Tinea Capitis in Adults: An 18-Year Epidemiological, Clinical, and Mycological Study in Korea

The study, conducted from June 2000 to June 2017, retrospectively evaluated 82 adults among 185 patients with tinea capitis, a dermatophyte infection of the scalp hair. The mean age of patients was 66.9 years, with a female predominance. The average duration from disease onset to mycological diagnosis was 22.5 weeks, and the misdiagnosis rate through only clinical examination was 65.9%. Most patients had an underlying chronic systemic illness (74.4%). The most common clinical subtype was diffuse pustular (26.8%), and 56.1% of patients showed localized or diffuse alopecia. Microsporum canis was the most common causative organism. Treatment with systemic and/or topical antifungal agents, oral corticosteroid, and antifungal shampoo led to complete resolution in 93.9% of patients, but 9.1% showed recurrence. The study concluded that the atypical presentation of tinea capitis in adults may lead to misdiagnosis or delayed diagnosis, emphasizing the need for a high index of suspicion and mycological examination in adults with inflammatory scalp conditions.