Scalp ringworm epidemic in Birmingham: a decline?

Sir, The anthropophilic dermatophyte fungus Trichophyton tonsurans has emerged in recent years as the commonest cause of tinea capitis in Britain's inner cities.1–4 We previously documented a dramatic increase in the annual number of new cases of T. tonsurans scalp infection seen at Birmingham Children's Hospital from 1 in 1991 to 32 in 1995.2 The median age was 5.5 years and almost all the children were of Afro‐Caribbean descent. The clinical presentation was highly variable, the diagnosis frequently unsuspected by the general practitioner (GP) and more than half the patients self‐referred to hospital.2 We have conducted a further retrospective study to see if this increase in frequency has been maintained. Laboratory records were reviewed to identify all patients under 16 years with tinea capitis from whom a dermatophyte was cultured between January 1996 and December 1998. One‐hundred and eleven further cases of T. tonsurans tinea capitis presented during this period.