Favid

Last Updated: 2019-08-27

Author(s): Anzengruber, Navarini

Headgrind, fungal grind, lichengrind, tinea capitis favosa, tinea favosa, dermatycosis favosa.
 

Notifiable special form of tinea capitis.

  • Endemic areas can be found in North Africa, Southeast Europe, Iran and in countries of the former Soviet Union.
  • Children are often affected.
  • Causative organism
    • Trichophyton schoenleinii.
  • Predisposition factors
    • Poor hygiene.
    • Wearing a headgear, especially by dividing hats with Favus-infected patients.
  • The dermatophyte is transmitted by other people, although the contact sensitivity is rather low.

  • Erythematous, scaly, follicularly localized, yellowish encrusted papules. If it comes to an enlargement, it is called "Scutulae".

  • Travel history.
  • Klinik.
  • Erregernachweis (Epilation der Haare oder Gewinnung von Schuppen: dann Nativpräparat und Kultur;  Biopsie).
  • Wood light (green-greyish fluorescence).

  • Besides the hairy head, extremities and face can also be affected.

  • Examination of other persons in the household.
  • The therapy should be carried out with both topical and systemic antifungals!
  • Removal of the crusts.
  • Topical Therapy
  • Clotrimazole Cream (Canesten® Cream)
  • Terbinafin cream (Terbinafin® cream 1%)
  • Ketoconazole cream (Nizoral® cream 2%)
  • Amorolfine cream (Loceryl® 0.25% cream)
  • Griseofulvin cream: not available in Switzerland
  • Bifonazole cream: not available in Switzerland
  • Econazole cream (Pevaryl® cream 1%)
  • Ciclopirox Cream (Ciclocutan® Cream or similar)

 

  • Ketoconazole-containing shampoo (Ketozol® shampoo, Keto-med® shampoo, Lur® shampoo, Nizoral® shampoo): leave on for 5-10 minutes. Repeat on the following 2 days.
  • Shampoo containing Ciclopirox (Sebiprox®-Shampoo): leave on for 5-10 minutes. Repeat on the following 2 days.
  • Pregnancy: Only nystatin is allowed.

Systemic Therapy

  • Only griseofulvin is permitted for children:
  • Griseofulvin 10 mg/kg bw/ daily for approx. 2 weeks (available in Germany, not in Switzerland).
  • However, we at the USZ recommend the use of itraconazole (e.g. Sporanox®) p.o. 200 mg 1x daily 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.