Griseofulvin and terbinafine in the treatment of tinea capitis in children.

Objective: To compare the effectiveness of griseofulvin and terbinafine in the treatment of tinea capitis in children.

Methods: Twenty four consecutive patients with culture proven tinea capitis were treated randomly with griseofulvin (10 mg/kg/day for 8 weeks) or terbinafine (62.5-250 mg/day for 4 weeks). Outcome was determined by absence of clinical signs, hair regrowth or negative mycology.

Results: Twenty four patients (16 male, 8 female) were treated. Age ranged between 2 and 15 years (mean 4.8). Seven patients presented with kerion, the remainder with a scaling and patchy alopecia pattern of tinea capitis. The responsible organisms were Microsporum canis (17 cases) and Trichophyton verrucosum (7 cases). Fourteen children were treated with griseofulvin and 10 with terbinafine. By three months follow up, 19 patients had cleared completely with good new hair regrowth. Three children had no active disease but only minimal new hair growth. One child (griseofulvin group) had no hair regrowth but was culture negative. She had sustained significant dermal and subcutaneous skin damage requiring plastic surgery. The other (terbinafine group) had ongoing active kerion.

Conclusions: Both griseofulvin and terbinafine are equally effective in the treatment of tinea capitis.