Template:Tinea capitis treatment: Difference between revisions
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===Antifungals=== | ===[[Antifungals]]=== | ||
*Coverage for Trichophyton and Microsporum and should use both topical and systemic therapy simultaneously | *Coverage for Trichophyton and Microsporum and should use both topical and systemic therapy simultaneously | ||
*Baseline liver function required prior to systemic antifungals | *Baseline liver function required prior to systemic antifungals | ||
====Topical==== | ====Topical==== | ||
*[[Selenium sulfide]] 2.25% shampoo daily x 2 weeks | *[[Selenium sulfide]] 2.25% shampoo daily x 2 weeks | ||
*[[Ketoconazole]] 2% shampoo daily x 2 weeks | *[[Ketoconazole]] 2% shampoo daily x 2 weeks | ||
====Systemic==== | ====Systemic==== | ||
*[[Griseofulvin]] (first line) | *[[Griseofulvin]] (first line) | ||
Revision as of 18:19, 10 February 2020
Antifungals
- Coverage for Trichophyton and Microsporum and should use both topical and systemic therapy simultaneously
- Baseline liver function required prior to systemic antifungals
Topical
- Selenium sulfide 2.25% shampoo daily x 2 weeks
- Ketoconazole 2% shampoo daily x 2 weeks
Systemic
- Griseofulvin (first line)
- No labs needed before griseofulvin treatment. However if repeat courses or if therapy continued beyond 8 weeks then obtain CBC and LFTs.
- Microsize formulation: 20 mg/kg per day for six to eight weeks.
- Ultramicrosize formulation: 10 mg/kg per day for six to eight weeks.
- Give with fatty food (like peanut butter, ice cream) for better absorption. Therapy can fail due to lack of absorption.
- Terbinafine is alternative first line however need LFTs prior to therapy.
- Second line:
- Fluconazole 150mg (6mg/kg) PO once a week x 8 weeks
- Itraconazole 200mg (5mg/kg) PO daily x 4 weeks