Superficial Fungal Infections

Tinea capitis, tinea corporis, and pityriasis versicolor are common superficial fungal infections in the pediatric population. • Tinea capitis is the most common dermatophyte infection worldwide. In North America, the cause is almost exclusively T tonsurans. Diagnosis of tinea capitis usually can be made by clinical features alone, especially when occipital or postauricular lymphadenopathy is present. Skin scrapings prepared with potassium hydroxide for microscopic examination, or a cotton swab for fungal culture, usually are diagnostic. • Treatment of tinea capitis requires systemic antifungal therapy. Terbinafine and griseofulvin are both effective against T tonsurans and are FDA-approved for this indication in children. • Adjunctive topical therapy for the patient and household contacts decreases transmission of this infection. • Topical antifungal therapy usually is effective for tinea corporis and pityriasis versicolor. However, recurrences of pityriasis versicolor are common.