 ratio , It is more prevalent in those who live in urban areas, large families, low socioeconomic level, crowded living conditions and immunocompromised people . Tinea capitis is caused by dermatophyte fungi Trichophyton and Microsporum genera. These fungi are classified as: anthropophilic, zoophilic, and geophilic according to the route of infection. These fungi invade the hair shaft in two routes: ectothrix and endothrix . T.tonsurans and T.violaceum are reported to be the most common cause of tinea capitis

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Clinical types of tinea capitis include : scaly type (characterized by fine scaling and circular alopecia), black dot (characterized by non-inflammatory patches with broken-off, swollen hair stubs), tinea agminate (patchy alopecia with scattered pustules or low-grade folliculitis), kerion (painful, boggy, inflammatory masses with alopecia, often confused with bacterial abscess) and favus (scutula, mousy odor) . Tinea incognito (steroid modified tinea) refers to dermatophytosis that has lost their usual clinical appearance due to the use of steroids.

The main clinical feature of dermatophyte scalp infections is the appearance of scaling of the scalp skin, which is associated with a variable degree of inflammation and itching . In some cases, the infection closely resembles seborrheic dermatitis or dandruff of the scalp. A pathognomonic feature is hair loss; hair often breaks a few millimeters or more above the skin surface. Broken or infected hairs are also slightly swollen and have a dull appearance .

Trichoscopy is a non-invasive and very useful technique for the diagnosis and follow-up of hair and scalp disorders. The presence of certain trichoscopic features allows accurate identifying of tinea capitis. In tinea capitis, specific signs can be seen like comma hair, corkscrew hair, bar code-like hair and zigzag hair . In tinea incognito trichoscopic finding include erythema, scaling, bent hair, Morse code hair, and micropustules .

Mycological examination was first performed using Potassium Hydroxide(KOH) to confirm the diagnosis of tinea capitis where the patients with positive KOH were considered to have endothrix when observing arthroconidia inside the hair shaft and ectothrix when observing arthroconidia outside the hair shaft. The fungal culture also done to accurately recognize the organism through inoculation of samples on Sabouraud medium agar (SDA) with and without chloramphenicol(nonspecific medium) . And Dermasel medium agar act as specific medium.

The increase in antifungal resistance has recently been observed worldwide and resistant strains of the dermatophytes T. rubrum and T. indotineae have spread globally, causing outbreaks of extensive, difficult to treat infections , so we need rapid and reliable diagnostic tools that provide clues regarding the causative organisms.

Study Type

Observational

Enrollment (Estimated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Walaa Hemdan Abu Alhassan, Demonstrator

Study Locations

  • Egypt
      • Sohag, Egypt
        • Faculty of Medicine , Sohag university
        • Contact:
        • Contact:
          • Walaa Hemdan

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study will be conducted at the Dermatology Outpatient Clinic in Sohag University Hospitals.

Study population: The study population will be all patients with tinea capitis both male and female in childhood period, Aged 1-18 years old

Description

Inclusion Criteria:

- Both male and female in childhood period (1-18 years) with tinea capitis

Exclusion Criteria:

  • Topical or systemic antifungal medications one month prior to enrollment in the study
  • Presence of systemic disease, such as hepatic,renal, cardiac, autoimmune diseases, or malignancy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
patients with tinea capitis both male and female in childhood period
Diagnostic test: Dermoscopic examination: the findings are divided into pathognomic and non-specific signs
  1. Pathognomic signs: comma hairs, corkscrew hairs, Morse code like hairs and zig-zag hairs.
  2. Non-specific signs: black dots, broken hairs, perifollicular scaling and inter follicular erythema
Diagnostic test: Direct Microscopy (KOH) examination
  1. Suspected lesions will be swabbed with 70% ethyl alcohol then scalp scraping using the blunt edge of a sterile surgical blade
  2. Skin scales and crusts will be collected from the erythematous, peripheral, actively expanding edges of the lesions onto clean glass slides by scraping the inflamed lesions the scales will contain infected stumps of hair
  3. Hair will be removed with the root intact (hair cutting will be avoided)
  4. Specimen will be prepared by mounting the sample in (10-30%) of potassium hydroxide with 40% Dimethyle sulphoxide (DMSO) drops on the petri slide to soften the tissue, allowing a thin layer of cells to form.
Diagnostic test: Fungal culture:
Specimen will be cultured on sabouraud's dextrose agar (SDA) at 25 -30 c for 2 to 4 weeks and another specimen will be cultured on a Dermasel agar base (Oxoid, UK), both supplemented with chloramphenicol and cycloheximide , staining the fungal colonies by Lactophenol cotton blue to help the examination of colonial morphology and microscopic examination of the macro-conidia allow the identification of the dermatophyte species and suitable treatment
Diagnostic test: Antifungal sensitivity:
Antifungal susceptibility testing will be performed to determine the specific sensitivity profiles of the fungal isolates. Antifungal susceptibility testing will be performed using seven antifungal agents: Terbinafine, Itraconazole, Griseofulvin, Fluconazole, Ketoconazole, Vorioconole and Miconazole. Dermatophytes colonies will be probed from Dermasel agar cultures.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of participants presenting with specific clinical patterns of tinea capitis
Time Frame: At the time of initial clinical evaluation
Clinical evaluation will be performed to identify and classify the presentation of tinea capitis lesions (e.g., scaly patches, black dots, kerion, favus).
At the time of initial clinical evaluation
Percentage of participants exhibiting specific dermoscopic features of tinea capitis
Time Frame: At the time of initial dermoscopic evaluation
Dermoscopic examination using a handheld dermatoscope to identify characteristic signs including comma hairs, corkscrew hairs, broken hairs, and scaling.
At the time of initial dermoscopic evaluation
Prevalence of isolated fungal species among pediatric tinea capitis cases
Time Frame: At the time of initial sample collection and culture identification
Mycological evaluation including direct microscopic KOH preparation and fungal culture on agar media to isolate and identify the causative fungal pathogens.
At the time of initial sample collection and culture identification

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sohag University

Investigators

  • Study Chair: Mohammed Abu El Hamd Ali, Faculty of Medicine , Sohag university
  • Study Chair: Doaa Gaber Abdelbaset, Faculty of Medicine , Sohag university

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 20, 2026

Primary Completion (Estimated)

November 20, 2026

Study Completion (Estimated)

August 20, 2027

Study Registration Dates

First Submitted

August 28, 2026

First Submitted That Met QC Criteria

September 1, 2026

First Posted (Actual)

September 3, 2026

Study Record Updates

Last Update Posted (Actual)

September 3, 2026

Last Update Submitted That Met QC Criteria

September 1, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Soh-Med-26-8-10MS

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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