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Successful treatment of griseofulvin-resistant tinea capitis in infants
A Lukacs1, H C Korting, A Lindner
1Dermatologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, Germany.
Abstract:
We report on three siblings, children of a farmer, aged 3-8 years, suffering from tinea capitis due to Microsporum canis. Initially, the infection was treated systemically with griseofulvin as well as externally for 5 months without success. Therapy was changed to itraconazole 33 mg per day orally. Laboratory investigations followed every 4-6 weeks. Dependent on the dose per kg body weight the children were cured clinically after 2-5 months and microbiologically after 5-8 months. Thus, itraconazole seems to be superior to conventional treatment with Microsporum canis-induced tinea capitis.
Insights
Itraconazole effectively treated tinea capitis in children caused by Microsporum canis when griseofulvin failed. This antifungal medication offers a superior alternative for difficult-to-treat fungal infections of the scalp.
Area of Science:
- Dermatology
- Mycology
- Pediatric Infectious Diseases
Background:
- Tinea capitis is a common fungal infection of the scalp, particularly in children.
- Microsporum canis is a frequent etiological agent of tinea capitis.
- Griseofulvin is a conventional first-line treatment, but resistance and treatment failures are reported.
Observation:
- Three siblings (ages 3-8) presented with tinea capitis due to Microsporum canis.
- Initial treatment with griseofulvin (oral and topical) for 5 months was unsuccessful.
- The children subsequently received oral itraconazole at 33 mg/day.
Findings:
- Clinical cure was achieved within 2-5 months of itraconazole therapy.
- Microbiological cure was confirmed between 5-8 months.
- Treatment success was dependent on the dosage per kilogram of body weight.
Implications:
- Itraconazole demonstrates superior efficacy compared to griseofulvin for Microsporum canis-induced tinea capitis.
- This finding suggests itraconazole as a valuable alternative for refractory cases.
- Further research into optimal dosing and long-term outcomes is warranted.