What are the treatment options for Tinea corporis under the breasts?

From the Guidelines

Tinea corporis under the breasts can be effectively treated with oral antifungal agents, such as itraconazole, 100 mg, given orally once a day for 15 days, which has shown a superior mycological cure rate of 87% compared to other treatments 1. When treating Tinea corporis under the breasts, it is essential to consider the causative agent, as different fungi may respond better to specific treatments.

• For cases caused by Trichophyton tonsurans, terbinafine may be a superior option, as suggested by studies 1.
• In addition to oral antifungal agents, proper hygiene measures, such as avoiding skin-to-skin contact with people known to have lesions, not sharing towels, and limiting exposure to swimming pools that have recently been associated with known outbreaks, can help prevent the spread of the infection 1.
• Keeping the area clean and dry, using mild soap, and thoroughly drying afterward can also help reduce moisture and create an environment unfavorable for fungal growth.
• Wearing cotton bras, changing them daily, and using cotton cloths or specialized products between skin folds can reduce moisture and help prevent the growth of fungi.
• Avoiding tight clothing and synthetic fabrics that trap moisture can also help prevent the recurrence of the infection.
• Topical antifungal medications, such as clotrimazole 1%, miconazole 2%, or terbinafine 1%, may also be used in conjunction with oral antifungal agents to enhance treatment efficacy.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Sufficient Econazole Nitrate Cream, 1% should be applied to cover affected areas once daily in patients with tinea pedis, tinea cruris, tinea corporis, and tinea versicolor, and twice daily (morning and evening) in patients with cutaneous candidiasis

Representative treatment periods are tinea capitis, 4 to 6 weeks; tinea corporis, 2 to 4 weeks;

The treatment options for Tinea corporis under the breasts are:

• Topical treatment: Apply econazole nitrate cream, 1% once daily to cover affected areas 2
• Oral treatment: Griseofulvin can be used with a treatment period of 2 to 4 weeks 3 Key points:
• Treatment should be continued until the infecting organism is completely eradicated
• The dosage of griseofulvin should be individualized, with a usual adult dose of 0.5 g daily 3

From the Research

Treatment Options for Tinea Corporis

• Topical antifungal agents are the primary treatment for tinea corporis, including those caused by dermatophytes 4, 5
• Treatment options include:
  • Azoles (e.g., clotrimazole) 4, 5
  • Allylamines (e.g., terbinafine) 4, 6, 5
  • Amorolfine 7
  • Ciclopiroxolamine 7
  • Tolnaftate 7
• Systemic antifungal agents, such as fluconazole and itraconazole, may be necessary for severe or extensive infections 8, 7
• Combination antifungal/steroid agents may be used, but with caution due to potential side effects 4, 5

Specific Treatment Regimens

• Terbinafine has been shown to be effective in treating tinea corporis, with clinical cure rates significantly higher than placebo 5
• Naftifine 1% has also been shown to be effective in achieving mycological and clinical cure 5
• Clotrimazole 1% has been shown to be effective in achieving mycological cure 5
• Fluconazole 150 mg once weekly for 2-4 weeks has been shown to be an efficacious and safe regimen for treating tinea corporis and cruris 8

Considerations for Treatment

• Treatment should continue for at least one week after clinical clearing of infection 4
• The presence of inflammation may necessitate the use of an agent with inherent anti-inflammatory properties or a combination antifungal/steroid agent 4
• Identification of the species and genotype of the dermatophyte and resistance testing may be necessary to guide treatment 7