Dermatomycoses
EBM Guidelines
Dec 20, 2023 • Latest change Mar 19, 2024
Table of contents
- Essentials
- Infection
- Obtaining a fungal specimen
- Antifungal drugs evd
- Athlete’s foot (tinea pedis) evd
- Onychomycosis (tinea unguium)
- Inguinal ringworm (tinea cruris)
- Ringworm of the body (tinea corporis)
- Scalp ringworm (tinea capitis)
- General remarks about cutaneous yeast infections (candidiasis)
- Oral yeast infections (candidiasis)
- Candidal angular cheilitis
- Candidal intertrigo
- Candidal paronychia
- Candidal balanitis
- Pictures
- References
Extract
- Before starting treatment, make sure that the patient does have a fungal infection and not another skin problem resembling it. Ringworm can be confirmed by obtaining fungal specimens.
- Typical inguinal ringworm (tinea cruris) or tinea in the interdigital spaces between the toes can be treated topically case by case based on the clinical picture.
- To avoid unnecessary use of antifungal drugs, onychomycosis should always be confirmed by obtaining a fungal specimen before starting the treatment. In addition, starting treatment without obtaining a fungal specimen will prevent reliable mycological diagnosis for several months.
- Most of the infections are caused by dermatophytes. Yeasts and moulds occur normally on the skin, nails and mucosa, and such a finding in a specimen does not necessarily mean that the infection is caused by these. The findings must be interpreted carefully in relation to the clinical picture.
- Remember the adverse effects of antifungal drugs and the possible interactions with other drugs. Consult locally available drug databases and other information sources.
Linked evidence summaries
- Topical terbinafine, naftifine and clotrimazole appears to be effective for tinea cruris and tinea corporis compared to placebo.B↑↑
- Oral terbinafine and itraconazole may be more effective than placebo for moccasin type tinea pedis.C
- Terbinafine appears to be more effective than azole in the treatment of onychomycosis.B
- Azoles appears to be more effective than placebo for toenail onychomycosis in adult patients.B
Search terms
Antifungal Agents, B35*, B37.2, Balanitis, Candida albicans, Candidiasis, Candidiasis, Oral, Dermatitis, Dermatitis, Seborrheic, Dermatology, Dermatomycoses, Folliculitis, Fungi, Infectious diseases, Intertrigo, Itraconazole, L30.4, Mycoses, N48.1, Onychomycosis, Paronychia, Potassium Permanganate, Scalp, Specimen Handling, Tinea, Tinea Capitis, Tinea Pedis, Urea, Wrestling, azoles, folliculitis, fungal, fungal culture, furuncle, fungal, kerion, maceration, moccasin-type tinea pedis, pulse treatment, terbinafine