Favus

Inherited bark, head bark, fungal bark, lichen bark, tinea capitis favosa, tinea favosa, dermatomycosis favosa.

A reportable special form of tinea capitis.

• Endemic areas are found in North Africa, South-Eastern Europe, Iran and countries of the former Soviet Union
• Frequently children are affected

• Pathogen: Trichophyton schoenleinii
• Predisposition factors
  • ↓ Hygiene
  • Wearing a head covering
• The dermatophyte is transmitted by other people, although the contagiousness is rather low

Erythematous, scaly, follicularly localised, yellowish encrusted papules. If enlargement occurs, the term "scutulae" is used

• Travel history
• Clinical
• Detection of pathogens (epilation of hair or recovery of dandruff: then native preparation and culture; biopsy)
• Wood light (green-greyish fluorescence)

In addition to the hairy head, the extremities and face may also be affected.

• Screen other people in the household
• Therapy should be carried out with both topical and systemic antifungal agents!
• Removal of the crusts

Topical therapy

• Clotrimazole cream
• Terbinafine cream (1%)
• Ketoconazole cream (2%)
• Amorolfin cream (0.25%)
• Griseofulvin cream: not on the market in Switzerland
• Bifonazole cream: not on sale in Switzerland
• Econazole cream (1%)
• Ciclopirox cream or solution

• Shampoo containing ketoconazole: leave on for 5-10 minutes. Repeat on the 2 following days
• Ciclopirox-containing shampoo: leave on for 5-10 minutes. Repeat on the 2 following days
• Pregnancy: Only nystatin is allowed

Systemic therapy

• Only griseofulvin is approved for children:
• Griseofulvin 10 mg/kg bw/day for approx. 2 weeks (available in Germany, not in Switzerland)
• However, we at the USZ recommend the use of itraconazole p.o. 200 mg 1x tgl. for 7 days (adapt dosage depending on age)

1. Cecchi R, Paoli S, Giomi A, Rossetti R. Favus due toTrichophyton schoenleiniiin a patient with metastatic bronchial carcinoma. British Journal of Dermatology 2003;148:1057-.
2. Bourlond A, Lachapelle JM, Aussems J, et al. Double-blind comparison of itraconazole with griseofulvin in the treatment of tinea corporis and tinea cruris. Int J Dermatol 1989;28:410-2.
3. Lachapelle JM, De Doncker P, Tennstedt D, Cauwenbergh G, Janssen PA. Itraconazole compared with griseofulvin in the treatment of tinea corporis/cruris and tinea pedis/manus: an interpretation of the clinical results of all completed double-blind studies with respect to the pharmacokinetic profile. Dermatology 1992;184:45-50.