Table 2.
Diagnostic and treatment practices for patients with tinea capitis diagnoses from 2005 to 2021.
| Diagnostic practicesa | All (n = 265)c | Dermatology (n = 132) | Pediatrics (n = 130) | P-value^ |
|---|---|---|---|---|
| Testing performed | 153 (57.7%) | 127 (96.2%) | 26 (20.0%) | |
| Fungal culture | 145 (54.7%) | 120 (90.9%) | 25 (19.2%) | |
| Potassium hydroxide preparation | 84 (31.7%) | 84 (63.6%) | 0 | |
| Scalp biopsy | 1 (0.4%) | 1 (0.8%) | 0 | |
| Wood's lamp | 1 (0.4%) | 0 | 1 (0.8%) | |
| No testing performed | 112 (42.3%)c | 5 (3.8%) | 104 (80.0%) | |
| Deemed not diagnostic after testing | 22 (8.3%) | 15 (11.3%) | 7 (5.4%) | |
| Performed confirmatory testing | 153 (57.7%) | 127 (96.2%) | 26 (20.0%) | p < 0.00001 |
| No confirmatory testing performed | 112 (42.3%)c | 5 (3.8%) | 104 (80.0%) | |
| Treatment practicesb | All (n = 243)c | Dermatology (n = 117) | Pediatrics (n = 123) | |
| Systemic antifungals | 225 (92.6%)c | 113 (96.6%) | 109 (88.6%) | |
| Griseofulvin | 195 (80.2%)c | 85 (72.6%) | 107 (87.0%) | |
| Terbinafine | 36 (14.8%) | 34 (29.1%) | 2 (1.6%) | |
| Itraconazole | 1 (0.4%) | 1 (0.9%) | 0 | |
| Ketoconazole | 1 (0.4%) | 1 (0.9%) | 0 | |
| Fluconazole | 1 (0.4%) | 0 | 1 (0.8%) | |
| Topical antifungals | 82 (33.7%) | 47 (40.2%) | 35 (28.5%) | |
| Ketoconazole | 57 (23.5%) | 39 (33.3%) | 18 (14.6%) | |
| Clotrimazole | 17 (7.0%) | 0 | 17 (13.8%) | |
| Econazole | 4 (1.6%) | 3 (2.6%) | 1 (0.8%) | |
| Terbinafine | 2 (0.8%) | 2 (1.7%) | 0 | |
| Miconazole | 1 (0.4%) | 0 | 1 (0.8%) | |
| Systemic corticosteroids | 2 (0.8%) | 1 (0.9%) | 1 (0.8%) | |
| Topical corticosteroids | 1 (0.4%) | 0 | 1 (0.8%) | |
| Prescribed systemic and/or topical therapy | 225 (92.6%)c | 113 (96.6%) | 109 (88.6%) | p = 0.02 |
| Prescribed topical therapy only | 18 (7.5%) | 4 (3.4%) | 14 (11.4%) |
a
No encounters utilized polymerase chain reaction testing or antifungal susceptibility testing.
b
Cases deemed not diagnostic after testing resulted are excluded from this section, as prescribed treatments were discontinued.
c
Three encounters in which patients were seen by emergency medicine physicians (all prescribed systemic griseofulvin only without confirmatory testing) were included in total count, but excluded from p-value calculations.
^
P-values were calculated using chi-square tests comparing dermatologists vs. pediatricians.