Tinea Unguium/Onychomycosis

See Onychomycosis section.

Management

Patient education: Avoid factors which predispose to infection, absorbent powders in intertriginous areas, e.g., for tinea pedis—shower-shoes in public facilities.

Topical antifungals for tinea corporis/cruris/pedis (unless lesions are extensive): Terbinafine, ciclopirox, clotrimazole, ketoconazole applied qd or bid × 3 wk, or continue 1 wk until after resolution of lesions.

Systemic antifungals for tinea capitis.

1. Terbinafine (Lamisil) <20 kg = 62.5 mg po qd, 20—40 kg = 125 mg po qd, >40 mg = 250 mg po qd × 2—4 wk.
2. Micronized griseofulvin with food: 20 mg/kg/d po × 8 wk; adults: 500 mg po qd × 1 mo.
3. Patient and household contacts should use an antifungal shampoo, such as selenium sulfide or ketoconazole to reduce spread.