Tinea Infections In Children

Tinea refers to superficial dermatophyte infection of keratinized tissues. Clinical terminology depends on site, including tinea corporis, capitis, pedis and cruris.

Tinea capitis is particularly common in children and requires systemic therapy because topical agents do not adequately penetrate infected hair follicles.

Tinea corporis

• Annular scaly plaques
• Raised active border
• Central clearing
• Pruritus

Tinea capitis

• Scalp scaling
• Patchy alopecia
• Broken hairs or black dots
• Cervical lymphadenopathy

Inflammatory tinea capitis may form a painful boggy kerion.

Typical tinea corporis can be diagnosed clinically.

For tinea capitis, obtain scalp scrapings or plucked hairs for fungal microscopy and culture where feasible.

A kerion can resemble bacterial abscess but is inflammatory fungal disease.

Tinea corporis

• Clotrimazole 1% cream twice daily for approximately 2 to 4 weeks, extending beyond visible lesion margins.

Alternative:

• Terbinafine 1% cream once or twice daily for approximately 1 to 2 weeks, depending on product and site.

Tinea capitis requires oral therapy.

Griseofulvin remains useful, particularly for Microsporum species:

• Griseofulvin microsize 20 to 25 mg/kg/day PO with a fatty meal, commonly for 6 to 8 weeks.

Terbinafine is highly effective for Trichophyton tinea capitis and is dosed by weight.

Do not incise a kerion unless a true bacterial abscess is independently present. Treat the dermatophyte aggressively to prevent scarring alopecia.