From the Guidelines
The recommended treatment for an 11-year-old with tinea corporis (ringworm) is a topical antifungal medication applied to the affected area twice daily for 2-4 weeks. First-line options include over-the-counter clotrimazole 1% cream, miconazole 2% cream, or terbinafine 1% cream 1. For more extensive cases, prescription-strength medications like ketoconazole 2% cream or econazole 1% cream may be used. The medication should be applied to the rash and about 2 cm beyond its borders to ensure complete coverage. Treatment should continue for at least one week after the rash has visibly cleared to prevent recurrence.
Key Considerations
- For severe or resistant cases, oral antifungal therapy with griseofulvin (10-20 mg/kg/day) or terbinafine (children >20kg: 125-250 mg daily) for 2-4 weeks may be necessary 1.
- During treatment, keep the affected area clean and dry, avoid sharing personal items like towels or clothing, and wash bedding and clothing in hot water to prevent reinfection.
- Tinea corporis is caused by dermatophyte fungi that infect the keratin in skin, hair, and nails, with the topical treatments working by disrupting the fungal cell membrane or inhibiting ergosterol synthesis, which is essential for fungal growth.
Additional Measures
- Children receiving appropriate therapy should be allowed to attend school or nursery 1.
- Index cases due to T. tonsurans warrant screening of all family members and close contacts and treatment for those positive cases 1.
- In asymptomatic carriers (no clinical infection, culture positive) with a high spore load, systemic treatment is generally justified 1.
Treatment Failure
- Initially consider lack of compliance, suboptimal absorption of drug, relative insensitivity of the organism and reinfection 1.
- In cases of clinical improvement but ongoing positive mycology, continue current therapy for a further 2–4 weeks 1.
- If there has been no initial clinical improvement, proceed to second-line therapy with itraconazole, 50–100 mg per day for 4 weeks, or 5 mg kg−1 per day for 2–4 weeks 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... Pediatric Use: Approximately 7.3 mg per kg of body weight per day of ultramicrosize griseofulvin is an effective dose for most pediatric patients. On this basis, the following dosage schedule is suggested: 16 to 27 kg: 125 mg to 187.5 mg daily. Over 27 kg: 187. 5 mg to 375 mg daily Representative treatment periods are ... tinea corporis, 2 to 4 weeks;
For an 11-year-old with tinea corporis (ringworm), the recommended treatment is griseofulvin (PO).
- The dosage is approximately 7.3 mg per kg of body weight per day.
- The treatment period for tinea corporis is 2 to 4 weeks.
- The dosage schedule suggested is:
- 16 to 27 kg: 125 mg to 187.5 mg daily
- Over 27 kg: 187.5 mg to 375 mg daily 2
From the Research
Treatment Options for Tinea Corporis (Ringworm)
The recommended treatment for an 11-year-old with tinea corporis (ringworm) is typically a topical antifungal medication. According to the study 3, several topical antifungal treatments are effective in treating tinea corporis, including:
- Terbinafine
- Naftifine 1%
- Clotrimazole 1% These treatments have been shown to have high clinical and mycological cure rates, with minimal adverse effects.
Comparison of Treatment Options
The study 3 also compared the effectiveness of different classes of topical antifungal treatments, including azoles, benzylamines, and allylamines. The results showed that:
- Azoles were slightly less effective in achieving clinical cure compared to azole and steroid combination creams
- There was no difference in mycological cure rate between azoles and benzylamines
- Terbinafine and naftifine were effective in achieving clinical and mycological cure
Duration of Treatment
The duration of treatment for tinea corporis typically ranges from 2 to 4 weeks, with some studies showing that shorter treatment durations can be effective 3. However, the optimal duration of treatment may depend on the specific treatment and the individual patient's response.
Other Considerations
While the studies provided do not specifically address the treatment of tinea corporis in 11-year-old patients, the results can be applied to this age group. However, it is essential to note that the treatment of tinea capitis (ringworm of the scalp) may require systemic antifungal medications, such as griseofulvin or terbinafine, as topical treatments alone may not be effective 4, 5, 6.