Use clogs for showers. Also see your doctor if you have signs of an infection swelling of the affected area, pus, fever. (https://www.ncbi.nlm.nih.gov/books/NBK279549/). B. D. Complaint of jock itch A. Tinea pedis tends to be asymmetrical, and may be unilateral. Moccasin tinea pedis . Tinea corporis and cruris infections are usually treated for two weeks, while tinea pedis is treated for four weeks with an azole or for one to two weeks with allylamine medication. Garlic Garlic may have a strong scent, but it. If you have a rash on your foot that doesn't improve within two weeks of beginning self-treatment with an over-the-counter antifungal product, see your doctor. Continue with Recommended Cookies, Transcribed Medical Transcription Sample Reports and Examples, SOAP / Chart / Progress Notes - Medical Reports, Postop Parathyroid Exploration & Parathyroidectomy, Posttransplant Lymphoproliferative Disorder, General Medicine-Normal Male ROS Template - 1(Medical Transcription Sample Report), See More Samples on SOAP / Chart / Progress Notes, View this sample in Blog format on MedicalTranscriptionSamples.com. Change the dressing daily and keep the area covered with an adhesive bandage until completely healed. Advertising on our site helps support our mission. tinea barbae but painful in bacterial infections[28]. Dermatologic Disorders - Merck Manuals Professional Edition He denies any hearing. Involvement of the plantar and lateral aspects of the foot with erythema and hyperkeratosis is referred to as the moccasin pattern of tinea pedis.4, Tinea corporis, tinea cruris, and tinea pedis can often be diagnosed based on appearance, but a KOH preparation or culture should be performed when the appearance is atypical.2, Tinea corporis, tinea cruris, and tinea pedis are generally responsive to topical creams such as terbinafine (Lamisil) and butenafine (Lotrimin Ultra), but oral antifungal agents may be indicated for extensive disease, failed topical treatment, immunocompromised patients, or severe moccasin-type tinea pedis. is a 9-yr-old black male Referral: None Source and Reliability: Self-referred with parent; seems reliable; report from . Infection is usually acquired by direct contact with the causative organism, for example using a shared towel, or by walking barefoot in a public change room. Approach to the Patient with a Skin Disorder. Physicians should confirm suspected onychomycosis and tinea capitis with a potassium hydroxide preparation or culture. dermatophyte fungi, invade the skin following trauma. [CDATA[ I. The safest tinea pedis treatment is topical antifungals, but recurrence is common and treatment must often be prolonged. Accessed June 8, 2021. o [teenager OR adolescent ], , MD, Dartmouth Geisel School of Medicine. V. Assessment Like tinea capitis, tinea barbae is treated with oral antifungal therapy as shown in table 3. //SOAP NOTE-TC.docx - 1 Running Head: JOURNAL 1 Journal 1: - Course Hero Many antifungal medications are suitable for both dermatophyte and yeast infections. It is often confused with non-infected nail dystrophy due to skin disease, particularly psoriasis (also . Incidence A. G. History of exposure to predisposing factors (e.g., communal showers, prolonged use of sneakers). Vinegar wet packs: 12 cup vinegar to 1 quart warm water; apply 15 minutes, bid. These include azoles, allylamines, butenafine, ciclopirox, and tolnaftate. 4. Lesions may be single or multiple and the size generally ranges from 1 to 5 cm, but larger lesions and confluence of lesions can also occur. Telephone call in 3 to 4 days Intertrigo: Rash is erythematous with oozing, exudation, and crusting; borders are not sharply defined, with no central clearing. These include: Patients with the hyperkeratotic variant of tinea pedis may benefit from the addition of a topical keratolytic cream containing salicylic acid or urea [5]. 1. information highlighted below and resubmit the form. Tinea unguium is increasingly prevalent with increased age and spreads from tinea pedis or less often, tinea manuum. The best evidence supports terbinafine for treating adolescents with tinea unguium, 24 although griseofulvin is usually used in children. Avoiding walking barefoot on the carpeting of hotel rooms. Antifungal drugs applied directly to the affected areas or taken by mouth usually cure the infection. Note(s) This . Also consider dyshidrotic eczema, palmoplantar psoriasis, and allergic contact dermatitis. Objective data Athletes foot is a form of ringworm. Education The lesions are raised erythematous vesicular borders that are well marginated. Spectazole 1% Cream, once daily (also effective against C. albicans) Tinea corporis particularly effects the upper parts of the body such as the shoulders, axilla, chest and back (Dimple et al, 2016). Avoid sneakers and plastic footwear. Options for Treatment of Superficial Fungal Infections*, Desenex Max, Lamisil, Lamisil AT, Lamisil AT Athletes Foot, Lamisil AT Jock Itch, Terbinex, Aloe Vesta, Antifungal, AZOLEN TINCTURE, Baza, Cruex, Desenex, Desenex Jock Itch, Fungoid, Lotrimin AF, Lotrimin AF Antifungal Liquid, Lotrimin AF Deodorant, Lotrimin AF Powder, Lotrimin AF Spray, Micaderm , Micatin, Miconazole 7, Micotrin AP, Micro-Guard , Mitrazol, Monistat 1 Day or Night Combination Pack, Monistat 1 Vaginal Ovule Combination Pack, Monistat 1 Vaginal Ovule Combination Pack (Prefilled), Monistat 3, Monistat 3 Vaginal Cream (Prefilled), Monistat 3 Vaginal Cream Combination Pack, Monistat 3 Vaginal Cream Combination Pack (Prefilled), Monistat 3 Vaginal Ovule Combination Pack, Monistat 3 Vaginal Suppositories Combination Pack, Monistat 7, Monistat 7 Vaginal Cream Combination Pack, Monistat-Derm, Mycozyl AP, Neosporin AF, Novana Anti-Fungal, Oravig, Remedy, Soothe & Cool INZO, Ting Antifungal, Triple Paste AF , Vagistat-3, Zeasorb Athlete's Foot, Zeasorb Jock Itch. Med Mycol. PDF Diagnosis and Treatment of Dermatophytes Infections - Ijsit All Rights Reserved. Tinea Pedis Treatment Guidelines Step 1: Treat the fungus Use a film forming solution version of terbinafine like Lamisil Once. 1. Tinea Corporis and Tinea Capitis | Pediatrics In Review | American II. I. Etiology: Epidermophyton floccosum and Trichophyton sp. Tinea Pedis (Athlete's Foot) - Merck Manuals Professional Edition Tinea pedis is a dermatophyte infection of the feet. A. Interdigital fissures TINEA CRURIS. Tinea capitis may progress to kerion, which is characterized by boggy tender plaques and pustules. Treatment is with topical antifungals, occasionally oral antifungals, moisture reduction, and . Soap note Tinea Pedis - Assignment Help Services Other risk factors include: 4. interdigitale) or Epidermophyton floccosum. If you have diabetes, see your doctor if you suspect that you have athlete's foot. F. Regional adenopathy Tinea pedis is a foot infection due to a dermatophyte fungus. Heat the slide with a match or alcohol lamp. He, reports that he noted the symptoms 2 weeks ago after he had been working on his farm. The condition is contagious and can be spread via contaminated floors, towels . Signs and symptoms of athlete's foot include an itchy, scaly rash. Scrapings from lesions in potassium hydroxide fungal preparation reveal hyphae and spores. Tinactin cream, apply tid (over-the-counter preparation; ineffective against C. albicans). X. Consultation/referral Do not, in general, treat tinea capitis or onychomycosis without first confirming the diagnosis with a potassium hydroxide preparation, culture, or, for onychomycosis, a periodic acidSchiff stain. 2. 3. 1. Oral treatments for fungal infections of the skin of the foot. The most common onychomycosis mimics include chronic trauma and psoriasis.25 Adolescents and young adults can develop dystrophic toenails from repeated sudden-stop trauma associated with basketball, soccer, and tennis.26 The great toes are most often involved in onychomycosis and trauma-related dystrophy, but exclusive little toe involvement is likely related to trauma. 2001; 39(4): 33540. If you have any concerns with your skin or its treatment, see a dermatologist for advice. 1. A. He neither, He avoids dusty and areas with pollen grains as it makes him, sneeze. Continue treatment for at least 4 weeks to prevent relapse. Do not lend or borrow shoes. These products contain clotrimazole, miconazole, tolnaftate or terbinafine. J. Your skin may become scaly and cracked or develop blisters. It can also sting or burn and smell bad. 6. Source: Manual of Ambulatory Pediatrics 2010. All rights reserved. This is moccasin athletes foot. Podiatry-Athlete's Foot (Medical Transcription Sample Report) B. Antifungal creamsuse one of the following: Diagnosis is by clinical appearance and by examination of plucked hairs or hairs and scale on potassium hydroxide wet mount. dermatophyte fungi Accessed June 8, 2021. LAS-INT-06 Study Group. Review/update the posted 2010-04-20, updated 2019-12-22. J. Unilateral involvement is a significant positive clinical finding. F. Hygiene The most common infections in prepubertal children are tinea corporis and tinea capitis, whereas adolescents and adults are more likely to develop tinea cruris, tinea pedis, and tinea unguium (onychomycosis). B. Your skin may appear irritated (red, purple, gray or white), scaly or flaky. Chronic infection (80% of patients acquire immunity; 20% may develop chronic infection). Estimates suggest that 3% to 15% of the population has athletes foot, and 70% of the population will have athletes point at some time in their lives. Conversely, if a nonfungal lesion is treated with an antifungal cream, the lesion will likely not improve or will worsen. Tinea infections of the feet, nails, and . B. Pruritus Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, Scaly, peeling or cracked skin between the toes, Itchiness, especially right after taking off shoes and socks, Inflamed skin that might appear reddish, purplish or grayish, depending on your skin color, Dry, scaly skin on the bottom of the foot that extends up the side, Share mats, rugs, bed linens, clothes or shoes with someone who has a fungal infection, Walk barefoot in public areas where the infection can spread, such as locker rooms, saunas, swimming pools, communal baths and showers. Tinea corporis, tinea cruris, and tinea pedis generally respond to inexpensive topical agents such as terbinafine cream or butenafine cream, but oral antifungal agents may be indicated for extensive disease, failed topical treatment, immunocompromised patients, or severe moccasin-type tinea pedis. Widespread fine scaling; extension onto sides of foot and heel is frequent. Its important to follow your healthcare providers treatment plan. Hyperkeratotic moccasin-type tinea pedis, 6020002, 25956006, 43581009, 403055000, 75996005, 403054001, Patient information: Ringworm, athletes foot, and jock itch (The Basics), Patient information: Ringworm (including athlete's foot and jock itch) (Beyond the Basics), Interdigital involvement is most commonly seen (this presentation is also known as, Small to medium-sized blisters, usually affecting the inner aspect of the foot (, Dry feet and toes meticulously after bathing, Avoid wearing occlusive footwear for long periods, Clean the shower and bathroom floors using a product containing bleach. Original page created in 2003. View. Mycology is negative. the unsubscribe link in the e-mail. Finally, we performed multiple targeted searches in PubMed and reference lists of previously retrieved studies to fill in remaining information gaps, such as the performance characteristics of laboratory tests used to diagnose fungal infections. Most common of all the fungal diseases. The more common chronic form is characterized by scaling, peeling, and erythema between the toes; however, it can spread to other areas of the foot. Copyright 2023 | WordPress Theme by MH Themes, UTD Oral toxicity associated with chemotherapy, Rx All C 2 check and keep this version, First Case of 2019 Novel Coronavirus in the United States. For example, tinea corporis can be confused with eczema, tinea capitis can be confused with alopecia areata, and onychomycosis can be confused with dystrophic toe-nails from repeated low-level trauma. Place two drops of 10% or 20% KOH on the scrapings, followed by a coverslip. Bathe daily; dry thoroughly after bathing. He states that the itching worsens whenever he removes his shoes. Lac-Hydrin cream (for Tinea Manum) Topical Antifungal (twice daily for 3-4 weeks) Technique Apply to normal skin 2 cm beyond affected area Continue for 7 days after symptom resolution First line: Imidazoles (e.g. Tinea versicolor - Diagnosis and treatment - Mayo Clinic Do not use griseofulvin to treat onychomycosis because terbinafine (Lamisil) is usually a better option based on its tolerability, high cure rate, and low cost. C. Domeboro solution becomes concentrated on exposure to air; keep in covered container. B. Check out this free SOAP note kit that includes a template, checklist, even more SOAP note examples, and 7 Tips to Improve Your Documentation. In feet with moccasin athletes foot, the skin on the bottoms, heels and edges of your feet are dry, itchy and scaly. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Often seen following trauma or in conjunction with atopic dermatitis. Scaling is visible in the interdigital space on close inspection. . Do not treat tinea capitis solely with topical agents, but do combine oral therapy with sporicidal shampoos, such as selenium sulfide (Selsun) or ketoconazole. Augmentin 500 mg, every 12 hours (over 40 kg) Medical Mycology. Tinea pedis has various patterns and may affect one or both feet. Diagnosis is by clinical appearance and sometimes by potassium hydroxide wet mount, particularly if the infection manifests as hyperkeratotic, ulcerative, or vesiculobullous or is not interdigital. Fungal skin infections. Tinea pedis | DermNet Your symptoms depend on the type of athletes foot that you have. By SOAPnote. It may affect one or more toenails and/or fingernails and most often involves the great toenail or the little toenail. Do not use oral ketoconazole to treat any tinea infection because of the U.S. Food and Drug Administration boxed warnings about hepatic toxicity and the availability of safer agents. Sometimes, your feet smell bad. A Wood lamp examination may be helpful to distinguish tinea from erythrasma because the causative organism of erythrasma (Corynebacterium minutissimum) exhibits a coral red fluorescence. Patients with chronic or recurrent tinea pedis may benefit from wide shoes, drying between the toes after bathing, and placing lamb's wool between the toes.5 Patients with tinea gladiatorum, a generalized form of tinea corporis seen in wrestlers, should be treated with topical therapy for 72 hours before return to wrestling.6, Several pitfalls of managing tinea infections are listed in Table 3.2,7,8, In the United States, tinea capitis most commonly affects children of African heritage between three and nine years of age.4 There are three types of tinea capitis: gray patch, black dot, and favus. Diagnosis is confirmed by skin scrapings, which are sent for microscopy in potassium hydroxide (when segmented hyphae may be observed) and culture (mycology). B. Other typical sites, such as toenails, groin, and palms of the hands, should be examined for fungal infection, which may support a diagnosis of tinea pedis. Mycopathologia. Tinea pedis is a dermatophyte infection of the feet. B. Elsevier; 2021. https://www.clinicalkey.com. Tinea cruris can affect all races, being particularly common in hot humid tropical climates. J. B. Infection may occur through contact with infected humans and animals, soil, or inanimate objects. Tinea pedis (fungal foot infection) | DermNet Candidiasis: Lesions are moist and intensely erythematous with sharply defined borders and satellite lesions; more common in females. However, concomitant treatment with 1% or 2.5% selenium sulfide (Selsun) shampoo or 2% ketoconazole shampoo should be used for the first two weeks because it may reduce transmission.12,13 For many years, the first-line treatment for tinea capitis has been griseofulvin because it has a long track record of safety and effectiveness. The cream is also labeled to cure tinea pedis on the bottom and sides of the feet when used twice daily for 2 weeks. It's caused by different types of fungi. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Education Finally, a few more tips for writing better SOAP notes: Write the notes as soon as you can after the session, or during the last few minutes if allowed. Differential diagnosis of tinea pedis includes, Dyshidrotic eczema Atopic Dermatitis (Eczema) Atopic dermatitis is a chronic relapsing inflammatory skin disorder with a complex pathogenesis involving genetic susceptibility, immunologic and epidermal barrier dysfunction, and environmental read more, Palmoplantar psoriasis ( see Table: Subtypes of Psoriasis Subtypes of Psoriasis ), Allergic contact dermatitis Allergic contact dermatitis (ACD) Contact dermatitis is inflammation of the skin caused by direct contact with irritants (irritant contact dermatitis) or allergens (allergic contact dermatitis). SOAP Tinea Corporis Soap Note Monday, September 6, 2010 7/27/10 1000 T.M. H. Vesicular eruption of the handsan id reactionmay occur. 3. Athlete's foot causes an itchy, stinging, burning rash on the skin on one or both of your feet. A. I. In: Ferri's Clinical Advisor 2021. Symptoms include pruritus and read more (due to type IV delayed hypersensitivity to various materials in shoes, particularly adhesive cement, thiuram compounds in footwear that contains rubber, and chromate tanning agents used in leather footwear), irritant contact dermatitis Irritant contact dermatitis (ICD) Contact dermatitis is inflammation of the skin caused by direct contact with irritants (irritant contact dermatitis) or allergens (allergic contact dermatitis). Subjective data Make small talk until the patient feels comfortable . Mayo Clinic; 2021. In addition to the common distal subungual form, which is characterized by thickened, brittle, discolored nails (Figure 5), onychomycosis may present with an uncommon proximal subungual form, which should raise suspicion of immunocompromise, and a white superficial form, which is more common in children than adults24 (Figure 6). April 2018. 2014 Feb. 13(2): 1625. A rare variant form appears as nummular (circle- or round-shaped) scaling patches studded with small papules or pustules that have no central clearing. 3. JOHN W. ELY, MD, MSPH, SANDRA ROSENFELD, MD, AND MARY SEABURY STONE, MD. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). A typical course is 2 to 4 weeks, but single dose regimes can be successful for mild infection [1,2]. Home Remedies for Athlete's Foot - Healthline Tinea pedis. Diagnosis: Diagnosis is generally made by physical findings. Onychomycosis is a common consideration in adolescents and adults with dystrophic toenails. E. Blisters on soles KOH dissolves squamous cells but leaves the fungal elements intact. health information, we will treat all of that information as protected health Medical Soap Notes: Pocket Size Progress Note Templates: Fill-In SOAP or H&P Notebook for Med Students, Nurses, and Physicians / Practical Gift For . Open sores often appear between your toes, but they may appear on the bottoms of your feet. Do not use topical clotrimazole or miconazole to treat tinea because topical butenafine (Lotrimin Ultra) and terbinafine have better effectiveness and similar cost (. Differential diagnosis Athlete's foot can sometimes lead to bacterial infections. Early disease can be limited to itching and scaling, but the more classic presentation involves one or more scaly patches of alopecia with hairs broken at the skin line (black dots) and crusting. Several drops of a potassium hydroxide (KOH) solution dissolve the skin cells so only fungal cells are visible. Copyright 2023 American Academy of Family Physicians. Use OR to account for alternate terms The link you have selected will take you to a third-party website. B. https://www.ncbi.nlm.nih.gov/books/NBK279549/. H. Check siblings carefully for signs of infection. In: Usatine RP, Smith MA, Mayeaux, Jr. EJ, Chumley HS, eds. 1. 4.5 (2k+) 4.7 (139) Chat. Tinea pedis is the most common dermatophytosis Overview of Dermatophytoses Dermatophytoses are fungal infections of keratin in the skin and nails (nail infection is called tinea unguium or onychomycosis). 2. What Is Athlete's Foot & How Do You Treat It? - Cleveland Clinic In: Kelly A, Taylor SC, Lim HW, Serrano A, eds. History and physical findings are generally adequate for diagnosis. Tinea unguium is more commonly known as onychomycosis. privacy practices. D. Note: For fungal infection of nailsDiflucan 200 mg once a week until nail grows out Athlete's foot is caused by the same type of fungi (dermatophytes) that cause ringworm and jock itch. A. It spreads in areas used by large groups of people, like locker rooms, swimming pools and saunas. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Looks infected (red, purple, gray or white skin; irritation and swelling). Diagnosis is by read more because moisture resulting from foot sweating facilitates fungal growth. An itchy, stinging, burning rash forms on infected skin. KOH preparations are often needed to confirm the diagnosis of tinea infections (Figure 7). Tinea is a geographically widespread group of fungal infections caused by dermatophytes. Loprox cream, for children older than 10 years, tid (also effective against C. albicans) Usatine RP, Reppa C. Tinea Pedis. E. Antibiotics for concurrent infection or cellulitis (However, nystatin is often effective for cutaneous. The diagnosis of onychomycosis should usually be confirmed with a KOH preparation, culture, or PAS stain because the treatment is long and potentially expensive, and the nonfungal mimics are common.27 In one study, less than 50% of dystrophic toenails resulted in positive fungal cultures.28 However, the involvement of multiple toenails, or accompanying tinea pedis, may justify treatment without confirming the diagnosis.29 The most sensitive diagnostic test, and the most expensive, is the PAS stain,30 which can be performed by placing toenail clippings or curettings in 10% formalin and transporting them to the pathology laboratory. It is important to note that tinea pedis presenting with inflammation or as the wet, soggy type may require the use of an astringent solution (e.g., Burow's solution) prior to initiation of antifungal therapy. Athletes foot can spread across the bottom of your foot. Apply talcum powder or antifungal powder to your feet to absorb moisture. Damp socks and shoes and warm, humid conditions favor the organisms' growth. However, it most commonly affects men (and people assigned male at birth) and people over the age of 60. Tinea on the body or scalp is sometimes known as ringworm. The scalp should also be cultured to identify the organism and immunocompromise should be considered. VII. Concomitant topical antifungal use may reduce recurrences. Wart on the finger. Identify cultural factors pertinent to their health, Question 10 / 10 pts Many nurses use the mnemonic term PERRLA, which means pupils are equal, round, and reactive to light and accomodation. A second treatment course with the same or a different agent is reasonable if the diagnosis is confirmed. Put on your socks before your underwear to prevent the fungus from spreading to your groin. Do not perform potassium hydroxide preparations or cultures on asymptomatic household members of children with tinea capitis, but do consider empiric treatment with a sporicidal shampoo. Its important to finish your full course of medicine. A. If treatment of tinea pedis is unsuccessful, consider reinfection, coexistent untreated fungal nail infection, reinfection due to untreated family member, or an alternative diagnosis. I. Etiology: Trichophyton mentagrophytes and Trichophyton rubrum, If we combine this information with your protected D. Scaling of feet Incidence increases in hot, humid weather. Some prescription antifungal medications for athletes foot are pills. dermatophyte fungi. People often wear socks and tight shoes every day, which keep their feet warm and moist. Topical Treatment of Common Superficial Tinea Infections Athlete's foot is closely related to other fungal infections such as ringworm and jock itch. DermNet does not provide an online consultation service.If you have any concerns with your skin or its treatment, see a dermatologist for advice. However, randomized clinical trials have confirmed that newer agents, such as terbinafine and fluconazole (Diflucan), have equal effectiveness and safety and shorter treatment courses1416 (Table 4).2,12,1720 Terbinafine may be superior to griseofulvin for Trichophyton species, whereas griseofulvin may be superior to terbinafine for the less common Microsporum species.21,22 Culture results are usually not available for two to six weeks, but 95% of tinea capitis cases in the United States are caused by Trichophyton, making terbinafine a reasonable first choice.23 However, kerion should be treated with griseofulvin unless Trichophyton has been documented as the pathogen.2,17 Failure to treat kerion promptly can lead to scarring and permanent hair loss.2, Microsize (Grifulvin V suspension): 20 to 25 mg per kg per day; single daily dose or two divided doses (maximum: 1 g per day), Ultramicrosize (Gris-Peg tablets): 10 to 15 mg per kg per day; single daily dose or two divided doses (maximum: 750 mg per day), Microsize: $44 ($165) for 300 mL of 125-mg-per-5-mL solution, Ultramicrosize: $263 ($430) for 60 250-mg tablets, No baseline testing in absence of liver disease, If required for longer than eight weeks, ALT, AST, bilirubin, and creatinine measurements and CBC every eight weeks2,17, Six to 12 weeks (continue for two weeks after symptoms and signs have resolved)2, 25 to 35 kg (55 lb to 78 lb): 187.5 mg once daily, CBC at six weeks for courses lasting longer than six weeks, Six weeks; longer for Microsporum infections, Assume Trichophyton unless culture reveals Microsporum, Daily dosing: 6 mg per kg per day for three to six weeks, Tablets: $100 for 30 150-mg tablets ($1,185 for 90 50-mg tablets), Suspension: $33 ($290) for 35 mL of 40-mg-per-mL suspension, Approved for children older than six months for other indications, Baseline ALT, AST, and creatinine measurement and CBC, Capsules: 5 mg per kg daily for four to six weeks, Solution: 3 mg per kg daily for four to six weeks, Pulse therapy with capsules: 5 mg per kg daily for one week each month for two to three months, Pulse therapy with oral solution: 3 mg per kg daily for one week each month for two to three months, Solution: NA ($265) for 150 mL of 10-mg-per-mL solution, Capsules: $102 ($590) for 30 100-mg capsules, Apply daily to affected nail and adjacent skin; remove with alcohol every seven days, 40 kg (89 lb) or more and adults: 250 mg daily, Approved for children older than four years for tinea capitis, ALT and AST measurement, CBC at six weeks, Six weeks for fingernails; 12 weeks for toenails, Approved for adults and children older than six months for other indications, Baseline ALT, AST, alkaline phosphatase, and creatinine measurements, CBC, 12 to 16 weeks for fingernails; 18 to 26 weeks for toenails.
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