Dawaa Reference

infectious

Tinea infections

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources7 sources

BAD Guidelines Tinea 2014 · DailyMed Clotrimazole 1% Cream Package Insert (DailyMed, NLM) · DailyMed Ketoconazole Cream 2% Package Insert, SetID ea56cddf-94c9-46b6-8791-995b741cfbd7 · DailyMed Miconazole Nitrate 2% Cream Package Insert (DailyMed, NLM) · UK eMC Terbinafine 250mg Tablet SmPC (Aurobindo Pharma - Milpharm Ltd.), product id 7133 · Tinea Corporis - StatPearls - NCBI Bookshelf (NBK544360) - disease-level clinical article · Egyptian National Drug Formulary - Antimicrobial 2023 (ketoconazole monograph, US Boxed Warnings)

Verified against6 documents
  • DailyMed Clotrimazole 1% Cream Package Insert (DailyMed, NLM)
  • DailyMed Ketoconazole Cream 2% Package Insert, SetID ea56cddf-94c9-46b6-8791-995b741cfbd7
  • DailyMed Miconazole Nitrate 2% Cream Package Insert (DailyMed, NLM)
  • UK eMC Terbinafine 250mg Tablet SmPC (Aurobindo Pharma - Milpharm Ltd.), product id 7133
  • Tinea Corporis - StatPearls - NCBI Bookshelf (NBK544360) - disease-level clinical article
  • Egyptian National Drug Formulary - Antimicrobial 2023 (ketoconazole monograph, US Boxed Warnings)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (1)

  • The patient reports an itchy red rash, usually on exposed neck, trunk or limbs [itching · rash]

Signs — what you find (4)

  • One or more round or oval patches or plaques [plaques]
  • The border is sharp, with a raised red scaly edge that may carry small blisters [blisters · scaling · vesicles]
  • How inflamed it looks varies widely from patient to patient
  • Lesions spread outwards and clear centrally, leaving light scaling, which is the ringworm look [scaling]

Tests (8)

  • History and examination usually settle it; tests are there to confirm
  • KOH microscopy of skin scrapings shows septate, branching, long narrow hyphae
  • Relying on KOH alone gives a false negative in up to 15% of cases
  • Fungal culture is reliable but slow: growth usually within 5 days, some species up to 4 weeks
  • Only after at least 4 weeks without a colony can a sample be called no growth
  • Sabouraud dextrose agar is the usual medium; the species is named from colony shape, pigment and surface
  • Antifungal susceptibility testing earns its place when the first treatment has failed
  • Dermoscopy shows characteristic features; corkscrew hairs are commonest on the scalp

If not this — what else fits (6)

  • If it fails to respond to antifungals, or KOH is negative, rethink the diagnosis
  • Discoid eczema, erythema annulare centrifugum and pityriasis versicolor all make rings
  • Skin candidiasis, subacute cutaneous lupus and pityriasis rosea can look the same
  • So can contact dermatitis, atopic eczema, seborrhoeic dermatitis and psoriasis
  • Extensive or severe skin involvement should raise suspicion of a serious mimic
  • The serious mimics to exclude are secondary syphilis, mycosis fungoides and parapsoriasis

SourceStatPearls "Tinea Corporis" - disease-level clinical article

Presentation findings are traced to the source above.

Rx: Main treatment | Oral - extensive, scalp or nail | Topical azole alternative

MAIN TREATMENT - choose one

1

CLOTRIMAZOLE

1st line

Formtopical

Adult dose and duration

Apply 1% cream thin layer to affected area twice daily x 2-4 weeks

Paediatric dose

Apply BID in children; safe from infancy

Choice

Alternatives, both topical azoles. Clotrimazole is the cheaper and the more widely stocked for tinea.

Dose source

DailyMed Clotrimazole 1% Cream Package Insert (DailyMed, NLM)

Why

Topical azole antifungal that disrupts fungal cell membrane synthesis; a first-line topical treatment for localised tinea infection of the skin.

Cautions
  • Continue for 14 days after lesion clearance to prevent recurrence.
  • Local skin irritation, burning, or redness may occur.
  • Avoid contact with eyes.
Egyptian brands
Egyptian brandManufacturerIndicative price
CANEMAZOLE 1% CREAM 20 GMUP PHARMA5.00 EGP
CANDISTAN 1% TOPICAL CREAM 15 GMKAHIRA > ARAB DRUG COMPANY (ADCO)7.25 EGP
DERMATIN 1% TOP. CREAM 14 GMPHARCO15.00 EGP
CANESTEN 1% CREAM 20 GMMEMPHIS > BAYER HEALTHCARE29.00 EGP
LOCASTEN 1% CREAM 20 GMALEXANDRIA29.00 EGP
CANDISTAN 1% TOPICAL CREAM 40 GMKAHIRA > ARAB DRUG COMPANY (ADCO)36.00 EGP
2

MICONAZOLE

1st line

Formtopical

Adult dose and duration

Apply 2% cream to the affected area twice daily x 2-3 weeks

Paediatric dose

Apply twice daily in children

Dose source

Tinea Corporis - StatPearls - NCBI Bookshelf (NBK544360) - disease-level clinical article

Why

Topical azole antifungal that disrupts fungal cell membrane ergosterol synthesis; the cited article lists miconazole 2% twice daily among the recommended topical regimens for localised tinea corporis.

Cautions
  • Topical miconazole can enhance warfarin effect via skin absorption.
  • The endpoint of therapy is the clinical resolution of symptoms.
  • Avoid eyes and mucous membranes.
Egyptian brands
Egyptian brandManufacturerIndicative price
MICONOL 2% CREAM 15 GMMEMPHIS5.00 EGP
DERMOZOL 2% GEL 15 GMPHARCO6.00 EGP
MICOBAN 2% CREAM 20 GMAMRIYA9.00 EGP
MICONAZ 2% CREAM 20 GMMUP15.00 EGP
MICONAZ 2% ORAL GEL 20 GMMUP23.00 EGP
DAKTARIN 2% CREAM 15 GMMINA PHARM > JANSSEN CILAG28.00 EGP
DAKTARIN 2% ORAL GEL 40 GMJANSSEN CILAG > SOFICOPHARM53.50 EGP
ADCOZOLE 2% TOPICAL CR. 15 GMARAB DRUG COMPANY (ADCO)7.25 EGP

ORAL - EXTENSIVE, SCALP OR NAIL

3

TERBINAFINE

Oral - extensive, scalp or nail

2nd line

Strength250 mg

Formoral.solid

Adult dose and duration

250 mg once daily for 2-4 weeks (tinea corporis/cruris) or 2-6 weeks (tinea pedis) x 2-4 weeks for tinea corporis or cruris, 2-6 weeks for tinea pedis

Paediatric dose

Specialist use only in children; weight-based dosing for tinea capitis under specialist supervision

Dose source

UK eMC Terbinafine 250mg Tablet SmPC (Aurobindo Pharma - Milpharm Ltd.), product id 7133

Why

Oral allylamine antifungal that inhibits fungal squalene epoxidase; reserved for extensive or recalcitrant tinea infection not responding to topical therapy.

Cautions
  • Indicated for extensive or recalcitrant tinea infections.
  • Taste disturbance (ageusia) can occur and persist after stopping.
  • Rare hepatotoxicity can occur - check baseline LFTs.
Egyptian brands
Egyptian brandManufacturerIndicative price
TRERBI 250 MG 10 TAB.MASH PREMIERE26.40 EGP (2.64/unit)
MYCOMIC 250 MG 10 TAB.FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > TABUK PHARMA26.50 EGP (2.65/unit)
MYCOMIC 250 MG 20 TABS.FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > TABUK PHARMA53.00 EGP (2.65/unit)
UNITOPFIN 250 MG 7 F.C. TABS.UNIPHARMA CO. > UNIPHARMA25.20 EGP (3.60/unit)
FUNGISAFE 250MG 7 TAB.AMOUN32.00 EGP (4.57/unit)
TERBIN 250 MG 14 TAB.GLOBAL NAPI PHARMACEUTICALS120.00 EGP (8.57/unit)
TERBINASIL 250 MG 7 TAB.JAMJOOM PHARMACEUTICALS-K.S.A68.00 EGP (9.71/unit)
LAMISIL 250MG 14 TAB.NOVARTIS146.50 EGP (10.46/unit)
LAMISIL ONCE 4G FILM FORMING SOLUTION.? strength differs? different route - not oral solidNOVARTIS50.00 EGP

TOPICAL AZOLE ALTERNATIVE

4

KETOCONAZOLE

Topical azole alternative

2nd line

Formtopical

Adult dose and duration

Apply 2% cream once daily to cover the affected and immediate surrounding area x 2-4 weeks (tinea corporis/cruris); 6 weeks for tinea pedis

Paediatric dose

Apply once daily in children

Dose source

DailyMed Ketoconazole Cream 2% Package Insert, SetID ea56cddf-94c9-46b6-8791-995b741cfbd7

Why

Topical azole antifungal alternative for tinea, used as a cream only: the ENDF's own ketoconazole monograph carries a US Boxed Warning that ketoconazole tablets are "not indicated for the treatment of onychomycosis, cutaneous dermatophyte infections, or Candida infections", and a second for hepatotoxicity "including fatal cases and cases requiring liver transplantation".

Cautions
  • Topical use only. The ENDF's own ketoconazole monograph carries a US Boxed Warning, verbatim: "Ketoconazole tablets are not indicated for the treatment of onychomycosis, cutaneous dermatophyte infections, or Candida infections." and a second one: "Ketoconazole has been associated with hepatotoxicity, including fatal cases and cases requiring liver transplantation; some patients had no apparent risk factors for hepatic disease."
  • Continue for a few days after clearance.
  • Local irritation may occur.
Egyptian brands
Egyptian brandManufacturerIndicative price
KONAZOLE 2% CREAM 15 GMALFACURE PHARMACEUTICALS6.00 EGP
CURAZOLE 2% TOPICAL CREAM 15 GMEVA PHARMA7.00 EGP
KETODERM 2% TOP. CREAM 20 GMSEDICO7.00 EGP
NIZODERM 2% CREAM 15 GMUNIPHARMA15.00 EGP
WELLOFUNG 2% TOPICAL CREAM 40 GMEGPI > HEALTH WELL48.00 EGP
KENZO 2% SHAMPOO 60 MLBORG27.50 EGP
ZAKAN 2GM/100ML SHAMPOO 60 MLSIGMA18.30 EGP
NIZAPEX 20MG/GM SHAMPOO 80 MLAPEX PHARMA68.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.