What is the recommended treatment for Tinea corporis?

Treatment of Tinea Corporis

Topical antifungal agents are the recommended first-line treatment for tinea corporis, with terbinafine cream 1% applied once daily for 1-2 weeks being the most effective option for most cases. 1, 2

First-Line Treatment Options

• Topical therapy is the standard treatment for localized tinea corporis infections 3
• Terbinafine cream 1% applied once daily for 1-2 weeks is highly effective with cure rates of 92% in children 2
• Azole antifungals (such as clotrimazole, ketoconazole) applied twice daily for 2 weeks are also effective options 3
• Treatment should continue for at least one week after clinical clearing of the infection 3

When to Consider Oral Therapy

• Oral antifungal therapy is indicated when the infection is:

  • Extensive (covering large body areas)
  • Resistant to topical treatment
  • Recurrent or chronic
  • Present in immunocompromised patients 4

• Effective oral treatment options include:

  • Itraconazole 100 mg daily for 15 days (87% mycological cure rate) 5
  • Terbinafine 250 mg daily for 1-2 weeks (particularly effective against T. tonsurans) 5, 6
  • Fluconazole 50-100 mg daily or 150 mg once weekly for 2-3 weeks 6

Treatment Selection Based on Causative Organism

• Terbinafine appears superior for Trichophyton tonsurans infections 5
• Itraconazole has shown superior efficacy compared to griseofulvin (87% vs 57% mycological cure rate) 5
• Proper identification of the causative organism through microscopy and culture can guide optimal treatment selection 4

Special Considerations

• For inflammatory tinea corporis with significant pruritus, especially in atopic patients:

  • A combination of antifungal and corticosteroid (e.g., isoconazole-diflucortolone) may be used initially for 5-7 days
  • This should be followed by antifungal monotherapy for two weeks 7
  • This approach has shown to reduce bacterial superinfections in atopic children 7

• Prevention measures are essential to avoid recurrence:

  • Avoid skin-to-skin contact with infected individuals
  • Do not share towels and other personal items
  • Cover lesions to prevent transmission 5
  • Properly clean contaminated combs and brushes 8

Treatment Monitoring and Follow-up

• Follow-up should include both clinical and mycological assessment 8
• Treatment failure may require:
  • Extending treatment duration
  • Switching to a different antifungal agent
  • Considering systemic therapy if initially treated topically 4