Management of tinea capitis in Israel: A comparative study.
Trichopyhton
dermatophyte
fungal infection
terbinafine
tinea capitis
Journal
Pediatric dermatology
ISSN: 1525-1470
Titre abrégé: Pediatr Dermatol
Pays: United States
ID NLM: 8406799
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
pubmed:
18
5
2021
medline:
1
9
2021
entrez:
17
5
2021
Statut:
ppublish
Résumé
Tinea capitis is a common fungal infection in Israel, most commonly caused by the dermatophyte Trichophyton tonsurans. To investigate the effectiveness of oral antifungal monotherapy in producing clinical or complete cure. We also evaluated the impact of topical therapy (bifonazole 1% shampoo and/or betamethasone valerate 0.1% solution), prior to oral treatment, on patients' likelihood of clinical or complete cure. A retrospective chart review was conducted. Patients with mycologically confirmed tinea capitis were treated with one of four regimens: (1) terbinafine (greater than 40 kg: 250 mg/day, 20 to 40 kg: 125 mg/day, less than 20 kg: 62.5 mg/day), (2) itraconazole 5 mg/kg daily, (3) fluconazole 6 mg/kg daily, or (4) griseofulvin 20 mg/kg daily. We used generalized linear models (GLM) to determine whether there was a significant association between the odds of cure and choice of treatment. The causative species was Trichophyton tonsurans in all but 6 cases that grew T violaceum. For pediatric patients, the odds of having complete or clinical cure within 6 weeks was greater if they used terbinafine compared to itraconazole, fluconazole, or griseofulvin (odds ratio [OR] = 9.06, P = .047). The likelihood of complete or clinical cure within 8 weeks of oral therapy was lower if topical steroids were previously used compared to if topical antifungals were used prior to systemic treatment (OR = 0.29, P = .046). Our findings substantiate prior literature demonstrating that terbinafine is non-inferior to griseofulvin, itraconazole, and fluconazole in the therapy of pediatric tinea capitis caused by T tonsurans.
Sections du résumé
BACKGROUND
BACKGROUND
Tinea capitis is a common fungal infection in Israel, most commonly caused by the dermatophyte Trichophyton tonsurans.
OBJECTIVES
OBJECTIVE
To investigate the effectiveness of oral antifungal monotherapy in producing clinical or complete cure. We also evaluated the impact of topical therapy (bifonazole 1% shampoo and/or betamethasone valerate 0.1% solution), prior to oral treatment, on patients' likelihood of clinical or complete cure.
METHODS
METHODS
A retrospective chart review was conducted. Patients with mycologically confirmed tinea capitis were treated with one of four regimens: (1) terbinafine (greater than 40 kg: 250 mg/day, 20 to 40 kg: 125 mg/day, less than 20 kg: 62.5 mg/day), (2) itraconazole 5 mg/kg daily, (3) fluconazole 6 mg/kg daily, or (4) griseofulvin 20 mg/kg daily. We used generalized linear models (GLM) to determine whether there was a significant association between the odds of cure and choice of treatment.
RESULTS
RESULTS
The causative species was Trichophyton tonsurans in all but 6 cases that grew T violaceum. For pediatric patients, the odds of having complete or clinical cure within 6 weeks was greater if they used terbinafine compared to itraconazole, fluconazole, or griseofulvin (odds ratio [OR] = 9.06, P = .047). The likelihood of complete or clinical cure within 8 weeks of oral therapy was lower if topical steroids were previously used compared to if topical antifungals were used prior to systemic treatment (OR = 0.29, P = .046).
CONCLUSIONS
CONCLUSIONS
Our findings substantiate prior literature demonstrating that terbinafine is non-inferior to griseofulvin, itraconazole, and fluconazole in the therapy of pediatric tinea capitis caused by T tonsurans.
Substances chimiques
Antifungal Agents
0
Naphthalenes
0
Itraconazole
304NUG5GF4
Griseofulvin
32HRV3E3D5
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
806-811Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Gupta AK, Bamimore MA, Renaud HJ, Shear NH, Piguet V. A network meta-analysis on the efficacy and safety of monotherapies for tinea capitis, and an assessment of evidence quality. Pediatr Dermatol. 2020;37(6):1014-1022. https://doi.org/10.1111/pde.14353
Mashiah J, Kutz A, Ben Ami R, et al. Tinea capitis outbreak among paediatric refugee population, an evolving healthcare challenge. Mycoses. 2016;59(9):553-557. https://doi.org/10.1111/myc.12501
Evron R, Ganor S, Wax Y, Sheshinski R. Epidemiological trends of dermatophytoses and dermatophytes in Jerusalem between 1954 and 1981. Mycopathologia. 1985;90(2):113-120. https://doi.org/10.1007/BF00436862
Gupta AK, Mays RR, Versteeg SG, et al. Tinea capitis in children: a systematic review of management. J Eur Acad Dermatol Venereol. 2018;32(12):2264-2274. https://doi.org/10.1111/jdv.15088
Worster A, Haines T. Advanced statistics: understanding medical record review (MRR) studies. Acad Emerg Med Off J Soc Acad Emerg Med. 2004;11(2):187-192.
Gupta AK, Adam P, Dlova N, et al. Therapeutic options for the treatment of tinea capitis caused by Trichophyton species: griseofulvin versus the new oral antifungal agents, terbinafine, itraconazole, and fluconazole. Pediatr Dermatol. 2001;18(5):433-438. https://doi.org/10.1046/j.1525-1470.2001.01978.x
Elewski B, Caceres HW, DeLeon L, et al. 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(1):41-54. https://doi.org/10.1016/j.jaad.2008.02.019
Mayser P, Nenoff P, Reinel D, et al. S1 guidelines: Tinea capitis. J Ger Soc Dermatol JDDG. 2020;18(2):161-179. https://doi.org/10.1111/ddg.14026
RStudio Team. RStudio: Integrated development environment for R. Published online 2020. http://www.rstudio.com/
Reynolds RD, Boiko S, Lucky AW. Exacerbation of tinea corporis during treatment with 1% clotrimazole/0.05% betamethasone diproprionate (Lotrisone). Am J Dis Child. 1991;145(11):1224-1225. https://doi.org/10.1001/archpedi.1991.02160110014007
Barkey WF. Striae and persistent tinea corporis related to prolonged use of betamethasone dipropionate 0.05% cream/clotrimazole 1% cream (Lotrisone cream). J Am Acad Dermatol. 1987;17(3):518-519. https://doi.org/10.1016/s0190-9622(87)80380-8
Long SS. No excuse for prescribing combination antifungal/corticosteroid creams. J Pediatr. 2017;186:2-3. https://doi.org/10.1016/j.jpeds.2017.05.011
Wheat CM, Bickley RJ, Hsueh Y-H, Cohen BA. Current trends in the use of two combination antifungal/corticosteroid creams. J Pediatr. 2017;186:192-195.e1. https://doi.org/10.1016/j.jpeds.2017.03.031
Hengge UR, Ruzicka T, Schwartz RA, Cork MJ. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 2006;54(1):1-15. https://doi.org/10.1016/j.jaad.2005.01.010
Evans EG, James IG, Seaman RA, Richardson MD. Does naftifine have anti-inflammatory properties? A double-blind comparative study with 1% clotrimazole/1% hydrocortisone in clinically diagnosed fungal infection of the skin. Br J Dermatol. 1993;129(4):437-442. https://doi.org/10.1111/j.1365-2133.1993.tb03172.x
Coondoo A, Phiske M, Verma S, Lahiri K. Side-effects of topical steroids: a long overdue revisit. Indian Dermatol Online J. 2014;5(4):416-425. https://doi.org/10.4103/2229-5178.142483