Internal Medicine

0521779407-20 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:22

Tinea Capitis Tinea Cruris/Corporis/Pedis 1431

specific therapy

■Griseofulvin 20 mg/kg/d for 8–12 weeks

■Terbinafine 250 mg/d for people >35 kg, 187 mg for children 25–25

kg and 125 mg/d for children <25 kg 4 weeks

■Itraconazole capsules

■Fluconazole solution or tablets

Topical Antifungal Drugs

■Adjunct usage to reduce fungal shedding/transmission in patients

and family members

■2% Ketoconazole shampoo

➣Ciclopirox shampoo

■2.5% Selenium sulfide lotion/shampoo

➣Prednisone should only be used in rare patients with severe

inflammation in conjunction with antifungal therapy.

follow-up

During Treatment

■Regularly assess response to therapy – clinical evidence of reduced

symptoms and new hair growth

Laboratory

■Not generally indicated

complications and prognosis

■Dermatophytid reaction – lichenoid pinpoint papules develop dur-

ing treatment generally on head/neck and progress to trunk and

extremities – up to 10%

➣Resolves without specific therapy

➣Not an allergic eruption

■Treat a secondary bacterial infection, if present.

■Scarring alopecia if left untreated

TINEA CRURIS/CORPORIS/PEDIS

BONI E. ELEWSKI, MD and JEFFREY P. CALLEN, MD

history & physical

History

■Wrestlers, athletes, contact sports

■Exposure to animals – cats, dogs

■Onychomycosis/tinea capitis are risk factors