Tinea: Difference between revisions
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**[[Griseofulvin]] 20-25mg/kg/d or BID | **[[Griseofulvin]] 20-25mg/kg/d or BID | ||
***Usually requires 8wk of treatment | ***Usually requires 8wk of treatment | ||
**[[Terbinafine]] for 2-4 weeks is as effective of 6-8 weeks of [[griseofulvin]]<ref>Fleece D, Gaughan JP, Aronoff SC. Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials. Pediatrics. 2004;114(5):1312-1315. doi:10.1542/peds.2004-0428</ref> | |||
***62.5mg/day in children <20kg | |||
***125mg/day in children 20-40kg | |||
***250mg/day in children >40kg<ref>Andrews MD, Burns M: Common tinea infections in children. Am Fam Physician 2008;77(10):1415-1420.</ref> | |||
**[[Selenium sulfide]] or [[ketoconazole]] shampoos are adjunct treatment | **[[Selenium sulfide]] or [[ketoconazole]] shampoos are adjunct treatment | ||
**Okay for child to go to school | **Okay for child to go to school | ||
Revision as of 01:44, 9 February 2021
Background
- Fungal infection caused by dermatophytes that feed on keratin
Tinea Types
- Tinea capitis (head)
- Tinea corporis (body)
- Tinea pedis (foot)
- Tinea cruris (groin)
Clinical Features
- Scaly, with variable pruritus
- Corporis: ring appearance with central clearing
- Capitis: patchy alopecia
Differential Diagnosis
Evaluation
- Clinical diagnosis with Wood's lamp
- Kerion
- Painful, itchy, eczematous
- Hair loss
- Fever, malaise
- Lymphadenopathy
Management
- Topical antifungal treatment for all except tinea capitis
- Terbinafine 1% BID x2-3wk
- 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
- Terbinafine for 2-4 weeks is as effective of 6-8 weeks of griseofulvin[1]
- 62.5mg/day in children <20kg
- 125mg/day in children 20-40kg
- 250mg/day in children >40kg[2]
- Selenium sulfide or ketoconazole shampoos are adjunct treatment
- Okay for child to go to school
- Griseofulvin 20-25mg/kg/d or BID
- Kerion[3]
- 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
- ↑ Fleece D, Gaughan JP, Aronoff SC. Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials. Pediatrics. 2004;114(5):1312-1315. doi:10.1542/peds.2004-0428
- ↑ Andrews MD, Burns M: Common tinea infections in children. Am Fam Physician 2008;77(10):1415-1420.
- ↑ Gnanasegaram M. Kerion. DermNet NZ. 2012. http://www.dermnetnz.org/fungal/kerion.html