ABSTRACT
Oral therapy is usually required in order to eradicate the organism, alleviating disease symptoms quickly and safely and to reduce transmission to others. Griseofulvin is more effective against Microsporum species than Trichophyton species, and the latter may require prolonged therapy. UK guidelines suggest the use of griseofulvin or terbinafine as first-line therapy, dependent on the organism suspected/isolated, with itraconazole used as second-line therapy. Widespread or intractable superficial candidiasis may require systemic therapy. Children who are not immune to varicella zoster virus are at risk of severe chickenpox when taking immunosuppressive therapy, including prolonged corticosteroids. Courses of oral corticosteroids for skin diseases in children are usually prednisolone 1–2 mg/kg in total and should be intermittent and short. Off-label prescribing in children, should as far as possible be supported by evidence of safety and efficacy. Oral azole antifungals and terbinafine are increasingly being used in preference to griseofulvin as they have a broader spectrum of activity and shorter treatment duration.
