Template:Tinea management

Coverage for Trichophyton and Epidermophyton and all treatment should be at lease 1 week past resolution of lesions

Topical Therapy

• Applies to Tinea corporis, pedis, cruris, and manus
• Topical antifungal treatment for all except tinea capitis
• Terbinafine 1% BID x2-3weeks or
• Clotrimazole 1% BID x2-3weeks or
• Ketoconazole 1% BID x2-3weeks
  • Must use for 7-10d beyond resolution of lesions

Capitis

• • Griseofulvin 500mg-1000mg PO once daily (20-25mg/kg/d)
    • Usually requires 8wk of treatment
  • Terbinafine for 2-4 weeks is as effective of 6-8 weeks of griseofulvin
    • 62.5mg/day in children <20kg
    • 125mg/day in children 20-40kg
    • 250mg/day in children >40kg
  • Selenium sulfide or ketoconazole shampoos are adjunct treatment
  • Okay for child to go to school

Kerion

• • 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

Tinea corporis

First line should be topical therapy. For refractory cases or severe bullous disease the below anti-fungals are all equivalent options.

• Fluconazole 150mg (6mg/kg) PO once a week x 2 weeks or
• Itraconazole 200mg (5mg/kg) PO daily q12hrs for 1 week or
• Griseofulvin 500-1000mg (20mg/kg) PO daily for 2-4 weeks