From the Guidelines
The drug of choice for tinea corporis is oral terbinafine, which appears superior for Trichophyton tonsurans, a common cause of the infection. When considering treatment options, it's essential to weigh the efficacy of different agents. According to a study published in Pediatrics 1, oral agents such as itraconazole have proven efficacious in treating most cases of tinea corporis. However, terbinafine is preferred due to its superior efficacy against certain strains of the fungus. Some key points to consider when treating tinea corporis include:
- The use of oral agents like terbinafine or itraconazole for extensive, severe, or resistant cases
- The importance of extending topical treatment application beyond the visible border of the lesion
- The need for patients to keep the affected area clean and dry, and to avoid sharing personal items
- The recommendation to wash clothes and bedding regularly to prevent reinfection or spread to others In terms of specific treatment regimens, oral terbinafine 250 mg daily for 2-4 weeks may be necessary for severe cases, while oral itraconazole 200 mg daily for 1-2 weeks is also an option. Topical treatments like terbinafine 1% cream or azoles such as clotrimazole 1%, miconazole 2%, or econazole 1% cream may be used for less severe cases, applied twice daily for 2-4 weeks.
From the FDA Drug Label
Uses • cures most athlete's foot (tinea pedis) • cures most jock itch (tinea cruris) and ringworm (tinea corporis) • relieves itching, burning, cracking and scaling which accompany these conditions The drug of choice for Tinea corporis is terbinafine (TOP), as it cures most ringworm (tinea corporis) and relieves accompanying symptoms 2.
- Key points:
- Terbinafine (TOP) is effective against tinea corporis
- It relieves itching, burning, cracking, and scaling
- No other drug in the studies is specified as the drug of choice for tinea corporis
From the Research
Tinea Corporis Treatment
The drug of choice for tinea corporis is terbinafine, an allylamine antifungal agent with fungicidal activity against a wide variety of dermatophytes, moulds, and certain dimorphic fungi 3, 4.
Efficacy of Terbinafine
- Oral terbinafine 250 mg/day is effective in the treatment of superficial dermatophyte infections, including tinea corporis, achieving mycological cure in > 80% of patients 3.
- Topical terbinafine 1% formulations are effective when applied once or twice daily for up to 2 weeks, achieving mycological cure in > 80% of patients with tinea corporis 3, 5, 6.
- Comparative data indicate that oral terbinafine is more effective than continuous or intermittent itraconazole in dermatophyte onychomycosis, and is as effective as itraconazole 400 mg/day in tinea pedis 3.
- Oral terbinafine is more effective than ketoconazole 200 mg/day in tinea corporis/cruris 3.
Treatment Duration and Dosage
- A 7-day once-daily course of terbinafine 1% cream is significantly more effective than placebo in achieving and maintaining mycological cure in tinea corporis/cruris 5.
- A randomised, assessor-blinded comparative study found no significant difference in efficacy between 250 mg and 500 mg oral terbinafine in the treatment of tinea corporis and cruris 7.
- One week of therapy with terbinafine 1% solution is highly effective, superior to vehicle, and safe for use in superficial fungal infections, including tinea corporis/cruris 6.