From the Guidelines
For a 10-year-old child with tinea corporis, I strongly recommend starting with oral itraconazole, 100 mg, given orally once a day for 15 days, as it has shown a superior mycological cure rate of 87% compared to other treatments. This recommendation is based on the study published in Pediatrics in 2017 1, which found itraconazole to be more effective than griseofulvin in treating tinea corporis in adolescents and adults. Although the study did not specifically focus on children, the efficacy and safety profile of itraconazole make it a suitable option for pediatric patients.
When considering treatment options, it's essential to note that:
- Oral agents, such as itraconazole, have proven efficacious in treating most cases of tinea corporis 1
- Terbinafine appears superior for T tonsurans, but itraconazole is a more suitable option for tinea corporis in general 1
- Topical antifungal creams, such as clotrimazole or miconazole, may not be sufficient for extensive or severe cases of tinea corporis
To prevent recurrence and spread, it's crucial to:
- Avoid skin-to-skin contact with people known to have lesions
- Not share towels or other personal items
- Limit exposure to swimming pools that have recently been associated with known outbreaks
- Maintain good hygiene and wear clean, loose-fitting clothes
It's also important to note that tinea corporis is caused by dermatophyte fungi that feed on keratin in the skin, creating the characteristic ring-shaped, scaly, itchy rash. Treatment works by either killing the fungi or preventing their growth. By following the recommended treatment and preventive measures, the child can effectively manage the infection and reduce the risk of recurrence.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... tinea corporis, 2 to 4 weeks; ... Pediatric patients (older than 2 years): A dosage of 10 mg/kg daily is usually adequate INDICATIONS AND USAGE Griseofulvin oral suspension, USP is indicated for the treatment of dermatophyte infections of the skin not adequately treated by topical therapy, hair and nails, namely: Tinea corporis
For a 10-year-old patient with tinea corporis, the recommended treatment is griseofulvin (PO) with a dosage of 10 mg/kg daily for 2 to 4 weeks 2. The patient's weight should be used to determine the exact dosage, with pediatric patients from 30 to 50 lbs receiving 125 mg to 250 mg daily and those over 50 lbs receiving 250 mg to 500 mg daily, in divided doses 2.
- The diagnosis of tinea corporis should be confirmed by laboratory testing, such as KOH preparation or fungal culture, before initiating treatment 2.
- Griseofulvin is indicated for the treatment of dermatophyte infections of the skin, including tinea corporis, that are not adequately treated by topical therapy 2.
From the Research
Treatment Options for Tinea Corporis in a 10-Year-Old
- Topical antifungal treatments are generally successful for tinea corporis unless the infection covers an extensive area or is resistant to initial therapy 3.
- The standard treatment of tinea corporis is with topical antifungals, and systemic antifungal treatment is indicated if the lesion is multiple, extensive, deep, recurrent, chronic, or unresponsive to topical antifungal treatment 4.
- Terbinafine and naftifine are effective treatments for tinea corporis, with higher clinical cure rates compared to placebo 5.
- Clotrimazole 1% is also effective in achieving mycological cure 5.
Duration of Treatment
- Tinea corporis and cruris infections are usually treated for two weeks 3.
- Treatment should continue for at least one week after clinical clearing of infection 3.
- Newer medications require fewer applications and a shorter duration of use 3.
Systemic Treatment
- Oral terbinafine 250 mg daily may not be sufficient for the treatment of tinea corporis, and an increased dose of 500 mg did not have any additional benefit 6.
- Griseofulvin, terbinafine, itraconazole, and fluconazole are effective treatments for tinea capitis, but their efficacy for tinea corporis is not well established 7.