ABSTRACT
Most of the fungi that affect the skin, hair and nails only proliferate under the ideal conditions of warmth, moisture and humidity. Topical therapy may be sufficient for dermatophytosis other than nail and scalp infections-for example, terbinafine topical formulations, tolnaftate, imidazole, amorolfine, cyclopiroxolamine, clotrimazole, miconazole, econazole, ketoconazole, bifonazole and tioconazole. It has been available for over 30 years and is still valuable for dermatophytic skin infection, in particular tinea capitis. Oral therapy using griseofulvin has been used extensively for the treatment of dermatophytosis. The duration of therapy varies from patient to patient and on the site and severity of the infection, with up to 12 weeks being required for skin and hair infections and approximately 12 months for nails. Oral ketoconazole has a high affinity for keratin and it has been used for dermatophytes, although the risk of hepatitis, albeit rare, makes this a secondary choice for therapy, especially now newer agents such as fluconazole, itraconazole and terbinafine are available.
