From the Guidelines
For a 10-year-old child with tinea cruris, I strongly recommend using terbinafine 1% cream applied daily for 1 week as the first line of treatment, despite it being approved for children 12 years and older, due to its high mycological cure rate of approximately 94% 1. When treating tinea cruris in children, it's essential to consider the efficacy and safety of the treatment options.
- The treatment should be applied to the affected area, and the child should be advised to keep the area clean and dry.
- The child should wear loose-fitting cotton underwear and change it daily to prevent moisture buildup.
- After bathing, the groin area should be thoroughly dried before applying medication. Other options like butenafine and clotrimazole can be considered, but terbinafine 1% cream has shown superior efficacy 1. It's crucial to note that oral antifungals like itraconazole may be effective in adults, but their use in children should be approached with caution and under the guidance of a pediatrician 1. During treatment, the child should avoid sharing towels and clothing to prevent spread or reinfection. The infection typically resolves within 2-3 weeks with proper treatment, but the full course of medication should be completed even if symptoms improve earlier.
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 treatment for tinea cruris in a 10-year-old can be terbinafine (TOP), as it is stated to cure most cases of jock itch (tinea cruris) 2.
From the Research
Treatment Options for Tinea Cruris in a 10-year-old
- Topical antifungal agents are considered the treatment of choice for tinea cruris, including terbinafine 1% cream, which has been shown to be effective in children with tinea corporis and tinea cruris 3.
- The efficacy of terbinafine 1% cream was assessed in an open clinical study, where 92.0% of patients (81 of 88) achieved complete clinical and mycologic cure or mycologic cure with minimum signs and symptoms or clinical improvement (> or = 50%) 3.
- Other topical antifungal treatments, such as naftifine 1% and clotrimazole 1%, have also been shown to be effective in achieving mycological and clinical cure in patients with tinea cruris and tinea corporis 4.
- A study comparing the efficacy and safety of oral terbinafine 250 mg and 500 mg in the treatment of tinea corporis and cruris found that both doses were effective, but the higher dose did not provide any additional benefit 5.
- Topical allylamines, such as terbinafine, and azoles are recommended as the best treatment options for tinea cruris, with the choice depending on patient compliance, medication accessibility, and cost 6.
Considerations for Treatment
- The treatment duration for topical antifungal agents can vary from one week to two months, but most studies use a treatment duration of two to four weeks 4.
- The choice of treatment should take into account the patient's age, diagnosis, and medical history, as well as the potential for adverse effects and interactions with other medications.
- It is essential to note that oral antifungal agents, such as griseofulvin, terbinafine, and fluconazole, may be used to treat tinea capitis, but their efficacy and safety in treating tinea cruris in children may vary 7.