Tinea pedis treatment options
Tinea pedis is the most common dermatophyte
infection.
Clinical types of tinea pedis
- Interdigital Tinea Pedis.
- Moccasin type.
- Inflammatory(vesicular) type.
- Ulcerative type.
Tips
- Controlling humidity and maceration is important in the prevention of recurrence of tinea pedis.
- Tinea pedis is the most common dermatophyte infection.
- Allylamines have been shown to be more efficacious than azoles.
- Topical therapy lasts 1–4 weeks.
- Systemic treatment is indicated, if topical therapy fails, in chronic conditions, or in cases of moccasin- type tinea pedis.
- If there is any evidence of serious bacterial infection, swabs should be taken and treated accordingly.
- Tinea pedis is uncommon in populations that do not wear shoes.
Topical tinea pedis treatment options
- Naftifine : once to twice daily.
- Terbinafine: twice daily for 7 days.
- Econazole: twice daily 4-6 wks.
- Oxiconazole: once to twice for 4 wks.
- Miconazole: twice daily 4-6 wks.
- Clotrimazole: twice daily 4-6 wks.
- Sertaconazole : twice daily 4 wks
- Luliconazole: once daily for 2 wks.
- Flutrimazole : twice daily for 2–4 weeks.
- Bifonazole : twice daily for 2–4 weeks.
Systemic Treatment options
Adult regimens
- Itraconazole: 200–400 mg/day × 1 week.
- Terbinafine: 250 mg/day for 2 weeks.
- Fluconazole: 150 mg weekly for up to 6 weeks.
- Griseofulvin: 750–1000 mg/day (microsize) or 500–750 mg/ day (ultramicrosize) × 4 weeks.
Children regimens
- Itraconazole: 3–5 mg/kg/day (maximum 400 mg) × 1 week.
- Terbinafine:125 mg (<25 kg), 187.5 mg (25–35 kg) or 250 mg (>35 kg) × 2 weeks.
- Fluconazole: 6 mg/kg/week × 4–6 weeks.
- Griseofulvin: 15–20 mg/kg/day (microsize suspension) × 4 weeks.
How to prevent recurrence of Tinea pedis?
- Regular use of talcum powders to reduce humidity and maceration.
- Eradication of the organisms is essential to prevent reinfection, disinfection of shoes with 1 % 8-hydroxycholine sulfate, formaldehyde and/or the environment may be helpful.
- Frequent hosing of the floors of shower rooms and the sides of swimming baths does reduce the prevalence of dermatophytes on these surfaces.
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804599/.
- https://www.ncbi.nlm.nih.gov/books/NBK470421/
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