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Tinea capitis is a fungal infection involving the hair shaft of the scalp. It is commonly referred to as ringworm and occurs primarily in children. Treatment with a systemic antifungal rather than topical treatment is required. Currently, two medications, griseofulvin (Grifulvin®) and terbinafine (Lamisil Granules®), are FDAapproved to treat tinea capitis. Treatment with griseofulvin is usually 6 to 8 weeks, while treatment with terbinafine requires 6 weeks. There are other medications currently not FDAapproved to treat tinea capitis that have similar cure rates and shorter durations of treatment for tinea capitis, and as a result, are being used off-label. The research-based literature related to the treatment of tinea capitis with various pharmacologic agents is reviewed.
Tinea capitis is a fungal infection involving the hair shaft of the scalp and hair follicles caused by dermatophyte fungi (Ali, Graham, & Forgie, 2007). While it may affect any age group, tinea capitis is particularly common among s chool-aged children (Alvarez & Silverberg, 2006). To treat tinea capitis, systemic anti-fungal rather than topical treatment is required. Topical anti-fungal treatments are not able to adequately penetrate the hair shaft to eliminate the infection (Ali et al., 2007; Chan & Friedlander, 2004). Because of the prevalence of tinea capitis, it is essential that nurses are aware of this condition and current available treatment regimens. The recent researchbased publications on the diagnosis and treatment of tinea capitis, and valuable evidence for nursing practice are reviewed.
Currently, griseofulvin (Grifulvin®) and terbinafine (Lamasil Granules®) are the only two medications approved by the United States Food and Drug Administration (FDA) for the treatment of tinea capitis (FDA, 2007; Roberts & Friedlander, 2005). There are newer anti-fungal agents available that have been shown to be safe and effective with a shorter duration of treatment, but are not yet approved by the FDA for the treatment of tinea capitis. Medications such as fluconazole and itraconazole are currently being prescribed offlabel for tinea capitis.
Off-label use refers to the use of legally available medications being prescribed for a function outside of the medication's approved label. For example, fluconazole (Diflucan®) is currently FDA approved to treat vaginal yeast infections but is sometimes used in pediatrics to treat tinea capitis (off-label use). Prescribing off-labelapproved medications is common and...