It sounds ancient, old, from another era, but ringworm, a scalp infection caused by a fungus, has never gone away. “It is a prevalent infection, especially in developing countries”, advances Jorge Romani, a dermatologist at the Hospital de Granollers (Barcelona). It has always been there and, although it is more common in the child population —it can be contracted by contact with a pet, such as a hamster or a rabbit—, for a couple of years it has begun to run in more youthful environments. An investigation by Spanish dermatologists has collected an outbreak associated with hairdressers, with more than a hundred cases among adolescents who cut their hair by fading and shaving.
The suspicion began a couple of years ago, in groups of dermatologists who realized that they shared a common patient pattern. “We had been observing scalp infections in adolescents with the habit of going to hairdressers to shave. But they were only specific observations and we decided to collect cases to define the clinical pattern, the causative fungus and the pattern to recognize it, because sometimes it can look like dandruff or eczema”, explains Romani, co-author of the study, which is pending publication. in the magazine Dermo-Syphiliographic Acts and of which the Spanish Academy of Dermatology and Venereology reported yesterday in a press release, although it has not allowed access to the document until it is published. In total, a group of dermatologists from all over Spain collected 107 cases with the epidemiological suspicion that they had been contracted in hairdressers. It is only “the tip of the iceberg”, says Romani.
Ringworm of the scalp (or tinea capitis) is, to the naked eye, a kind of skin rash: the lesion is usually round, with an area of flaking, dry, like dandruff, which can also itch. The infection is treated with oral antifungals, but the treatment is long, from several weeks (up to three months) and, if it is not detected early, there is a risk that the disease will progress and, in addition to causing pain and fever, it can lead to destruction of the hair and that areas with permanent alopecia remain.
After analyzing the hundred cases reported in Spain, the researchers revealed that the fungus that caused most of the cases was a usual suspect: the Trychophyton tonsurans, the microorganism responsible for most tinea capitis. It can be transmitted from person to person by very direct contact or by contact with surfaces or utensils that may contain spores of the fungus. “The dermatophytes [como el Trychophyton tonsurans] they feed on skin and if they have no way to invade it, they die. But the spores can persist for days. Our epidemiological suspicion is that the outbreak occurred in hairdressers due to poor hygiene habits. [con los utensilios empleados]but we don’t know for sure. This will depend on the investigation of the public health services”, says Romani.
Of the 107 reported cases, 106 are men. These are adolescents with lesions in the neck area, “which is precisely where shaving is most hasty,” adds the dermatologist. Specialists associate this increase in cases with a youthful fashion for hairstyles whose maintenance requires going to the hairdresser very frequently to get a haircut.
The doctor also points out that, among the cases studied, a long diagnostic delay has been detected and, in some cases, the lesions have spread to other parts of the neck and even to the face. Although most of the cases, he qualifies, were limited to local lesions and were resolved satisfactorily with antifungal treatment. “20% of the ringworms had a lot of inflammation, probably because, as it contracts with an irritation mechanism, [el rasurado ya es una agresion sobre la piel que favorece la penetracion de las esporas]it already produces more inflammation ”, adds Romani.
It is not the first time that cases of ringworm associated with hairdressers have been reported. A German study reported 18 cases linked to barbershops in 2020. The clinical history and clinical picture suggested transmission through contaminated hairdressing utensils. “Shaving with a high potential for microtrauma could serve as an entrance for the pathogen and, if the equipment is contaminated, could lead to a higher incidence of tinea capitis or barbae,” the German researchers noted.
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Source: EL PAIS