Tinea capitis

Abstract

Tinea capitis is the most common dermatophyte infection during childhood. In Germany, only griseofulvin is approved for therapy by regulatory agencies. In recent years, several newer antifungal agents such as itraconazole, fluconazole and terbinafine have broadened the therapeutic armamentarium and are used for the treatment of childhood tinea capitis. Itraconazole and terbinafine seem to be equally or more effective in treatment of tinea capitis within a shorter period of time than griseofulvin. Fluconazole is probably also effective for this indication, although supporting data is limited. Encountered side effects as well as interactions with other drugs appear to be well within acceptable limits for all three drugs. In conclusion, systemic therapy of scalp ringworm with itraconazole and terbinafine, as well as perhaps fluconazole, seems to be an equivalent or a superior therapeutic approach as compared to the use of griseofulvin. For the future, regulatory approval for the use of these newer antifungal agents in tinea capitis of childhood is recommended.

The significance of itraconazole for treatment of fungal infections of skin, nails and mucous membranes

“…Itraconazole is characterized by very good tolerability when administered to children just as griseofulvin, terbinafine and fluconazole, which allows for safe treatment. In various open therapy studies and randomized double‐blind studies itraconazole has proved to be an efficacious and well‐tolerated therapy option for tinea capitis that in comparison to griseofulvin is at least equivalent with regards to efficacy and safety with a clinical and mycological cure rate between 80 and 90 percent [47, 48] and the additional advantage of shorter treatment duration [49]. Further, the tolerability of itraconazole is considered somewhat better than that of griseofulvin [47].…”