From the Guidelines
Tinea corporis in pediatric patients is typically treated with topical antifungal medications as first-line therapy, with oral antifungals reserved for more severe or resistant infections, as supported by the most recent evidence from 1. For mild to moderate cases, apply topical antifungals such as clotrimazole 1% cream, miconazole 2% cream, or terbinafine 1% cream twice daily for 2-4 weeks, continuing for at least one week after the rash resolves. Some key points to consider in the treatment of Tinea corporis include:
- Avoiding skin-to-skin contact with people known to have lesions, not sharing towels and other fomites, and limiting exposure to swimming pools that have recently been associated with known outbreaks, as recommended by 1.
- Oral agents, such as itraconazole, have proven efficacious in the treatment of most cases of T corporis, with a mycological cure rate of 87% when given for 15 days, as shown in 1.
- Terbinafine appears superior for T tonsurans, and can be used for children weighing 10-20 kg (62.5 mg daily), 20-40 kg (125 mg daily), or >40 kg (250 mg daily) for 2-4 weeks.
- Parents should be advised to keep the affected area clean and dry, avoid sharing personal items, and wash bedding and clothing regularly in hot water. The evidence from 1 suggests that treatment with oral antifungals, such as itraconazole, can be effective in treating Tinea corporis, especially in cases where topical treatment is not sufficient. It is essential to note that the treatment of Tinea corporis should prioritize the prevention of further infection and the promotion of a clean and dry environment to support the healing process, as emphasized by 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... Pediatric patients (older than 2 years): A dosage of 10 mg/kg daily is usually adequate (pediatric patients from 30 to 50 lbs, 125 mg to 250 mg daily; pediatric patients over 50 lbs, 250 mg to 500 mg daily, in divided doses). Representative treatment periods are ... tinea corporis, 2 to 4 weeks;
The recommended treatment for tinea corporis in pediatric patients (older than 2 years) is:
- A dosage of 10 mg/kg daily of griseofulvin (PO)
- Treatment period: 2 to 4 weeks 2
From the Research
Tinea Corporis Pediatric Treatment
- The treatment of tinea corporis in pediatric patients can be challenging, and there are various options available.
- According to a study published in the American Family Physician 3, topical therapy is generally successful for tinea corporis unless the infection covers an extensive area or is resistant to initial therapy.
- In such cases, systemic therapy may be required, and medications like griseofulvin, terbinafine, itraconazole, and fluconazole can be used.
- A study published in the Indian Journal of Dermatology, Venereology and Leprology 4 compared the efficacy and safety of 250 mg versus 500 mg oral terbinafine in the treatment of tinea corporis and cruris, and found that oral terbinafine 250 mg daily yielded a poor cure rate in tinea cruris and corporis after 4 weeks of treatment, and an increased dose of 500 mg did not have any additional benefit.
Treatment Options
- Griseofulvin has been the mainstay of treatment for tinea infections, including tinea corporis, for decades 5, 6, 7.
- Terbinafine, itraconazole, and fluconazole are newer oral antifungal agents that have been shown to be effective in the treatment of tinea corporis 5, 6, 7, 4.
- Topical clotrimazole can be used in combination with oral antifungal agents for the treatment of tinea corporis 4.
Efficacy and Safety
- The efficacy and safety of different treatment options for tinea corporis in pediatric patients have been studied, and the results show that griseofulvin, terbinafine, itraconazole, and fluconazole are effective and safe for use in children 5, 6, 7.
- However, the choice of treatment depends on various factors, including the extent of involvement, social situation, and availability of resources 7.