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KMID : 0378019800230040062
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New Medical Journal
1980 Volume.23 No. 4 p.62 ~ p.72
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A Mycological and Immunological Survey for Tinea Capitis in Kyungki Prcovince
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Abstract
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Since 1978, the number of patients with tip_ea capitis have increased in the out-patient dermatology clinic of Korea University Hospital Iocated in Segal. Before 1978, patients with ringworm of the scalp were scarcely seen in the clinic.
This study was planned to investigate the causes of the increased incidence of tinea capitis clinically, mycologically and immunologically.
To obtain the clinical and mycological findings, the survey included the school children from the inland areas and island areas of Kyungki province which surrounds Seoul, as well as the out-patients in the clinic. The immunological data were obtained from the school children who had lived in a dormitory (Group 1) and the out-patients in the clinic (Group 2). Controls of Group 1 were the school children who had lived together with the patients with tinea capitis, but without history of the disease. Controls of Group 2 were the patients without the infection of dermatophytes and atopic diseases. The mycological studies were performed by means of KGH mount and culture. To investigate the immunological status of the patients and control groups immediate and delayed reactions to intradermally administered trichophytin and microsporin antigens were studied.
The results were as follows:
1. Clinical findings
a. The morbidity and ratio of male to female were 1.48% and 2 to I respectively among the children at the inland school of Kyungki province.
b. The percentage of incidence was 2.51 and ratio of male to female was equal among the school children of an ordinary school in the island areas of Kyungki province. Among the boarding school children morbidity was 29.28%. All these patients were male.
c. The incidence of tinea capitis was 0.24% among total 7, 986 out-patients. Patio; of male to female patients was 1.7 to I.
d. With comparison of previous reports, morbidity seemed to be increased in Kyungkiprovince and Seoul. Recently the ratio of male to female was decreasing to become almost equal. Kerions were more frequent in Seoul area than Kyungki province.
2. Mycological findings
a. The strains isolated from the patients of the inland areas totaled 4 species and 10 strains. These included T. ferrugineum 5, T. mentagrophytes 2, M. canis 2 and M. gypseum 1.
b. 35 strains were isolated from the patients of the island areas totaling 3 species, namely T. ferrugineum 27, T. mentagrophytes 6, and M. canis 2.
c. 15 strains, including 4 species, were cultured from patients in the out-patient clinic. They included M. canis 12, M. gypseum 1, T. ferrugineum 1 and T. mentagrophytes 1.
d. T. ferrugineum was the most frequent causative agent of tinea capitis in Kyungki province and M. canis was the most frequent causative agent in Seoul area.
3. Immunological findings
a. Immediate reactions with trichophytin and microsporin were not reliable enough to diagnose the disease and to measure the immune status of the patients and the control groups, because of the different sensitivity to various fungal species and individual responses.
b. The frequency of positive delayed reaction among the children with tinea capitis from the boarding school was lower than the frequency of the control group who had lived with the patients without occurrence of the disese. Thus cell-mediated immunity seemed to have some effect in prevension of infection in the control group. .
c. The frequency of positive delayed reaction among the out-patients with tinea capitis in Seoul was higher than the fregency in the control group.
d. The frequency of positive delayed reaction in the patients with inflammatory tinea capitis was higher than the frequency in the patients with non-inflammatory tinea capitis. This suggested that the inflammatory reaction of kerions was related to cell-mediated immunity.
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