# Tinea infections - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - 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) ## Treatment metadata - Clotrimazole — topical - Miconazole — topical - Terbinafine — 250 mg — oral.solid - Ketoconazole — topical ## Complete treatment card ```text TINEA INFECTIONS 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) Review status: REVIEWED against 6 sources listed above (2026-08) 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 Source StatPearls "Tinea Corporis" - disease-level clinical article Status traced to the source above Rx: Main treatment | Oral - extensive, scalp or nail | Topical azole alternative MAIN TREATMENT - choose one 1. CLOTRIMAZOLE [1st line] Adult Apply 1% cream thin layer to affected area twice daily x 2-4 weeks Peds Apply BID in children; safe from infancy Choice Alternatives, both topical azoles. Clotrimazole is the cheaper and the more widely stocked for tinea. 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. Caution Continue for 14 days after lesion clearance to prevent recurrence. Local skin irritation, burning, or redness may occur. Avoid contact with eyes. Egypt CANEMAZOLE 1% CREAM 20 GM UP PHARMA 5.00 EGP CANDISTAN 1% TOPICAL CREAM 15 GM KAHIRA > ARAB... 7.25 EGP DERMATIN 1% TOP. CREAM 14 GM PHARCO 15.00 EGP CANESTEN 1% CREAM 20 GM MEMPHIS > BAY... 29.00 EGP LOCASTEN 1% CREAM 20 GM ALEXANDRIA 29.00 EGP CANDISTAN 1% TOPICAL CREAM 40 GM KAHIRA > ARAB... 36.00 EGP 2. MICONAZOLE [1st line] Adult Apply 2% cream to the affected area twice daily x 2-3 weeks Peds Apply twice daily in children 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. Caution Topical miconazole can enhance warfarin effect via skin absorption. The endpoint of therapy is the clinical resolution of symptoms. Avoid eyes and mucous membranes. Egypt MICONOL 2% CREAM 15 GM MEMPHIS 5.00 EGP DERMOZOL 2% GEL 15 GM PHARCO 6.00 EGP MICOBAN 2% CREAM 20 GM AMRIYA 9.00 EGP MICONAZ 2% CREAM 20 GM MUP 15.00 EGP MICONAZ 2% ORAL GEL 20 GM MUP 23.00 EGP DAKTARIN 2% CREAM 15 GM MINA PHARM > ... 28.00 EGP DAKTARIN 2% ORAL GEL 40 GM JANSSEN CILAG... 53.50 EGP ADCOZOLE 2% TOPICAL CR. 15 GM ARAB DRUG COM... 7.25 EGP ORAL - EXTENSIVE, SCALP OR NAIL 3. TERBINAFINE [2nd line] Adult 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 Peds Specialist use only in children; weight-based dosing for tinea capitis under specialist supervision 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. Caution Indicated for extensive or recalcitrant tinea infections. Taste disturbance (ageusia) can occur and persist after stopping. Rare hepatotoxicity can occur - check baseline LFTs. Egypt TRERBI 250 MG 10 TAB. MASH PREMIERE 26.40 EGP (2.64/unit) MYCOMIC 250 MG 10 TAB. FUTURE PHARMA... 26.50 EGP (2.65/unit) MYCOMIC 250 MG 20 TABS. FUTURE PHARMA... 53.00 EGP (2.65/unit) UNITOPFIN 250 MG 7 F.C. TABS. UNIPHARMA CO.... 25.20 EGP (3.60/unit) FUNGISAFE 250MG 7 TAB. AMOUN 32.00 EGP (4.57/unit) TERBIN 250 MG 14 TAB. GLOBAL NAPI P... 120.00 EGP (8.57/unit) TERBINASIL 250 MG 7 TAB. JAMJOOM PHARM... 68.00 EGP (9.71/unit) LAMISIL 250MG 14 TAB. NOVARTIS 146.50 EGP (10.46/unit) LAMISIL ONCE 4G FILM FORMING SOLUTION. NOVARTIS 50.00 EGP -> ? strength differs, ? different route - not oral solid TOPICAL AZOLE ALTERNATIVE 4. KETOCONAZOLE [2nd line] Adult 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 Peds Apply once daily in children 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". Caution 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. Egypt KONAZOLE 2% CREAM 15 GM ALFACURE PHAR... 6.00 EGP CURAZOLE 2% TOPICAL CREAM 15 GM EVA PHARMA 7.00 EGP KETODERM 2% TOP. CREAM 20 GM SEDICO 7.00 EGP NIZODERM 2% CREAM 15 GM UNIPHARMA 15.00 EGP WELLOFUNG 2% TOPICAL CREAM 40 GM EGPI > HEALTH... 48.00 EGP KENZO 2% SHAMPOO 60 ML BORG 27.50 EGP ZAKAN 2GM/100ML SHAMPOO 60 ML SIGMA 18.30 EGP NIZAPEX 20MG/GM SHAMPOO 80 ML APEX PHARMA 68.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)