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Rashid S, Rashid A, Bhat BA. A scalable and diversity-oriented synthesis of (±)-paeoveitols. SYNTHETIC COMMUN 2022. [DOI: 10.1080/00397911.2022.2119414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
- Showkat Rashid
- CSIR – Natural Products and Medicinal Chemistry Division, Indian Institute of Integrative Medicine, Sanatnagar Srinagar, India
| | - Auqib Rashid
- CSIR – Natural Products and Medicinal Chemistry Division, Indian Institute of Integrative Medicine, Sanatnagar Srinagar, India
| | - Bilal A. Bhat
- CSIR – Natural Products and Medicinal Chemistry Division, Indian Institute of Integrative Medicine, Sanatnagar Srinagar, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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Genedy RM, Sorour OA, Elokazy MAW. Trichoscopic signs of tinea capitis: a guide for selection of appropriate antifungal. Int J Dermatol 2020; 60:471-481. [PMID: 33141453 DOI: 10.1111/ijd.15289] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/01/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Tinea capitis is the most common pediatric dermatophyte infection. Optimal treatment regimen differs according to the type of the dermatophyte involved. OBJECTIVES The aim of this work was to study the trichoscopic signs in relation to isolated organism in a sample of Egyptian patients with tinea capitis and the possibility of using them as a guide for selection of appropriate antifungal. METHODS This study was carried out on 60 subjects with tinea capitis. Patients were mycologically examined, both direct microscopy with KOH preparation and culture of the scraped hair materials on Sabouraud dextrose agar. Culture mounts were used for identification of the organism. Trichoscopic examination of all patients was performed using the Dermlite DLIII dermoscope. RESULTS There was significant higher prevalence of both comma and corkscrew hair in endothrix infection and T. violaceum-infected cases. On the other hand, there was significant higher prevalence of zigzag, barcode hairs, and white sheaths in ectothrix infection and M. canis-infected cases. CONCLUSION While some trichoscopic findings are nonspecific, others were found to be more specific. Finding zigzag hairs and barcode hairs points to ectothrix infection (M. canis), and it is recommended to start treatment with griseofulvin. On the other hand, finding comma hairs and corkscrew hairs without zigzag hairs and barcode hairs points to endothrix infection (T. violaceum), and it is recommended to start treatment with terbinafine in the usual dose.
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Affiliation(s)
- Rasha M Genedy
- Department of Dermatology and Venereology, Alexandria University, Alexandria, Egypt
| | - Osama A Sorour
- Department of Dermatology and Venereology, Alexandria University, Alexandria, Egypt
| | - Miada A W Elokazy
- Department of Dermatology and Venereology, Alexandria University, Alexandria, Egypt
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Sardana K, Khurana A, Gupta A. Parameters that determine dissolution and efficacy of itraconazole and its relevance to recalcitrant dermatophytoses. Expert Rev Clin Pharmacol 2019; 12:443-452. [PMID: 30952196 DOI: 10.1080/17512433.2019.1604218] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Recalcitrant dermatophytoses is on the rise. Though myriad factors contribute to recalcitrance including terbinafine resistance, itraconazole largely remains sensitive. However, there are increasing instances of patients not responding adequately to itraconazole despite low MICs, probably due to issues plaguing the pelletization process, resulting in suboptimal quality. Data on this topic was searched on pubmed using the search items: itraconazole, MIC, MFC, quality, assay, pharmacokinetics, pharmacodynamics, dermatophytoses, and recalcitrance. Areas covered: A detailed analysis of the manufacturing process of itraconazole with emphasis on pelletization and parameters affecting the dissolution and bioavailability is presented. Important formulation factors including drug-polymer ratio, polymer type, coating thickness, bead size, and number are discussed. Also covered is the rationale of dosimetry of itraconazole in dermatophytoses based on the skin pharmacokinetics and MIC of the organism. Expert opinion: The process of pelletization has multiple components aiming to achieve maximum dissolution of the drug. Variations in the process, pellet quality, number, and polymer determine absorption. Morphometric analysis of pellets is a simple method to quantify quality of the drug. Once the process has been standardized, dosimetry depends on the route of secretion and site of infection, accounting for the variation of doses from 100 mg to 400 mg/day.
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Affiliation(s)
- Kabir Sardana
- a Department of Dermatology , Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital , New Delhi , India
| | - Ananta Khurana
- a Department of Dermatology , Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital , New Delhi , India
| | - Aastha Gupta
- a Department of Dermatology , Post Graduate Institute of Medical Education and Research Dr. Ram Manohar Lohia Hospital , New Delhi , India
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Salehi Z, Shams-Ghahfarokhi M, Razzaghi-Abyaneh M. Antifungal drug susceptibility profile of clinically important dermatophytes and determination of point mutations in terbinafine-resistant isolates. Eur J Clin Microbiol Infect Dis 2018; 37:1841-1846. [PMID: 29980898 DOI: 10.1007/s10096-018-3317-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 06/26/2018] [Indexed: 11/24/2022]
Abstract
With regard to increasing number of antifungal-resistant dermatophytes, antifungal susceptibility testing of dermatophytes serves as a useful tool in managing clinical dermatophytosis. This study aimed to determine antifungal susceptibility profile of clinically important dermatophytes and determination of point mutations in terbinafine-resistant isolates. Based on our results, dermatophytosis was confirmed in 97 cases by direct microscopic examination, culture, and sequencing of ITS region. Antifungal susceptibility of 97 dermatophyte isolates distributed in four species including Trichophyton interdigitale (26 isolates), T. rubrum (19 isolates), T. tonsurans (29 isolates), and Epidermophyton floccosum (21 isolates) was assessed to nine antifungal agents using CLSI M38-A2 guidelines. Minimum inhibitory concentration range (MIC range) for luliconazole and terbinafine was 0.001-0.008 μg/ml and 0.003-> 32 μg/ml, compared to 0.03-64 μg/ml for griseofulvin, 0.01-16 μg/ml for itraconazole and voriconazole, 0.03-8 μg/ml for ketoconazole, 0.03-32 μg/ml for econazole, 0.03-1 μg/ml for lanoconazole, and 0.01-4 μg/ml for butenafine. Trichophyton tonsurans was the most susceptible (MIC = 0.006 μg/ml) and E. floccosum was the most resistant (MIC = 0.02 μg/ml) species to terbinafine. Terbinafine resistance was reported for two species, i.e., T. rubrum and T. tonsurans at the total rate of 2% which was due to Leu393Phe substitution in both species. Taken together, our results assist clinicians and prompt the current knowledge about the necessity of antifungal susceptibility testing to select effective strategies for management of clinical cases of dermatophytosis.
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Affiliation(s)
- Zahra Salehi
- Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 14115-331, Iran
| | - Masoomeh Shams-Ghahfarokhi
- Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 14115-331, Iran.
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Specific Identification and Antifungal Susceptibility Pattern of Clinically Important Dermatophyte Species Isolated from Patients with Dermatophytosis in Tehran, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2018. [DOI: 10.5812/archcid.63104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Moto JN, Maingi JM, Nyamache AK. Prevalence of Tinea capitis in school going children from Mathare, informal settlement in Nairobi, Kenya. BMC Res Notes 2015; 8:274. [PMID: 26116079 PMCID: PMC4483201 DOI: 10.1186/s13104-015-1240-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 06/17/2015] [Indexed: 11/18/2022] Open
Abstract
Background Tinea capitis is a common infection especially in poor resource settings. This study was aimed at determining the prevalence Tinea capitis in children from selected schools from an urban slum in Nairobi city of Kenya. Methods A cross-sectional study was carried out in 150 school going children during the period between May and September 2013. A questionnaire was administered and cultures of scalps, skin scrapping/hair stubs samples were performed and the etiological agents identified and confirmed. Results In a total of one hundred and fifty (150) children recruited 89 (59.3%) were males and 61 (40.7%) females aged between 3 and 14 years. The overall prevalence rates in dermatophytes infection was 81.3% (122/150) with etiological agents consisting Trichophyton spp. (61.3%), Microsporum spp. (13.3%) and Epidermophyton spp. (7.3%) infections with infections occurring either singly (56%), duo (38%) or tipple co-infections (6%). Conclusion This study demonstrates a high prevalence of Tinea infections with Trichophyton tonsurans as the predominant etiological agent in school going children of the urban slums of Nairobi. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1240-7) contains supplementary material, which is available to authorized users.
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Fuller LC, Barton RC, Mohd Mustapa MF, Proudfoot LE, Punjabi SP, Higgins EM. British Association of Dermatologists' guidelines for the management of tinea capitis 2014. Br J Dermatol 2015; 171:454-63. [PMID: 25234064 DOI: 10.1111/bjd.13196] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2014] [Indexed: 01/19/2023]
Affiliation(s)
- L C Fuller
- Department of Dermatology, Chelsea & Westminster Hospital, Fulham Road, London, SW10 9NH, U.K
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Dias MFRG, Quaresma-Santos MVP, Bernardes-Filho F, Amorim AGDF, Schechtman RC, Azulay DR. Update on therapy for superficial mycoses: review article part I. An Bras Dermatol 2014; 88:764-74. [PMID: 24173183 PMCID: PMC3798354 DOI: 10.1590/abd1806-4841.20131996] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 12/20/2012] [Indexed: 11/22/2022] Open
Abstract
Superficial fungal infections of the hair, skin and nails are a major cause of
morbidity in the world. Choosing the right treatment is not always simple because of
the possibility of drug interactions and side effects. The first part of the article
discusses the main treatments for superficial mycoses - keratophytoses,
dermatophytosis, candidiasis, with a practical approach to the most commonly-used
topical and systemic drugs , referring also to their dosage and duration of use.
Promising new, antifungal therapeutic alternatives are also highlighted, as well as
available options on the Brazilian and world markets.
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Kumar L, Verma S, Bhardwaj A, Vaidya S, Vaidya B. Eradication of superficial fungal infections by conventional and novel approaches: a comprehensive review. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2013; 42:32-46. [DOI: 10.3109/21691401.2013.769446] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gupta AK, Drummond-Main C. Meta-analysis of randomized, controlled trials comparing particular doses of griseofulvin and terbinafine for the treatment of tinea capitis. Pediatr Dermatol 2013; 30:1-6. [PMID: 22994156 DOI: 10.1111/j.1525-1470.2012.01866.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Two oral antifungal agents, griseofulvin and terbinafine, have regulatory approval in the United States, but it is unknown whether one has superior overall efficacy. Genus-specific differences in efficacy are believed to exist for the two agents. It is not clear at what doses and durations of treatment these differences apply. The goals of this meta-analysis were to determine whether a statistically significant difference in efficacy exists between these agents at a given dose and duration of each in tinea capitis infections overall and to determine whether a genus-specific difference in efficacy exists for these two treatments at a given dose and duration of each. We performed a literature search for clinically and methodologically similar randomized controlled trials comparing 8 weeks of griseofulvin (6.25-12.5 mg/kg/day) to 4 weeks of terbinafine (3.125-6.25 mg/kg/day) in the treatment of tinea capitis. A meta-analysis was performed using the Mantel-Haenszel method and random effects model; results were expressed as odds ratios with 95% confidence intervals. Meta-analysis of randomized controlled trials did not show a significant difference in the overall efficacy of the two drugs at the doses specified, but specific efficacy differences were observed based on the infectious species. For tinea capitis caused by Microsporum spp., griseofulvin is superior (p = 0.04), whereas terbinafine is superior for Trichophyton spp. infection (p = 0.04). Our results support species-specific differences in treatment efficacy between griseofulvin and terbinafine and provide a clinical context in which this knowledge may be applied.
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Deng S, Hu H, Abliz P, Wan Z, Wang A, Cheng W, Li R. A random comparative study of terbinafine versus griseofulvin in patients with tinea capitis in Western China. Mycopathologia 2011; 172:365-72. [PMID: 21701791 DOI: 10.1007/s11046-011-9438-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 06/08/2011] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the efficacy and safety of terbinafine with griseofulvin in the treatment of tinea capitis in Western China. METHODS Children (2-14 years of age) with clinically diagnosed and potassium hydroxide microscopy-confirmed tinea capitis were randomized into three groups: group GRI4 received 4 weeks of griseofulvin; group TBF2 received 2 weeks of terbinafine; and Group TBF4 received 4 weeks of terbinafine. Clinical and mycological evaluations were done in 0, 2, 4, and 8 weeks and 1 year after therapy started. The isolated pathogenic fungi were evaluated for in vitro susceptibility by detecting the minimal inhibitory concentration (MIC) against terbinafine, griseofulvin, itraconazole, and ketoconazole. RESULTS The clinical effectiveness rate of GRI4, TBF2, and TBF4 were 100% (95% CI-confidence interval: 82-100%), 96.3% (95% CI: 81-100%), and 100%(95% CI: 85-100%), respectively, at week 8 and 100% after 1 year for the 3 groups; clinical cure rates were 84.2%(95% CI: 77-99%), 85.2%(95% CI: 71-98%), and 78.3%(95% CI: 61-95%), respectively, at week 8 and 100% after 1 year for all agents; mycological cure rates were 100%(95% CI: 74-100%), 95.0%(95% CI: 74-100%), and 94.1%(95% CI: 50-93%) at week 8 and 100% after 1 year for the 3 groups. In vitro, all patient-derived cultures were sensitive to the four antifungal agents. CONCLUSION Data from the clinical trial and in vitro antifungal activity indicated that terbinafine is efficacious and well tolerated in the treatment for Trichophyton infections (T. violaceum; Arthroderma vanbreuseghemii; and T. tonsurans) of the scalp, i.e., a 2- to 4-week course of terbinafine is as effective as a 4-week course of griseofulvin; in fact, a 2-week course of terbinafine is sufficient. Terbinafine is an effective alternative to griseofulvin against tinea capitis of Trichophyton infections.
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Affiliation(s)
- S Deng
- Department of Dermatology, First Hospital and Xinjiang Medical University, Urumqi, Xinjiang Province, People's Republic of China
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Ginter-Hanselmayer G, Seebacher C. Treatment of tinea capitis - a critical appraisal. J Dtsch Dermatol Ges 2010; 9:109-14. [DOI: 10.1111/j.1610-0387.2010.07554.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bennassar A, Grimalt R. Management of tinea capitis in childhood. Clin Cosmet Investig Dermatol 2010; 3:89-98. [PMID: 21437064 PMCID: PMC3047946 DOI: 10.2147/ccid.s7992] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Indexed: 11/23/2022]
Abstract
Tinea capitis (TC) is a common dermatophyte infection affecting primarily prepubertal children. The causative pathogens belong to only two genera: Trichophyton and Microsporum. Although there is a great local variation in the epidemiology of TC worldwide, T. tonsurans is currently the most common cause of TC with M. canis second. Even though there is an emerging number of anthropophilic scalp infections, M. canis remains the predominant causative organism in many countries of the Mediterranean basin, the most important dermatophyte carriers being stray cats and dogs as well as pet puppies, kittens and rabbits. TC always requires systemic treatment because topical antifungal agents do not penetrate down to the deepest part of the hair follicle. Since the late 1950s, griseofulvin has been the gold standard for systemic therapy of TC. It is active against dermatophytes and has a long-term safety profile. The main disadvantage of griseofulvin is the long duration of treatment required which may lead to reduced compliance. The newer oral antifungal agents including terbinafine, itraconazole, ketokonazole, and fluconazole appear to have efficacy rates and potential adverse effects similar to those of griseofulvin in children with TC caused by Trichophyton species, while requiring a much shorter duration of treatment. They may, however, be more expensive.
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Affiliation(s)
- Antoni Bennassar
- Dept of Dermatology, Hospital Clinic, University of Barcelona, Barcelona, Spain
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Gupta AK, Williams JV, Zaman M, Singh J. In vitropharmacodynamic characteristics of griseofulvin against dermatophyte isolates ofTrichophyton tonsuransfrom tinea capitis patients. Med Mycol 2009; 47:796-801. [DOI: 10.3109/13693780802712523] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mirmirani P, Willey A, Chamlin S, Frieden IJ, Price VH. Tinea capitis mimicking cicatricial alopecia: What host and dermatophyte factors lead to this unusual clinical presentation? J Am Acad Dermatol 2009; 60:490-5. [DOI: 10.1016/j.jaad.2008.09.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Revised: 08/31/2008] [Accepted: 09/05/2008] [Indexed: 11/16/2022]
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Elewski BE, Cáceres HW, DeLeon L, El Shimy S, Hunter JA, Korotkiy N, Rachesky IJ, Sanchez-Bal V, Todd G, Wraith L, Cai B, Tavakkol A, Bakshi R, Nyirady J, Friedlander SF. Terbinafine hydrochloride oral granules versus oral griseofulvin suspension in children with tinea capitis: Results of two randomized, investigator-blinded, multicenter, international, controlled trials∗. J Am Acad Dermatol 2008; 59:41-54. [DOI: 10.1016/j.jaad.2008.02.019] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2007] [Revised: 02/11/2008] [Accepted: 02/13/2007] [Indexed: 11/25/2022]
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Gupta AK, Cooper EA. Update in Antifungal Therapy of Dermatophytosis. Mycopathologia 2008; 166:353-67. [DOI: 10.1007/s11046-008-9109-0] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Revised: 01/15/2008] [Accepted: 01/30/2008] [Indexed: 10/22/2022]
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Prohic A. An epidemiological survey of tinea capitis in Sarajevo, Bosnia and Herzegovina over a 10-year period. Mycoses 2008; 51:161-4. [DOI: 10.1111/j.1439-0507.2007.01451.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Tinea capitis is an infection of the scalp and hair shaft caused by dermatophyte fungi. It is seen in all age groups, and the incidence seems to be on the rise in North America. Clinical diagnosis of tinea capitis can be challenging, as symptoms can vary from minimal pruritus with no hair loss, to severe tenderness, purulence, and permanent scarring in inflammatory kerion lesions. The diagnosis of tinea capitis must be confirmed in the laboratory by using fungal stains or obtaining cultures, since treatment may be prolonged with potential side effects. Systemic therapy is needed because topical antifungals cannot effectively penetrate the hair shaft to eradicate the infection. Oral griseofulvin remains the standard treatment agent, but terbinafine and itraconazole are also effective alternatives (although currently without Food and Drug Administration approval).
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Affiliation(s)
- Samina Ali
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Stollery Children's Hospital, Edmonton, Alberta, Canada.
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Seebacher C, Abeck D, Brasch J, Cornely O, Daeschlein G, Effendy I, Ginter-Hanselmayer G, Haake N, Hamm G, Hipler C, Hof H, Korting HC, Kramer A, Mayser P, Ruhnke M, Schlacke KH, Tietz HJ. Tinea capitis: ringworm of the scalp. Mycoses 2007; 50:218-26. [PMID: 17472621 DOI: 10.1111/j.1439-0507.2006.01350.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The guideline tinea capitis, as passed by three German medical societies, is presented in the present study.
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Seebacher C, Abeck D, Brasch J, Cornely O, Daeschlein G, Effendy I, Ginter-Hanselmayer G, Haake N, Hamm G, Hipler UC, Hof H, Korting HC, Kramer A, Mayser P, Ruhnke M, Schlacke KH, Tietz HJ. Tinea Capitis. J Dtsch Dermatol Ges 2006; 4:1085-91. [PMID: 17176418 DOI: 10.1111/j.1610-0387.2006.06133.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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