Management of Fungal Infections

Symptomatic Management

Oral antihistamines, such as cetirizine or loratadine 10 mg daily, can be used for symptomatic management of pruritus in patients with fungal infections, as recommended by the Journal for ImmunoTherapy of Cancer 1, 2
Low-potency topical corticosteroids, such as hydrocortisone 1-2.5% cream, may be used sparingly for severe pruritus, but should not be used as monotherapy as they can worsen fungal infections, according to the Journal for ImmunoTherapy of Cancer 3

If lesions cover more than 10% body surface area, consider non-urgent dermatology referral and continue topical antifungals with oral antihistamines, as suggested by the Journal for ImmunoTherapy of Cancer 2
For extensive involvement, systemic antifungal therapy, such as oral terbinafine or itraconazole, may be required, as recommended by the Journal for ImmunoTherapy of Cancer 1
If lesions cover more than 30% body surface area or fail to respond to topical therapy after 2-3 weeks, consider same-day dermatology consultation and systemic antifungal therapy, according to the Journal for ImmunoTherapy of Cancer 1, 2