Treatment and prophylaxis of tinea infections

Superficial fungal infections affect millions of people throughout the world. Among them, tinea represents cutaneous infections by dermatophytes. Therapeutic strategies depend upon the affected body site. Hence, clinicians distinguish several types of tinea including the corporis, faciei, cruris, pedis, manuum, capitis, barbae and unguium variants. There are several ways of tackling the tinea problem. Numerous topical and oral antifungals are available today. Topical antifungals remain the most commonly recommended treatment for many superficial dermatophytoses. Active compounds include imidazoles; morpholines and allylamines, with a few other miscellaneous drugs. The recent development of new generation oral agents (fluconazole, itraconazole, terbinafine) has enhanced the armamentarium against difficult-to-treat tineas. The antifungal efficacy and pharmacokinetic profiles of these drugs allow shorter durations of treatment and the innovative use of intermittent pulse regimens. The modern formulations fully meet the requirements of being well tolerated, involving little risk and acting specifically against relevant pathogens. However, the response rates to date do not always come up to the high expectations offered by in vitro studies.