Original articleMeta-analysis of randomized, controlled trials comparing griseofulvin and terbinafine in the treatment of tinea capitis
Section snippets
Inclusion criteria
Only randomized controlled trials (RCT) were included. The subjects were immunocompetent children and adults with a diagnosis of tinea capitis confirmed by the presence of dermatophytes by direct microscopy, culture, or both.
The primary outcome measure was the complete cure rate. Complete cure is defined as the achievement of both clinical and mycological cure. The secondary outcome measures were: (1) mycological cure rate (defined as the absence of dermatophytes on direct microscopy and
Included studies
The search yielded 8 RCT comparing griseofulvin and terbinafine. One open study was excluded from the analysis because no data on the cure rates from each type of treatment were provided.3 Seven studies comparing griseofulvin and terbinafine and involving 2163 subjects were analyzed and their characteristics are listed in Table I.
In most studies, the majority of the pathogens were Trichophyton species. One study was comprised entirely of Microsporum species6 and another had similar proportions
Griseofulvin
Griseofulvin is derived from Penicillium griseofulvum. It is fungistatic, arresting mitosis at the metaphase stage of microtubule spindle formation, thereby arresting cell division and impairing fungal cell wall synthesis in actively growing fungi. Griseofulvin has been the standard of care11 and is licensed for treatment of tinea capitis in most countries. It has served as a standard for comparison with the newer antifungal agents. The advantages of griseofulvin are that it is inexpensive and
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2023, Journal of the American Academy of DermatologyAnnular skin lesions in infancy
2022, Clinics in DermatologyCitation Excerpt :Tinea cruris in infants has a similar appearance to tinea corporis and faciei with possible arcuate or annular plaques and peripheral scaling in the diaper area;2,31,32,38 moreover, there are no satellite papules or pustules unless a concomitant Candida infection of the inguinal region is present.31 Tinea capitis can present with annular plaques in the scalp with peripheral scaling, alopecia, and pruritus.39-42 There may also be associated cervical and/or occipital lymphadenopathy.39
A Retrospective Study of Tinea Capitis Management in General Pediatric Clinics and Pediatric Emergency Departments at 2 US Centers
2021, Journal of PediatricsCitation Excerpt :Griseofulvin (ultramicrosize and microsize) requires 6-12 weeks of therapy at doses up to 25 mg/kg.9 Newer antifungals such as terbinafine and fluconazole have shown equivalent clinical efficacy for T tonsurans, the most common dermatophyte infection in the US.7,10,11 Furthermore, terbinafine has increased bioavailability in the cutaneous tissue when compared with griseofulvin, leading to lower dosing and shorter courses of treatment.12
Systemic Antifungal Agents
2020, Comprehensive Dermatologic Drug Therapy, Fourth Edition
Funding sources: None.
Conflicts of interest: None declared.