Treatment of Topical Treatment-Resistant Tinea Corporis in Young Children

Treatment Duration and Endpoint

The British Association of Dermatologists emphasizes that the definitive endpoint for treatment should be mycological cure, not just clinical response, to ensure the infecting organism is completely eradicated 1
The British Journal of Dermatology strongly recommends follow-up with repeat mycology sampling until mycological clearance is documented, to prevent clinical relapse 1

Start griseofulvin at 10-20 mg/kg/day and administer with fatty food to increase absorption and bioavailability, as recommended by the British Journal of Dermatology 2
Continue treatment for the full 2-4 week course, even if lesions clear earlier, and perform repeat microscopy or culture to confirm mycological clearance at 2-4 weeks 1

If there is no clinical improvement after 2-4 weeks, consider that griseofulvin has variable efficacy depending on the causative organism, with an 88.5% response for Microsporum vs. 67.9% for Trichophyton species, as reported by the British Journal of Dermatology 2
In resistant cases, doses up to 25 mg/kg/day may be necessary for more prolonged periods, and alternative agents like itraconazole or terbinafine may be superior, particularly for Trichophyton infections 2, 3

Screen and treat family members, as over 50% may be affected with anthropophilic species, and implement preventive measures including avoiding skin-to-skin contact and not sharing personal items 1
Clean all contaminated items with disinfectant or 2% sodium hypochlorite solution to prevent the spread of infection 1