What is the treatment for severe tinea corporis (ringworm of the body)?

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From the Guidelines

Severe tinea corporis should be treated with oral itraconazole, 100 mg, given orally once a day, for 15 days, as it has shown a superior mycological cure rate of 87% compared to other treatments. When considering treatment options, it is essential to prioritize morbidity, mortality, and quality of life as the primary outcomes. In the context of severe tinea corporis, oral antifungal medications are necessary to effectively treat the infection.

  • The choice of oral antifungal medication is crucial, and according to the study published in Pediatrics 1, itraconazole has proven to be efficacious in the treatment of most cases of T corporis.
  • The study found that itraconazole, 100 mg, given orally once a day, was superior to griseofulvin, 500 mg, orally, once a day, when given for 15 days, with a mycological cure rate of 87% versus 57%, respectively.
  • While terbinafine appears to be superior for T tonsurans, the study suggests that itraconazole is a more effective treatment option for severe tinea corporis in general.
  • In addition to oral antifungal medication, good hygiene practices are essential during treatment, including washing affected areas with soap and water daily, drying thoroughly, wearing loose-fitting cotton clothing, and avoiding sharing personal items.
  • It is also important to launder clothing, bedding, and towels in hot water to prevent reinfection, as suggested by the study 1, which highlights the importance of avoiding skin-to-skin contact and not sharing towels and other fomites.

From the FDA Drug Label

Uses for the cure of most athlete's foot, jock itch and ringworm The FDA drug label does not answer the question.

From the Research

Severe Tinea Corporis Treatment

  • Severe tinea corporis treatment may require systemic therapy if the infection covers an extensive area or is resistant to initial therapy 2
  • Topical therapy is generally successful unless the infection is severe, in which case systemic therapy may be required 2
  • The combination of systemic terbinafine and itraconazole therapy may be an effective and safe therapeutic strategy in the management of dermatophytosis, including severe tinea corporis 3

Treatment Options

  • Oral terbinafine and itraconazole are commonly used antifungal agents for the treatment of tinea corporis 4, 5
  • Itraconazole seems to be more effective than terbinafine in the treatment of tinea corporis 5, 6
  • There is no significant benefit in increasing the dose of terbinafine or using a combination regimen of terbinafine and itraconazole in the treatment of tinea corporis 4, 6

Treatment Duration

  • Treatment should continue for at least one week after clinical clearing of infection 2
  • Prolonged duration of treatment is required for complete cure, with cure rates at 8 weeks being greater than that at 4 weeks for all groups 6
  • The standard treatment duration for tinea corporis is usually 2-4 weeks, but may need to be extended in severe cases 2, 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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