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Successful treatment of tinea capitis with 2% ketoconazole shampoo.
Int J Dermatol. 2000 Apr; 39(4):302-4.IJ

Abstract

BACKGROUND

Oral antifungal drugs are required for effective treatment of tinea capitis. Topical antifungal shampoo's, namely ketoconazole 2% shampoo or products with selenium sulfide or salicylic acid are recommended as adjunctive therapy. Topical antifungal monotherapy has not been successful in the treated of tinea capitis. The purpose of this open study was to evaluate ketoconazole 2% shampoo as a monotherapy for the treatment of tinea capitis.

METHOD

A total of 16 black children, aged 3-6, all with proven tinea capitis caused by Trichophyton tonsurans, were treated daily for 8 weeks with 2% ketoconazole shampoo for a total of 56 treatments. Clinical and mycologic examinations were performed every 2 weeks and again at 4 weeks following treatment. The number of colonies were counted on each plate after each visit. Patients with positive cultures after 8 weeks were placed on oral griseofulvin; those with negative cultures were followed monthly by culture for an additional 12 months.

RESULTS

Marked clinical improvement occurred in all patients within 2 weeks and absence of pruritus was noted by the patients as early as 2-6 days. After 8 weeks of shampoo, 14 of the 15 (93%) children were clinically healed. Mycologically, the cultures dropped from a confluent growth of T. tonsurans to less than 100 colonies within 2 weeks; fewer than 50 at week 4 and 20 colonies or fewer after week 6. At 8 weeks of treatment the number of colonies remained at 20 or fewer. Six of the 15 children (40%) had negative cultures after 2, 4, and 6 weeks. One child relapsed at the first 4-week follow-up visit. Five of 15 (33%) of the children remained culturally negative for 12 months post-treatment.

CONCLUSIONS

Ketoconazole 2% shampoo alone reduces the number of viable arthroconidia in children with tinea capitis thus reducing the transmissibility and contagious nature of the disease. Unexpectedly, complete cure was obtained in 5/15 (33%) of the children. The children remained clinically and mycologically clear as long as one year after treatment.

Authors+Show Affiliations

Department of Dermatology, Louisiana State University Medical Center, New Orleans, LA 70112, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10809984

Citation

Greer, D L.. "Successful Treatment of Tinea Capitis With 2% Ketoconazole Shampoo." International Journal of Dermatology, vol. 39, no. 4, 2000, pp. 302-4.
Greer DL. Successful treatment of tinea capitis with 2% ketoconazole shampoo. Int J Dermatol. 2000;39(4):302-4.
Greer, D. L. (2000). Successful treatment of tinea capitis with 2% ketoconazole shampoo. International Journal of Dermatology, 39(4), 302-4.
Greer DL. Successful Treatment of Tinea Capitis With 2% Ketoconazole Shampoo. Int J Dermatol. 2000;39(4):302-4. PubMed PMID: 10809984.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful treatment of tinea capitis with 2% ketoconazole shampoo. A1 - Greer,D L, PY - 2000/5/16/pubmed PY - 2000/6/17/medline PY - 2000/5/16/entrez SP - 302 EP - 4 JF - International journal of dermatology JO - Int. J. Dermatol. VL - 39 IS - 4 N2 - BACKGROUND: Oral antifungal drugs are required for effective treatment of tinea capitis. Topical antifungal shampoo's, namely ketoconazole 2% shampoo or products with selenium sulfide or salicylic acid are recommended as adjunctive therapy. Topical antifungal monotherapy has not been successful in the treated of tinea capitis. The purpose of this open study was to evaluate ketoconazole 2% shampoo as a monotherapy for the treatment of tinea capitis. METHOD: A total of 16 black children, aged 3-6, all with proven tinea capitis caused by Trichophyton tonsurans, were treated daily for 8 weeks with 2% ketoconazole shampoo for a total of 56 treatments. Clinical and mycologic examinations were performed every 2 weeks and again at 4 weeks following treatment. The number of colonies were counted on each plate after each visit. Patients with positive cultures after 8 weeks were placed on oral griseofulvin; those with negative cultures were followed monthly by culture for an additional 12 months. RESULTS: Marked clinical improvement occurred in all patients within 2 weeks and absence of pruritus was noted by the patients as early as 2-6 days. After 8 weeks of shampoo, 14 of the 15 (93%) children were clinically healed. Mycologically, the cultures dropped from a confluent growth of T. tonsurans to less than 100 colonies within 2 weeks; fewer than 50 at week 4 and 20 colonies or fewer after week 6. At 8 weeks of treatment the number of colonies remained at 20 or fewer. Six of the 15 children (40%) had negative cultures after 2, 4, and 6 weeks. One child relapsed at the first 4-week follow-up visit. Five of 15 (33%) of the children remained culturally negative for 12 months post-treatment. CONCLUSIONS: Ketoconazole 2% shampoo alone reduces the number of viable arthroconidia in children with tinea capitis thus reducing the transmissibility and contagious nature of the disease. Unexpectedly, complete cure was obtained in 5/15 (33%) of the children. The children remained clinically and mycologically clear as long as one year after treatment. SN - 0011-9059 UR - https://www.unboundmedicine.com/medline/citation/10809984/Successful_treatment_of_tinea_capitis_with_2_ketoconazole_shampoo_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0011-9059&date=2000&volume=39&issue=4&spage=302 DB - PRIME DP - Unbound Medicine ER -