Table 4.

Treatment options for tinea gladiatorum^{14,41,42,53,81}

Indication	Medication	Dosing Regimen	Comments
Tinea capitis: Diffuse/inflammatory tinea corporis treatment
Adult	Terbinafine	250 mg, PO, daily for 2-4 wk	Potential rare hepatotoxicity, anemia, neutropenia, thrombocytopenia, agranulocytosis. LFT elevations in approximately 3%-4% treated. Possible gastrointestinal upset. Obtain baseline CBC and LFT and repeat every 4-6 wk during treatment.
	Itraconazole	200 mg, PO, daily for 2-6 wk	Potential rare hepatotoxicity. LFT elevations in approximately 2%-4% treated. Possible gastrointestinal upset. Obtain baseline LFT and repeat every 4-6 wk during treatment.
	Ketoconazole	200 mg, PO, daily for 2-4 wk	Potential severe hepatotoxicity/hepatic failure (1:10,000 treated), hemolytic anemia, neutropenia. Possible gastrointestinal upset. Avoid alcohol because of liver effects and disulfiram-type effect. Obtain baseline CBC and LFT and repeat every month during treatment.
Children	Griseofulvin (micronized)	20 mg/kg, PO, daily for 8 wk	For child >30 kg. Rare hepatotoxicity and photosensitivity. Possible leukopenia and granulocytopenia. Possible gastrointestinal upset. Obtain CBC and LFT at 6 wk of treatment.
	Terbinafine	Weight, 10-20 kg: 62.5 mg, PO, daily for 2-4 wk	For child >2 years old. Potential rare hepatotoxicity, anemia, neutropenia, thrombocytopenia, agranulocytosis. LFT elevations in approximately 3%-4% treated. Possible gastrointestinal upset. Obtain baseline CBC and LFT and repeat every 4-6 wk during treatment.
		Weight, 20-40 kg: 125 mg, PO, daily for 2-4 wk
		Weight >40 kg: same as adult dosing
Tinea corporis: Limited area treatment
	Clotrimazole cream	Applied to lesion and surrounding area twice daily
	Miconazole cream	Applied to lesion and surrounding area twice daily
	Terbinafine cream	Applied to lesion and surrounding area twice daily
	Butenafine cream	Applied to lesion and surrounding area once daily
Prophylaxis
Adult	Fluconazole	100 mg, PO, 1x/wk	Rare severe hepatotoxicity/hepatic failure, leukopenia, thrombocytopenia, agranulocytosis. Possible gastrointestinal upset. Avoid alcohol because of liver effects and disulfiram-type effect. Obtain baseline CBC and LFT and repeat every 4-6 wk during treatment.

CBC, complete blood count; LFT, liver function test; PO, orally.