Dermatophyte Infections (Ring Worm)

Skin infection
Treatment Samples for microscopy and culture can help to confirm the diagnosis but do not need to be taken from people with suspected uncomplicated athlete's foot, mild infections of the groin area, or mild skin ringworm, when empirical treatment can be started immediately. Clotrimazole 1% or miconazole 2% cream, applied 2-3 times daily continuing for 10 days after lesions have healed. If ineffective, terbinafine 1% cream can be applied 1-2 times daily for up to one week. In some cases, the harder skin of the soles and palms may be affected. This sometimes requires oral therapy eg terbinafine 250mg daily for 2-6 weeks. Both topical and systemic terbinafine are not recommended for children.
Nail infection
Treatment Send nail scrapings or clippings for mycology.  Treat with systemic therapy only if laboratory proof of dermatophytic infection. Oral terbinafine 250mg daily for 6-12 weeks in fingernail infection and for 3-6 months in toenail infection gives an approximately 80% cure rate. Not recommended for children.
Note: Self-adhesive packets for mycology samples can be obtained from microbiology.
P Oral terbinafine should not be prescribed without laboratory proof of dermatophyte infection.

 

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