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Evidence summaries

Treatment of Tinea Capitis

Ketokonazole, itraconazole, terbinafine and griseofulvin all appear to be effective in tinea capitis. There is no evidence available to suggest the use of alternative treatments in preference to griseofulvin with a selenium sulphide shampoo. Level of evidence: "B"

A systematic review 1 including 9 studies was abstracted in DARE. Griseofulvin is equally effective than ketokonazole. In one study griseofulvin showed a higher clinical cure rate (96% vs 73%). Data from case reports and a single uncontrolled trial suggest that itraconazole is effective. Two open-label studies suggest that terbinafine results in clinical cure rates between 80 and 100%. In a single comparative trial 93% of patients taking terbinafine and 88% of patients taking griseofulvin were mucologically cured at 12 weeks. Treatment with griseofulvin can result in 20% of patients experiencing adverse effects. Also other antifungal agents may have serious side effects.

Comment: The quality of evidence is downgraded by indirectness (differences in studied interventions).

    References

    • Abdel-Rahman SM, Nahata MC. Treatment of tinea capitis. Ann Pharmacother 1997 Mar;31(3):338-48. [PubMed][DARE]

Primary/Secondary Keywords