Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Tinea”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2005

Prevalence and risk factors for tinea pedis in Israeli soldiers.

BACKGROUND: Tinea pedis is a common infection in soldiers. However, prevalence and risk factors for tinea pedis in soldiers were investigated in only a few studies. OBJECTIVES: To investigate the prevalence and risk factors for tinea pedis in Israeli soldiers. METHODS: A cross-sectional study including interviews, clinical skin examination and mycological tests was performed in Israeli soldiers. The presence of tinea pedis was assessed using the Athlete's Foot Severity Index (AFSI), a scoring system that was developed in order to evaluate the presence and severity of tinea pedis. In soldiers with clinical evidence of tinea pedis (AFSI > 1), scrapings were taken for direct microscopic examination (20% KOH preparation) and fungal culture. Statistical analyses were performed using chi-square or Fisher's exact test for dichotomous variables (as needed), or t-tests for continuous variables. Logistic regression was used for multivariate analyses of dichotomous variables. RESULTS: Two hundred and twenty-three soldiers were included in the study: 205 men (91.9%) and 18 women (8.1%). Mean age was 19.6 years (SD 1.0 year). Clinical point prevalence was 60.1%. Mycological point prevalence was 27.3%. Further analyses were performed using the clinical point prevalence. Univariate analyses demonstrated that the prevalence of tinea pedis varied with the setting of military training (basic training: 70.3%, advanced infantry training: 81.5%, armor commander training: 56.4% and armor officer training: 34.8%) and was associated with male gender, frequency of sock changes and the length of military service. A multivariate analysis demonstrated that tinea pedis was associated with the setting of the military training (OR 1.6, 95% CI 1.2-2.1) and male gender (OR 4.3, 95% CI 1.4-13.8); however, there was no association with hygiene measures (e.g. frequency of changing socks or sleeping with socks) or the length of military service. CONCLUSION: Tinea pedis is highly prevalent in Israeli soldiers. Association of tinea pedis with the setting of military training suggests that contagious spread may be an important risk factor. We suggest that environmental interventions should be planned to in order to decrease the morbidity of tinea pedis among soldiers.

Adult↗
PubMed2000

Tinea corporis gladiatorum: a cross-sectional study.

BACKGROUND: Tinea corporis gladiatorum has been an infrequently reported condition in the dermatological literature. Two previous reports have investigated wrestlers during recognized epidemics of tinea corporis gladiatorum, but no study has examined wrestlers to determine the point prevalence of tinea corporis gladiatorum in a team without a known epidemic. Furthermore, no comparative study exists. OBJECTIVE: The purpose of this article is to determine the prevalence of tinea corporis gladiatorum in high school wrestlers in comparison with high school indoor track athletes. METHODS: Members of both the high school wrestling and indoor track teams were examined for the presence of tinea corporis. Students with clinical lesions of tinea corporis were evaluated with potassium hydroxide examination. The prevalence of tinea corporis in each group was compared. RESULTS: Seven of the 29 high school wrestlers (24%) had lesions of tinea corporis. No members of the track team had evidence of tinea corporis. There was a statistical difference between the two groups (P =.005). CONCLUSION: Tinea corporis gladiatorum can be found quite frequently among high school wrestlers. Because infection with dermatophytes can disqualify a wrestler from competing in matches, vigilant surveillance and rapid initiation of therapy can reduce the suspension of a team's practice and competition.

Adolescent↗
PubMed2000

Tinea capitis.

Tinea capitis is a common dermatophyte infection of the scalp in children. Dermatophytes are classified into three genera; tinea capitis is caused predominantly by Trichophyton or Microsporum species. On the basis of host preference and natural habitat, dermatophytes are also classified as anthropophilic, geophilic and zoophilic. The etiological agents of tinea capitis usually fall in the first and last categories. In North America, tinea capitis is now predominantly due to Trichophyton tonsurans. During the past 100 years the most common North American organism for tinea capitis was initially Microsporum canis followed later by M. audouinii. In other parts of the world the epidemiology varies. Tinea capitis is generally observed in children over the age of 6 years and before puberty, with African Americans being the most affected group. Clinical presentations are seborrheic-like scale, 'black dot' pattern, inflammatory tinea capitis with kerion and tiny pustules in the scalp. The clinical diagnosis should be confirmed by mycological examination. Wood's light examination was of value in diagnosing tinea capitis due to M. canis and M. audouinii; however, it is not helpful in T. tonsurans tinea capitis. Asymptomatic carriers may be a significant reservoir of infection and spread of spores may also involve inanimate objects. Carriers may benefit from shampooing their hair. Treatment of tinea capitis requires an oral antifungal agent. The data from the use of terbinafine, itraconazole and fluconazole are promising and suggest that these agents have an efficacy similar to griseofulvin while shortening the duration of therapy. Both griseofulvin and the newer antimycotics have a favorable adverse-effect profile and are associated with high compliance.

Antifungal Agents↗
PubMed2000

Tinea gladiatorum: wrestling's emerging foe.

Tinea corporis, or ringworm, has become a common nuisance in competitive wrestling. Although it is a fairly benign infectious skin disease, it has significant effects on the ability of a wrestler to compete because of infection control issues. Very little has been published in the medical literature describing this problem. The majority of the literature has described outbreaks in an isolated group of wrestlers. One must examine ringworm infections in wrestlers as an entity distinct from tinea corporis infections typically seen in the paediatric population, thus the term 'tinea gladiatorum'. Tinea gladiatorum outbreaks have been caused by the dermatophyte, Trichophyton tonsurans. The epidemiology and microbiology point to person-to-person contact as the main source of transmission in wrestlers. The clinical features of tinea gladiatorum may or may not be consistent with those found in the general population. Ancillary tests, including potassium hydroxide preparations and fungal cultures may have to be done to confirm the diagnosis. Treatment guidelines for tinea corporis have failed to produce the desired goals in this particular population. More research studying different treatment regimens in the wrestling environment is needed to define the optimal treatment to return wrestlers to competition quickly without putting other wrestlers at risk for infection. Intuitive hygiene practices have been suggested to prevent spread of the infection, but they have not been substantiated. Anecdotal reports suggest that hygiene practices fall short of producing adequate primary or secondary prevention. Pharmaceutical prophylaxis has been effective, but universal drug prophylaxis carries risks including drug adverse effects and potential drug resistance. The role of potential asymptomatic carriers of dermatophytes has yet to be elucidated in the origin and/or perpetuation of tinea gladiatorum outbreaks. There are many unanswered questions about tinea gladiatorum. Sports medicine professionals must work to define this entity more completely before making recommendations about treatment, prevention and infection control. The ultimate goal is the eradication of tinea infections from the wrestling world. Energy should be focused on primary and secondary prevention, as well as treatment. Without a thorough knowledge of tinea gladiatorum as a distinct disease entity, wrestling has been losing its battle with this formidable opponent.

Humans↗
PubMed2003

Difficulties in diagnosing and treating tinea in adults at the Department of Dermatology in Bialystok (Poland).

In the years 1981-2000, the department of dermatology at the Medical University of Bialystok, Poland, carried out a retrospective study of common difficulties in the diagnosis and treatment of tinea. The aim of this study was to assess the incidence of incorrect diagnosis and therapy of tinea and tinea incognito (TI) in the patients hospitalized at the institution over a 19-year period. Tinea was identified in 814 patients (4.3% of all patients). TI was diagnosed in 318 patients (39.1% of all patients with tinea). The most diagnostic-therapeutic problems were observed in the patients with tinea pedis, tinea cutis glabrae superficialis, intertrigo candidamycetica, tinea profunda cutis glabrae and tinea profunda barbae. The most common clinical isolates were T. rubrum, T. mentagrophytes, and Candida albicans. A high percentage of TI was present in comparison with all other tinea conditions.

Adult↗
PubMed2003

The periodic acid-Schiff stain in diagnosing tinea: should it be used routinely in inflammatory skin diseases?

BACKGROUND: The clinical presentation of tinea is usually, but not always, characteristic. The purpose of this study was to determine whether the routine use of the periodic acid-Schiff (PAS) stain in inflammatory skin disorders is requisite for identifying clinically undiagnosed tinea cases and to ascertain whether there are histopathologic clues that suggest the diagnosis of a dermatophyte infection. METHODS: Hematoxylin and eosin (H&E)-stained slides from 60 PAS-positive tinea cases were examined histologically by two observers. One observer, aware of the diagnosis of tinea, searched for hyphal elements and also recorded in detail epidermal, dermal, and follicular changes. The second observer, not aware of the diagnosis beforehand, reviewed the same slides, together with randomly mixed slides from 21 non-tinea cases, recording the same parameters as the first reviewer. RESULTS: Of the 60 cases of tinea, only 45% were diagnosed clinically. Histologic examination of H&E sections by the two observers disclosed the presence of hyphal elements in 68 and 45%, respectively. No significant histologic differences, except for the presence of hyphae, were observed between tinea and non-tinea cases. CONCLUSIONS: The finding that only 57% of PAS-positive cases of tinea showed hyphal elements on H&E examination alone, together with no other differentiable histologic characteristics, lends strong support for the routine use of PAS-staining for inflammatory skin disorders.

Coloring Agents↗
PubMed1999

The prevalence of common skin conditions in Australian school students: 4 Tinea pedis.

Tinea pedis is a condition that is common, often undiagnosed and frequently inadequately treated. It is reported as being rare in young children, but there are relatively few population-based reports of prevalence. A randomized sample of 2491 students from schools throughout the State of Victoria, Australia, were examined by dermatologists and dermatology registrars, who recorded clinical signs suggestive of tinea pedis, which were then confirmed by fungal culture. The age- and sex-adjusted prevalence of culture-proven tinea pedis was 5.2% [95% confidence interval (CI) 3.58-6.82] increasing with age from 2.1% (95% CI 0.95-3.28) in 4-6 year olds to 9.7% (95% CI 5.21-14.26) in 16-18 year olds. A higher proportion of males (6.0%) had tinea pedis than females (4.3%). Trichophyton mentagrophytes and T. rubrum were the most common dermatophytes isolated on culture. Less than 40% of those with a positive diagnosis had reported on the questionnaire that they had tinea. Of those who reported correctly that they had tinea, 75% had used one or more products to treat their condition, of which more than 40% were classified as unlikely to have any therapeutic effect on tinea pedis. These data confirm that tinea pedis, a potentially transmissible disease, is common in Australian schoolchildren, including those in primary school. There is a need for education programmes in schools on the nature of tinea pedis, the treatment available, and the public health approach to infection control within the school and home environment.

Adolescent↗
PubMed1998

Diagnosis and management of common tinea infections.

The estimated lifetime risk of acquiring a dermatophyte infection is between 10 and 20 percent. Recognition and appropriate treatment of these infections reduces both morbidity and discomfort and lessens the possibility of transmission. Dermatophyte infections are classified according to the affected body site, such as tinea capitis (scalp), tinea barbae (beard area), tinea corporis (skin other than bearded area, scalp, groin, hands or feet), tinea cruris (groin, perineum and perineal areas), tinea pedis (feet), tinea manuum (hands) and tinea unguium (nails). To determine the best treatment approach, the physician must consider several factors: (1) the anatomic locations of the infection, (2) the safety, efficacy and cost of treatment options and (3) the likelihood that the patient will comply with treatment. Newer medications in both oral and topical forms, including imidazoles and allylamines, have greatly increased the cure rate for tinea infections. Certain types of tinea may be treated with "pulse" regimens; these innovative therapies lower treatment costs and improve patient compliance.

Administration, Cutaneous↗
PubMed2000

Tinea pedis in Korean children.

BACKGROUND: Tinea pedis is an infrequent disease in children before the age of puberty. There are few epidemiologic and clinical data regarding cases of tinea pedis observed in children. Materials and methods We prospectively collected all cases of tinea pedis in children diagnosed during the years 1995-1997. Only those showing a positive result with potassium hydroxide preparation were included in the study. We performed fungal cultures in Sabouraud's agar in all cases to document the etiologic fungi. The clinical characteristics were investigated. RESULTS: A total of 21 children, aged 3 months to 14 years, were included. Fifteen patients were boys and six were girls. The mean age was 7.1 years. All the children were otherwise healthy. Prior to the establishment of the diagnosis of tinea pedis, 17 patients (80.9%) were treated for eczema without improvement. The intertriginous type was most common (53.3%). The first or second toe-webs were the sites of predilection (32.3%). Eighteen children (86%) had a family history of tinea pedis and more than half of cases (52.4%) showed occurrence in the summer. The results of fungal cultures were positive in 13 patients (57%). Trichophyton rubrum was the most commonly isolated pathogen (69.2%). The other associated dermatoses were onychomycosis (33.3%), atopic dermatitis (14%), plantar warts (10%), and chronic urticaria (5%). Tinea pedis and onychomycosis cleared after treatment with topical antifungals with or without systemic antifungals in all cases. CONCLUSIONS: Tinea pedis in children can occur more frequently than suspected. Our study shows the strong association with a family history and the seasonal relationship with occurrence in summer in more than half of cases. We suggest that tinea pedis should be considered in the differential diagnosis of foot dermatitis in children.

Adolescent↗
PubMed2002

Population-based epidemiologic study of tinea pedis in Israeli children.

BACKGROUND: In recent years we have seen an increasing number of children in Israel with tinea pedis. OBJECTIVE: To determine the prevalence of tinea pedis in 5- to 14-year-old schoolchildren in a comprehensive epidemiologic population-based study. METHODS: A total of 1148 children, ages 5 to 14 years, from 7 schools with different socioeconomic backgrounds from the Jerusalem area were examined for the presence of tinea pedis. Scrapings from suspected lesions of fungal infection were sent to a mycologic laboratory for KOH microscopy and fungal identification. Information on the children's background and predisposing factors (regarding living conditions, hygiene, etc.) were provided by means of questionnaires filled out by each child. RESULTS: Of the 1148 children examined, 29.6% exhibited erythema and scaling, but only 6.9% of these were mycologically positive for tinea pedis. was the main causative agent (68%) of tinea pedis. The prevalence of tinea pedis increased with age, hyperhidrosis and particularly repeated foot washing (a 3.2 higher rate in children who washed their feet twice a day those who did not wash daily). CONCLUSION: The prevalence of tinea pedis in children has increased in recent decades in Israel and should be considered in the differential diagnosis of dermatologic diseases affecting the feet. Washing habits have a significant effect on tinea pedis in children.

Adolescent↗
PubMed2005

Eighty-four consecutive cases of tinea faciei in Siena, a retrospective study (1989-2003).

Consecutive cases of tinea faciei diagnosed in Siena between 1989 and 2003 were studied retrospectively for differences in clinical form, demographic data and species of dermatophyte isolated. The series consisted of 84 cases (59 females, 25 males) with a mean age of 27 years. Mean age of females (32.4 years) was significantly greater than that of males (14.2 years). The dermatophytes most frequently isolated were Microsporum canis (38 cases) and Trichophyton rubrum (31 cases). Clinical form was typical of tinea in 54 subjects (64.3%) and was tinea incognito because of inappropriate therapy in the other 30 (35.7%) subjects. The mean age of patients with the typical form (19.2 years) was significantly lower than that of those with tinea incognito (41.1 years). All cases in the age range 6-15 years had typical tinea, whereas the maximum frequency of cases with tinea incognito was 46-50 years. In the group with tinea incognito there was a majority of women and the dermatophytes isolated differed with gender. No such difference was observed in the group with typical tinea.

Adolescent↗
PubMedDate not supplied

Ciclopirox olamine lotion 1%: bioequivalence to ciclopirox olamine cream 1% and clinical efficacy in tinea pedis.

Studies were conducted to assess the bioequivalence of a new antimycotic formulation, ciclopirox olamine lotion 1%, to an established compound, ciclopirox olamine cream 1%. Results of in vitro studies, using skin samples from human cadavers and domestic pigs, demonstrated that the two formulations equally penetrate all layers of the stratum corneum and inhibit the growth of Trichophyton mentagrophytes and Candida albicans. In vivo studies in guinea pigs and in human volunteers demonstrated the comparable therapeutic efficacy of the lotion and the cream in experimental trichophytosis. In addition, a multicenter, double-blind clinical trial was undertaken to compare ciclopirox olamine lotion 1% with the vehicle alone in the treatment of patients with tinea pedis. Patients with plantar, interdigital, or vesicular tinea pedis were enrolled in the studies. Patients were treated for 28 days. Clinical and mycological responses were determined during treatment and two weeks posttreatment. Ciclopirox olamine lotion 1% was found to be significantly more effective than its vehicle in the treatment of patients with common tinea pedis. Minor localized side effects (pruritus, burning sensation) were reported in 2% of 89 patients treated with ciclopirox olamine lotion 1%. The results demonstrate the bioequivalence of ciclopirox olamine lotion 1% and ciclopirox olamine cream 1% and confirm the clinical effectiveness and safety of the lotion in the treatment of tinea pedis, a generally recalcitrant fungal infection. It is concluded that ciclopirox olamine lotion 1% can be used as an alternative to ciclopirox olamine cream 1% for treatment of tinea pedis, tinea versicolor, tinea cruris, tinea corporis, and cutaneous candidiasis when the convenience and/or cosmetic elegance of a lotion is desired.

Administration, Topical↗
PubMed1998

Increased incidence of Trichophyton tonsurans tinea capitis in Ontario, Canada between 1985 and 1996.

In Canada, since the 1990s, Trichophyton tonsurans has emerged as the main cause of tinea capitis. Prior to this the more common agents were T. verrucosum, Microsporum canis and M. audouinii. Over the past few years the incidence of T. tonsurans has increased such that in 1985 and 1996 the cases of mycologically confirmed tinea capitis due to T. tonsurans were 9% and 76%, respectively. The epidemic of T. tonsurans has reduced the role of Wood's lamp in diagnosis of tinea capitis. The age distribution of tinea capitis due to T. tonsurans closely matches that of mycologically confirmed tinea capitis, being most common in children under 14 years of age. There is no significant sex difference in children who develop T. tonsurans tinea capitis; however, subjects are significantly more likely to live in urban than rural areas. This should provide guidance regarding where to concentrate health resources and deliver patient/parent education to combat this epidemic of tinea capitis.

Adolescent↗
PubMed1998

Treatment of tinea capitis with itraconazole capsule pulse therapy.

BACKGROUND: The number of newly diagnosed cases of tinea capitis in children appears to be on the rise, particularly in urban centers. OBJECTIVE: The purpose of this study was to assess the effectiveness, safety, and compliance of itraconazole pulse therapy for tinea capitis. METHODS: Fifty subjects (48 children [less than 18 years of age] and 2 adults) with tinea capitis were treated with pulse itraconazole in a multicenter evaluation. Each pulse lasted 1 week, with 2 weeks between the first two pulses and 3 weeks between the second and third pulses. The decision to administer a second or third pulse was determined by the response of the subject at the time that the next pulse was due. During the 1-week pulse of active therapy, itraconazole (5 mg/kg/day) was dosed as follows: more than 40 kg, 200 mg per day (two capsules per day); 20 to 40 kg, 100 mg per day (one capsule per day); and 10 to 19 kg, 50 mg per day (one half of a capsule per day). The duration of the study was 12 weeks with mycologic evaluation at this time. Subjects who were classified as treatment failures at 12 weeks after the start of therapy were given the option of receiving an additional 1-week pulse of active therapy, with 3 weeks between successive pulses. RESULTS: The causative organisms were Trichophyton tonsurans (41 subjects), T violaceum (7), T. soudanense (1), and T rubrum (1). Thirteen subjects were lost to follow-up, with 37 subjects (35 children and 2 adults) available for evaluation 12 weeks after the start of therapy. At this time, cure (clinical and mycologic) was observed in 30 (81%) of 37 subjects. When the tinea capitis was mild, cure was obtained after one pulse in two subjects and after two pulses in five subjects. With tinea capitis of moderate extent, complete cure was obtained after one pulse in one subject, two pulses in eight subjects, and after three pulses in seven subjects. When tinea capitis was severe, two and three pulses produced complete cure in one and six subjects, respectively. Of the seven subjects whose conditions failed to respond (three subjects with moderate disease and four subjects with severe disease), five subjects chose to receive extra itraconazole. Clinical and mycologic cure was observed after four pulses in four subjects and after five pulses in one subject. There were no associated clinical adverse effects with itraconazole therapy. CONCLUSION: With tinea capitis, itraconazole pulse therapy is effective and safe and is associated with high compliance. The pulse regimen enables the duration of treatment to be individualized, according to the extent of disease and its rate of resolution.

Antifungal Agents↗
PubMed2004

Molecular typing study of the Microsporum canis strains isolated from an outbreak of tinea capitis in a school.

Tinea capitis is a dermatophyte infection of the scalp that occurs most often in prepubescent children. Tinea capitis may be transmitted by shared use of contaminated hairbrush, by contact with fomites or by direct physical contact with an infected person. Occasionally, outbreak of tinea capitis would happen under some special conditions. Last year, we found an outbreak of tinea capitis in a school due to Microsporum canis. In epidemiological study, we performed the prevalence survey to all of the exposed persons by physical examinations and mycological laboratory tests, including KOH preparation and fungal cultures. We also investigated the environment in the school. In molecular typing study of the M. canis isolated from patients and the environment, random primer amplification polymorphic DNA (RAPD) method, the specific amplification of subrepeat element in the ribosomal DNA nontranscribed spacer (NTS), and the analysis of DNA sequence in the intertranscribed spacer (ITS) of rDNA were performed. The total number of exposed children was seventy-one, among them forty-two were attacked by tinea capitis. The ratio between boy and girl was 13:1. The ages of the patients was ranged from 3.5 years old to 10 years old. Four patients bred cat or dog as pet. Most patients appeared noninflammatory type of tinea capitis and several patients were inflammatory type. Under microscopic examination the invaded hair were all ectothrix. The pathogens isolated from these patients were M. canis. And we also isolated M. canis from the carpet and the pillowcase in the school. The patterns of total strains of M. canis in the RAPD method and PCR amplification of the rDNA NTS region study were identical, and the isolates from patients and the environment contained the same DNA sequences in the ITS region. The outbreak of tinea capitis was caused by M. canis. The M. canis isolated from patients and from the environment were probably the same origin.

Child↗
PubMed2000

Once weekly fluconazole is effective in children in the treatment of tinea capitis: a prospective, multicentre study.

In an open, multicentre evaluation carried out in Brazil, Canada and South Africa we have demonstrated that fluconazole 8 mg kg-1 once weekly is effective in tinea capitis caused by Trichophyton and Microsporum species. There were 61 children, aged (mean +/- SE) 5.0 +/- 0.3 years; weight (mean +/- 5.6) 20.0 +/- 0.9 kg; 41 males, 20 females; one Asian, 57 Black, one Caucasian and two Hispanic. The organisms were Trichophyton violaceum (33 patients), T. tonsurans (11) and Microsporum canis (17). The extent of tinea capitis at pretherapy was: mild (18 patients), moderate (30) and severe (13). Patients with tinea capitis due to Trichophyton species were initially treated for 8 weeks with an extra 4 weeks of fluconazole if clinically indicated. All 44 patients with tinea capitis due to Trichophyton species were completely cured (clinically and mycologically) when evaluated 8 weeks after completion of active treatment, following 8 weeks of once weekly dosing in 35 patients and 12 weeks of once weekly dosing in nine patients. In Microsporum canis tinea capitis, an extra 4 weeks was administered at week 12 in patients where it was clinically indicated at the time. Sixteen of 17 patients with M. canis tinea capitis were completely cured (clinically and mycologically) when evaluated 8 weeks following the end of treatment when given for 8, 12 and 16 weeks in 12, one and three patients, respectively. Overall, complete cure (clinical and mycological) occurred in 60 of 61 patients at follow-up 8 weeks from the end of therapy. The duration of once weekly fluconazole in the 60 patients was 8 weeks (47 patients), 12 weeks (10 patients) and 16 weeks (three patients), respectively. Clinical adverse effects consisted of a mild, reversible gastrointestinal complaint in three (4.9%) of 61 children. A laboratory abnormality with elevated liver function tests was observed in one (5.9%) of 17 patients; this was asymptomatic, and reversible. No patient discontinued therapy. The data suggest that once weekly fluconazole dosing is effective, safe and associated with high compliance when used to treat tinea capitis.

Antifungal Agents↗
PubMedDate not supplied

Oral griseofulvin remains the treatment of choice for tinea capitis in children.

Tinea capitis is one of the most common infections of children. The standard treatment is griseofulvin. Itraconazole and terbinafine have in large part replaced griseofulvin in the treatment of onychomycosis and, in addition to fluconazole and ketoconazole, are evolving treatments for tinea capitis. The purpose of this review is to compare the efficacy, safety, and cost of oral antifungal agents for tinea capitis. Small, open-label studies of itraconazole, terbinafine, and fluconazole have reported encouraging results, suggesting that these drugs may be effective alternatives to griseofulvin; however, in large controlled studies griseofulvin continues to exhibit greater or equal efficacy. Ketoconazole appears to be the least efficacious. All five drugs appear relatively safe, however, only griseofulvin has a long track record of safety, is Food and Drug Administration (FDA) approved for the treatment of tinea capitis in children, and has the least known drug interactions. Fluconazole is FDA approved for use in children more than 6 months of age, yet not for the treatment of tinea capitis. Oral griseofulvin and terbinafine tablets are the least expensive of the antifungal agents; griseofulvin suspension is, however, more expensive than fluconazole suspension. For the combined reasons of efficacy, safety, and cost, and a long track record of use, we feel oral griseofulvin is still the present treatment of choice for tinea capitis. Newer antifungals are currently under investigation, and their role in treating tinea capitis in children is still being defined.

Administration, Oral↗
PubMed2001

Tinea capitis update: a continuing conflict with an old adversary.

Infection with tinea capitis in childhood is a common, age-old problem that continues to plague patients and their families. As is true for most infectious diseases, the epidemiology of tinea capitis is in a constant state of flux and varies considerably with respect to geography and specific patient populations. Trichophyton tonsurans is now the most common cause of tinea capitis in the United States. A recent epidemiologic observation is a striking increase in the incidence of tinea capitis, particularly among African-Americans. Clinical studies over the past decade that have investigated the response of tinea capitis to griseofulvin, the mainstay treatment for this condition, suggest a decrease in sensitivity to this pharmacologic agent, in association with this new epidemiology. Important advances in the diagnosis and treatment of tinea capitis include a renewed interest in the use of the cotton swab method of diagnosing fungal cultures in children, and the ongoing investigation of promising new medications for the treatment of tinea capitis, including terbinafine, itraconazole, and fluconazole in this era of resistant organisms.

Antifungal Agents↗