Superficial fungal infections in children and adolescents

Children with superficial fungal infections are commonly seen in clinical practice. Although tinea capitis and tinea corporis are the most common childhood mycoses, thrush and candida diaper dermatitis also occur frequently in infants. At times, diagnosis can be a challenge, but is made easier with the use of the potassium hydroxide microscopy and fungal cultures. Most childhood superficial fungal infections are adequately treated with topical antifungal medication. These medications are effective and the majority are safe for use in children. Oral antifungal drugs are required for children with tinea capitis, tinea unguium, and those who are immunosuppressed either from disease or therapy. Griseofulvin is the current systemic drug of choice to use in children. Several newer systemic antimycotics are currently being investigated for pediatric use. Terbinafine appears to have the best safety profile and the least risk of drug interactions. Itraconazole and fluconazole are also potential substitutes for griseofulvin in the future. The new agents, fluconazole, itraconazole, and terbinafine, have definitely improved the treatment of tinea unguium. Despite the availability of effective medications for treatment of superficial fungal infections, failure to take local and environmental measures to prevent transmission and reinfection will nullify the use of any treatment.