الفهرس 
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Abstract
Summary
Introduction:
Tinea capitis is a common, benign, superficial fungl infection of hair follicles and hair shafts. It is more common in children and caused by dermatophyte.
The species of dermatophytes causing tinea capitis vary from country to another.
Dermatophytes causing Tinea capitis belonging to two asexual genera: Microsporum, Trichophyton .They can also classified according to mode of transmission to anthropophilic, zoophilic and geophilic
Recently, the predominant organisms are T.tonsurans which spreads directly or indirectly. M.canis zoophilic dermatophyte, is responsible for most cases of tinea capitis in children. Infection may occur by direct contact with infected person, animals or with their hair.
The prevalence of tinea capitis is closely related to socioeconomic status and life style, age, sex, life style and contact with animals.
Tinea capitis has decreased in developed countries, while it presents a high prevalence in developing countries especially school children.
The incidence declines with the onset of puberty and seborrhea.
Studies show that Tinea capitis is generally more common in boys
There are 4 types of hair invasion with distinctive patterns of spores:
Small-spored ectothrix hair invasion:
It is caused by M.audouinii, M.canis and M.gypseum.
Large-spored ectothrix:
It is caused by T.verrucosum, T.mentagrophytes and T.rubrum
Endothrix hair invasion:
It is caused by T.violaceum, T.rubrum and others.
Favus type: It is caused by T. schöenleinii.
The clinical appearance of T.capitis is ranging and variable so it may be misdiagnosed. There are 4 common clinical types:
1-Kerion (It is a painful, inflammatory mass, follicles may be seen discharging pus, and mycetoma like grains may be found).
2-Favus:( It is characterized by the presence of yellowish cup-shaped crusts known as scutula). Both types end in cicatricial alopecia. 3-Black-dot: the affected hair breaks at the surface of the scalp. 4- Scaly: patches of partial alopecia with lots of fine scales. The diagnosis usually can be made with a focused history, physical examination, and potassium hydroxide microscopy. Occasionally, Wood’s lamp examination, fungal culture, is required.
Treatment includes topical and systemic antifungals. Currently only a single agent, griseofulvin, is approved by the U.S. Food and Drug Administration
Adjunctive topical antifungal therapy, such as shampoos containing selenium sulfide, or ketoconazole by the patient and family members. The patient should also avoid sharing combs or caps with other people to avoid spreding of infection.
Antifungal resistance continues to grow and complicate patient management, despite the introduction of new antifungal agents. In vitro susceptibility testing is often used to select agents suitable to infection but its most important use is to detect resistance. Objectives: study the prevalance of different strains of tinea capitis and Its response to different antifungal agents among patients attending Beni-suef university hospital.
Subjects and Methods:
Type of study:
The study is a cross-sectional with descriptive and analytical design.
Study site:
This study was conducted in Beni Suef University Hospital for patients attending the Dermatology Clinic.
Administrative procedures:
Approvals were taken to collect data from the chosen patients.
Study population and sample:
100 Patients were chosen to represent urban and rural districts and both genders.
Study tools:
Microbiological samples were obtained from each patient with T.capitis and transferred to the microbiology laboratory.
The microorganisms were isolated and identified by routine microbiological methods and in vitro antifungal susceptibility was done
Results and discussion:
We found that M.canis is the most common strain (64.1%) followed by T.mentagrophytes (16.3%), T.rubra (7.6%), M.gypsie (6.5%), M.audonii (5.4%)
As regards in vitro susceptibility testing against evolved strains we found that Terbinafine is the most effective (76.1%) followed by Clotrimazole (68.5%),Griseofulvin(65.2%),Itraconazole (54.3%) ,Miconazole (50%), Ketoconazole (48.9%), Fluconazole (40.2%), Capsofungin (34.8%),Posafungin(20.7%).