Favus Medication

  • Author: Jacek C Szepietowski, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 23, 2012
 

Medication Summary

The goals of pharmacotherapy are to eradicate the infection, to reduce morbidity, and to prevent complications.

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Antifungals

Class Summary

Mechanism of action usually involves inhibiting pathways (enzymes, substrates, transport) necessary for sterol/cell membrane synthesis or altering the permeability of the cell membrane (polyenes) of the fungal cell.[17]

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Griseofulvin (Fulvicin P/G, Grifulvin V)

 

Fungistatic activity. Dermatophytes are sensitive, but yeastlike fungi and molds are resistant. Fungal cell division is impaired by interfering with microtubule. Binds to keratin precursor cells. Keratin is gradually replaced by noninfected tissue, which is highly resistant to fungal invasions.

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Terbinafine (Lamisil)

 

Fungicidal agent and member of allylamine family.

Inhibits squalene epoxidase, which decreases ergosterol synthesis, causing fungal-cell death.

Use until symptoms significantly improve.

In young children, tab may be split and hidden in food.

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Itraconazole (Sporanox)

 

Fungistatic activity. Synthetic triazole antifungal agent that slows fungal cell growth by inhibiting cytochrome P-450-dependent synthesis of ergosterol, a vital component of fungal cell membranes.

Not registered for administration in children in most countries.

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Fluconazole (Diflucan)

 

Fungistatic activity. Synthetic oral antifungal (broad-spectrum bistriazole) that selectively inhibits fungal cytochrome P-450 and sterol C-14 alpha-demethylation, which prevents conversion of lanosterol to ergosterol, thereby disrupting cellular membranes.

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Contributor Information and Disclosures
Author

Jacek C Szepietowski, MD, PhD  Professor, Vice-Head, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University; Director of the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Poland

Disclosure: Stiefel GSK Company Salary Employment; Orfagen Consulting fee Consulting; Maruho Consulting fee Consulting; Astellas Consulting fee Consulting; Abbott Consulting fee Consulting; Leo Pharma Consulting fee Consulting

Coauthor(s)

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Franklin Flowers, MD  Chief, Division of Dermatology, Professor, Department of Medicine and Otolaryngology, Affiliate Associate Professor of Pediatrics and Pathology, University of Florida College of Medicine

Franklin Flowers, MD, is a member of the following medical societies: American College of Mohs Micrographic Surgery and Cutaneous Oncology

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Paul Krusinski, MD  Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous Chief Editor, William D. James, MD, to the development and writing of this article.

References

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  2. Khaled A, Ben Mbarek L, Kharfi M, et al. Tinea capitis favosa due to Trichophyton schoenleinii. Acta Dermatovenerol Alp Panonica Adriat. 2007;16:34-46.

  3. Raszeja-Kotelba B, Adamski Z, Pawlowicz A. A case of tinea favosa capitis caused by Trichophyton schoenleinii. Przegl Dermatol. 1993;80:518-24.

  4. Besbes M, Cheikhrouhou F, Sellami H, Makni F, Bouassida S, Ayadi A. Favus due to Trichophyton mentagrophytes var. quinckeanum. Mycoses. Sep 2003;46(8):358-60. [Medline].

  5. Garcia-Sanchez MS, Pereiro M Jr, Pereiro MM, Toribio J. Favus due to Trichophyton mentagrophytes var. quinckeanum. Dermatology. 1997;194(2):177-9. [Medline].

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  8. Pawlowicz A. Epidemiology of tinea capitis, particularly tinea favosa in the Poznan region. Postepy Dermatol (Poznan). 1996;13:347-400.

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  11. Matte SM, Lopes JO, Melo IS, Beber AA. A focus of favus due to Trichophyton schoenleinii in Rio Grande do Sul, Brasil. Rev Inst Med Trop Sao Paulo. Jan-Feb 1997;39(1):1-3. [Medline].

  12. Prochnau A, de Almeida HL Jr, Souza PR, Vetoratto G, Duquia RP, Defferrari R. Scutular tinea of the scrotum: report of two cases. Mycoses. May 2005;48(3):162-4. [Medline].

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  16. García-Vargas A, Mayorga-Rodríguez JA, Sandoval-Tress C. Scalp demodicidosis mimicking favus in a 6-year-old boy. J Am Acad Dermato. 2007;57, suppl. 2:S19-S21.

  17. Kwasniewska J. Current antifungal agents in dermatology. Postepy Dermatol (Poznan). 1997;14:129-35.

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  22. Szepietowski J. Dermatomycoses and onychomycosis. A practical guide. Medycyna Praktyczna, Krakow. 2001.

 
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Tinea favosa of the scalp shows erythematous lesions with pityroid scaling. Some hairs are short and brittle.
Favus of the scalp shows extensive lesions with scarring alopecia.
Typical fluorescence under Wood lamp examination.
Favus, wax montage. Courtesy of Professor Dr Feliks Wasik, Dermatology, Medical University of Wroclaw, Poland.
Black man, aged 45 years, with favuslike yellow crusting of scalp. Potassium hydroxide and fungal culture were negative.
Culture of Trichophyton schoenleinii on Sabouraud agar. Courtesy of Anna Pawlowicz, PhD, and Professor Barbara Raszeja-Kotelba, MD, Dermatology, University School of Poznan, Poland.
Culture of Trichophyton schoenleinii on Sabouraud agar. Note pleomorphism of the culture. Courtesy of Anna Pawlowicz, PhD, and Professor Barbara Raszeja-Kotelba, MD, Dermatology, University School of Poznan, Poland.
Microculture of Trichophyton schoenleinii shows dichotomic branching and terminal swelling. Light-field microscopy, original magnification X 1000. Courtesy of Anna Pawlowicz, PhD, and Professor Barbara Raszeja-Kotelba, MD, Dermatology, University School of Poznan, Poland.
Microculture of Trichophyton schoenleinii shows characteristic dichotomic branching. Light-field microscopy, original magnification X 1000. Courtesy of Anna Pawlowicz, PhD, and Professor Barbara Raszeja-Kotelba, MD, Dermatology, University School of Poznan, Poland.
Microculture of Trichophyton schoenleinii shows numerous terminal chlamydospores. Light-field microscopy, original magnification X 1200. Courtesy of Anna Pawlowicz, PhD, and Professor Barbara Raszeja-Kotelba, MD, Dermatology, University School of Poznan, Poland.
Infected hair filled with hyphae shows bubbles of gas and gas tunnels (light field microscopy, original magnification X 2300).
 
 
 
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