General measures
If a zoophilic dermatophyte is detected, animals with relevant contact should be examined and treated if necessary.
In recurrent cases, household contacts should be considered.
Topical therapy
Localized tinea corporis is primarily treated topically.
Suitable topical preparations in Switzerland include, for example, terbinafine-containing topical agents such as Lamisil Cream 1%, clotrimazole-containing preparations such as Canesten Cream, ketoconazole-containing creams such as Nizoral Cream 2%, econazole-containing preparations such as Pevaryl Cream 1%, and ciclopirox-containing creams such as Mycoster Cream.
In Germany, options include terbinafine-containing creams such as Lamisil Cream, Terbiderm Cream, or Terbinafin AbZ Cream; clotrimazole-containing creams such as Canesten Cream; ketoconazole-containing creams such as Nizoral 2% Cream; econazole-containing preparations such as Epi-Pevaryl 1% Cream; ciclopirox-containing topical preparations, and amorolfine-containing creams such as Loceryl Cream.
In Austria, terbinafine-containing creams such as Lamisil 1% cream, clotrimazole-containing preparations such as Canesten Clotrimazole cream, ketoconazole-containing creams such as Fungoral 2% cream, and econazole-containing preparations such as Pevaryl cream are available.
Topical therapy usually lasts 2–4 weeks and should generally be continued for an additional 1–2 weeks beyond clinical resolution.
Systemic therapy
Systemic therapy is indicated for multiple, extensive, deep, chronic, recurrent, immunosuppressed, or topically refractory cases, as well as for Majocchi’s granuloma.
Itraconazole 200 mg orally once daily for 1–2 weeks.
Alternatively: Fluconazole 150–200 mg orally once weekly for 2–4 weeks.
Alternatively: Terbinafine 250 mg orally once daily for 2–4 weeks.
Alternatively: Griseofulvin by mouth for 2–4 weeks; not commercially available in Switzerland.
For Trichophyton indotineae, terbinafine is often unreliable; itraconazole is preferred in these cases, usually for a longer duration.
A general combination of topical and systemic therapy is not mandatory in all cases, but may be appropriate with systemic treatment.
During pregnancy, nystatin is not effective against dermatophytes and is therefore not a treatment option for tinea corporis.
