Tinea capitis - ein aktueller Überblick

Zusammenfassung

Klinisches Bild, Nativpräparat sowie mykologische Kultur sind die diagnostischen Eckpfeiler der Tinea capitis. Griseofulvin ist in Deutschland für die systemische Therapie der Kopfpilzerkrankung bei Kindern das bislang einzig uneingeschränkt zugelassene Medikament. Die neuen Ergosterolbiosyntheseinhibitoren Terbinafin, Itraconazol und Fluconazol sind zwar in kontrollierten Studien für andere Indikationen geprüft und zur systemischen antimykotischen Behandlung von Erwachsenen zugelassen, jedoch noch nicht für Kinder mit Tinea capitis. Bisher fehlen umfangreichere doppelblinde und randomisierte Vergleichsstudien mit Griseofulvin und den neuen Ergosterolbiosyntheseinhibitoren bei Tinea capitis. Fast alle größeren offenen Studien konnten jedoch zeigen, dass die neuen Antimykotika Terbinafin, Itraconazol und Fluconazol dem Griseofulvin durch kürzere Therapiezeiten und höhere Heilungsraten überlegen sind.

Abstract

Clinical picture, potassium hydroxide preparation and fungal culture are the principal diagnostic tools of tinea capitis. In Germany, griseofulvin is the only approved antifungal agent for the treatment of tinea capitis in children. The modern ergosterole biosynthesis inhibitors (terbinafine, itraconazole, and fluconazole) are namely tested and allowed for antifungal therapy in adults. They are not yet admitted for the treatment of children with tinea capitis. Thus, far few randomized double blind controlled studies concerning the effectiveness of these agents for the systemic therapy of tinea capitis have been published. Almost all open studies showed that the modern antifungals terbinafine, itraconazole, and fluconazole are superior to griseofulvin because of shorter duration of therapy and higher rates of cure.

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