Tinea: Difference between revisions

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==Management==
==Management==
*Topical antifungal tx for all except tinea capitis
*Topical antifungal treatment for all except tinea capitis
*Clotrimazole 1% BID x2-3wk
*Clotrimazole 1% BID x2-3wk
**Must use for 7-10d beyond resolution of lesions
**Must use for 7-10d beyond resolution of lesions
*Capitis
*Capitis
**Griseofulvin 20-25mg/kg/d or BID
**Griseofulvin 20-25mg/kg/d or BID
***Usually requires 8wk of tx
***Usually requires 8wk of treatment
**Selenium or ketoconazole shampoos are adjunct tx
**Selenium or ketoconazole shampoos are adjunct treatment
**Okay for child to go to school
**Okay for child to go to school
*Kerion<ref>Gnanasegaram M. Kerion. DermNet NZ. 2012. http://www.dermnetnz.org/fungal/kerion.html</ref>
*Kerion<ref>Gnanasegaram M. Kerion. DermNet NZ. 2012. http://www.dermnetnz.org/fungal/kerion.html</ref>
**Oral griseofulvin, itraconazole, or terbinafine for 6-8 wks
**Oral griseofulvin, itraconazole, or terbinafine for 6-8 wks
**[[Cephalexin]] 40mg/kg/d in 4 divided doses in addition to systemic antifungal tx if there is evidence or high risk of bacterial secondary infection
**[[Cephalexin]] 40mg/kg/d in 4 divided doses in addition to systemic antifungal treatment if there is evidence or high risk of bacterial secondary infection
**Ketoconazole shampoo, isolated towels decrease spread to household members
**Ketoconazole shampoo, isolated towels decrease spread to household members



Revision as of 05:19, 15 July 2016

Background

  • Fungal infection caused by dermatophytes that feed on keratin

Tinea Types

Tinea Corporis
Tinea Capitis

Clinical Features

  • Scaly, with variable pruritus
  • Corporis: ring appearance with central clearing
  • Capitis: patchy alopecia

Differential Diagnosis

  • Pityriasis rosea
  • Lichen planus
  • Psoriasis
  • Eczema
  • Contact dermatitis

Diagnosis

  • Clinical diagnosis with Wood's lamp
  • Kerion
    • Painful, itchy, eczematous
    • Hair loss
    • Fever, malaise
    • Lymphadenopathy

Management

  • Topical antifungal treatment for all except tinea capitis
  • Clotrimazole 1% BID x2-3wk
    • Must use for 7-10d beyond resolution of lesions
  • Capitis
    • Griseofulvin 20-25mg/kg/d or BID
      • Usually requires 8wk of treatment
    • Selenium or ketoconazole shampoos are adjunct treatment
    • Okay for child to go to school
  • Kerion[1]
    • Oral griseofulvin, itraconazole, or terbinafine for 6-8 wks
    • Cephalexin 40mg/kg/d in 4 divided doses in addition to systemic antifungal treatment if there is evidence or high risk of bacterial secondary infection
    • Ketoconazole shampoo, isolated towels decrease spread to household members

Disposition

  • Discharge

See Also

References

  1. Gnanasegaram M. Kerion. DermNet NZ. 2012. http://www.dermnetnz.org/fungal/kerion.html