Related Experiment Videos
Management of onychomycosis in children
1Division of Dermatology, University of Toronto Faculty of Medicine, Ontario, Canada. agupta@execulink.com
Abstract:
Onychomycosis is less common in children than in adults. When onychomycosis is suspected, appropriate mycologic tests should be carried out for confirmation. Tinea pedis may be associated with onychomycosis. Family members also may have onychomycosis or tinea pedis. Oral antifungal therapy is required, particularly when the extent of onychomycosis is moderate or severe. The longest clinical experience with antifungal therapy is with griseofulvin, a drug that has to be administered for several months. The newer oral antifungal agents for the treatment of onychomycosis in children include itraconazole, terbinafine, and fluconazole. Pulse therapy with itraconazole given either in oral solution or capsule form, is the preferred regimen. Terbinafine (continuous) or fluconazole (intermittent) regimens are other treatment options. It is important to take steps to reduce the risk of reinfection and to treat tinea pedis at an early stage.
Insights
Onychomycosis, a fungal nail infection, is less common in children but requires mycologic confirmation. Oral antifungal therapy, including newer agents like itraconazole, is essential for moderate to severe cases.
Area of Science:
- Dermatology
- Mycology
- Pediatrics
Background:
- Onychomycosis, a fungal nail infection, is less prevalent in pediatric populations compared to adults.
- Early diagnosis and confirmation through mycologic testing are crucial when onychomycosis is suspected.
- Co-existing conditions such as tinea pedis and familial infections warrant consideration.
Purpose of the Study:
- To review the diagnostic considerations and treatment options for pediatric onychomycosis.
- To highlight the efficacy and administration of various oral antifungal therapies in children.
- To emphasize preventive measures against reinfection and early management of tinea pedis.
Main Methods:
- Review of existing clinical literature on pediatric onychomycosis.
- Analysis of oral antifungal agents, including griseofulvin, itraconazole, terbinafine, and fluconazole.
- Evaluation of treatment regimens such as pulse therapy and continuous/intermittent administration.
Main Results:
- Oral antifungal therapy is indicated for moderate to severe pediatric onychomycosis.
- Itraconazole (pulse therapy), terbinafine (continuous), and fluconazole (intermittent) are effective newer agents.
- Griseofulvin has the longest history of use but requires prolonged administration.
Conclusions:
- Prompt mycologic confirmation is vital for accurate diagnosis of pediatric onychomycosis.
- Pulse itraconazole is a preferred regimen, with terbinafine and fluconazole as alternative options.
- Integrated management including treatment of tinea pedis and prevention of reinfection is key.