Tinea capitis treatment and management

Authors

  • Ali Alzahrani King Abduaziz University, Rabigh, KSA
  • Ali Alshafie National Guard Hospital, Jeddah, KSA
  • Faisal Murayr Medical University of Gdansk, Poland
  • Mushari Alkhaldi Medical University of Warsaw, Poland
  • Mousa Ghazwani University of Warmia And Mazury, Olsztyn, Poland
  • Nareman Shamlan Batterjee Medical Collage, Jeddah, KSA
  • Sultan Bakri Prince Mohammad Bin Nasser, Jazan, KSA
  • Saad Almugbel Imam Muhammad ibn Saud Islamic University, Riyadh, KSA
  • Ahmad Alqadheb Department of Family Medicine, Security Forces Hospital, Riyadh, KSA
  • Sharaf Albelihshi Ibn Sina National College, Jeddah, KSA

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20182452

Keywords:

Griseofulvin, Terbinafine, Antifungal, Tinea capitis, Trichophyton, Microsporum

Abstract

Griseofulvin has been the normal treatment for tinea capitis. However, newer antifungal agents, mainly terbinafine, are increasingly being used due to the short period of treatment and more reliable absorption rates. We pursued to compare the efficacy of oral terbinafine and oral griseofulvin in the treatment and management of tinea capitis. A systematic search of PubMed and the Cochrane Library was conducted up to July 2017 to recognize relevant trials. We also searched for additional trials included in published systematic reviews and bibliographies of all relevant studies comparing terbinafine and griseofulvin in the treatment and management of tinea capitis in immunocompetent patients. Five studies comprising 2035 subjects were included. There was no significant difference in efficacy between griseofulvin (mean duration of treatment 8 weeks, range 6-12 weeks) and terbinafine (mean duration of treatment 4 weeks, range 2-6 weeks); odds ratio=1.2 favoring terbinafine (95% confidence interval [CI]=0.79-1.9; p=0.4). Subgroup analysis revealed that terbinafine was more efficacious than griseofulvin in treating Trichophyton species (1.7; 95% CI=1.28-2.1; p<0.001) and griseofulvin was more efficacious than terbinafine in treating Microsporum species (0.4; 95% CI=0.3-0.7; p<0.001). Both griseofulvin and terbinafine demonstrated good safety profiles in the studies. The present meta-analysis recommends that terbinafine is more efficacious than griseofulvin in treating tinea capitis caused by Trichophyton species, while griseofulvin is more efficacious than terbinafine in treating tinea capitis caused by Microsporum species.

References

Rayala BZ, Morrell DS. Common Skin Conditions in Children: Skin Infections. FP Essent. 2017;453:26-32.

Mirmirani P, Tucker LY. Epidemiologic trends in pediatric tinea capitis: a population-based study from Kaiser Permanente Northern California. J Am Acad Dermatol. 2013;69(6):916-21.

DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177-88.

Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557-60.

Rademaker M, Havill S. Griseofulvin and terbinafine in the treatment of tinea capitis in children. N Z Med J. 1998;111:55-7.

Haroon TS, Hussain I, Aman S, Nagi AH, Ahmad I, Zahid M, et al. A randomized double-blind comparative study of terbinafine and griseofulvin in tinea capitis. J Dermatolog Treat. 1995;6:167-9.

Lipozencic J, Skerlev M, Orofino-Costa R, Zaitz VC, Horvath A, Chouela E, et al. A randomized, double-blind, parallel-group, duration-finding study of oral terbinafine and open-label, high-dose griseofulvin in children with tinea capitis due to Microsporum species. Br J Dermatol. 2002;146:816-23.

Elewski BE, Caceres HW, DeLeon L, El Shimy S, Hunter JA, Korotkiy N, 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;59:41-54.

Fuller LC, Smith CH, Cerio R, Marsden RA, Midgley G, Beard AL, et al. A randomized comparison of 4 weeks of terbinafine vs 8 weeks of griseofulvin for the treatment of tinea capitis. Br J Dermatol. 2001;144:321-7.

Gupta KA, Adam P, Dlova N, Lynde CW, Hofstader S, Morar 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;18:433-8.

Gupta AK, Saunder DN, Shear NH. Antifungal agents: an overview, part II. J Am Acad Dermatol. 1994;30:911-33.

Balfour JA, Faulds D. Terbinafine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in superficial mycoses. Drugs. 1992;43:259-84.

Perveze Z, Johnson MW, Rubin RA, Sellers M, Zayas C, Jones JL, et al. Terbinafine-induced hepatic failure requiring liver transplantation. Liver Transpl. 2007;13:162-4.

Agarwal K, Manas DM, Hudson M. Terbinafine and fulminant hepatic failure. N Engl J Med. 1999;340:1292-3.

Product Information: Lamisil, terbinafine. Novartis Pharmaceuticals Corp, East Hanover, NJ, 2005.

Bennett ML, Fleischer AB, Loveless JW, Feldman SR. Oral griseofulvin remains the treatment of choice for tinea capitis in children. Pediatr Dermatol. 2000;17:304-9.

Fleece D, Gaughan JP, Aronoff SC. Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials. Pediatrics. 2004;114:1312-5.

Gonzalez U, Seaton T, Bergus G, Jacobson J, Martı´nez-Monzo´n C. Systemic antifungal therapy for tinea capitis in children. Cochrane Database Syst Rev. 2007;4:CD004685.

Bagyalakshmi R, Senthilvelan B, Therese KL, Murugusundram S, Madhavan HN. Application of polymerase chain reaction (PCR) and PCR based restriction fragment length polymorphism for detection and identification of dermatophytes from dermatological specimens. Indian J Dermatol. 2008;53:15-20.

Gonza´lez U, Seaton T, Bergus G, Jacobson J, Martı´nez-Monzo´n C. Systemic antifungal therapy for tinea capitis in children. Cochrane Database Syst Rev. 2007;(4):CD004685.

Downloads

Published

2018-06-22

How to Cite

Alzahrani, A., Alshafie, A., Murayr, F., Alkhaldi, M., Ghazwani, M., Shamlan, N., Bakri, S., Almugbel, S., Alqadheb, A., & Albelihshi, S. (2018). Tinea capitis treatment and management. International Journal Of Community Medicine And Public Health, 5(7), 2600–2605. https://doi.org/10.18203/2394-6040.ijcmph20182452

Issue

Section

Review Articles