Common tinea infections in children.

The common dermatophyte genera Trichophyton, Microsporum, and Epidermophyton are major causes of superficial fungal infections in children. These infections (e.g., tinea corporis, pedis, cruris, and unguium) are typically acquired directly from contact with infected humans or animals or indirectly from exposure to contaminated soil or fomites. A diagnosis usually can be made with a focused history, physical examination, and potassium hydroxide microscopy. Occasionally, Wood's lamp examination, fungal culture, or histologic tissue examination is required. Most tinea infections can be managed with topical therapies; oral treatment is reserved for tinea capitis, severe tinea pedis, and tinea unguium. Topical therapy with fungicidal allylamines may have slightly higher cure rates and shorter treatment courses than with fungistatic azoles. Although oral griseofulvin has been the standard treatment for tinea capitis, newer oral antifungal agents such as terbinafine, itraconazole, and fluconazole are effective, safe, and have shorter treatment courses.