Comparison of topical and oral treatments for tinea gladiatorum.
OBJECTIVE
Little has been published regarding treatment guidelines for tinea gladiatorum in the competitive wresting population, where outbreaks are commonplace. This study compares the efficacy of a first-line topical treatment regimen and an oral treatment regimen.


METHODS
A randomized, prospective, open-label pilot study was conducted during the 1997 to 1998 interscholastic wrestling season.


METHODS
Training rooms at two suburban high schools.


METHODS
Male high school wrestlers with culture-proven tinea corporis were included in the study. There were 22 wrestlers enrolled; 17 finished the study.


METHODS
Wrestlers were randomized to receive either clotrimazole 1% cream applied twice daily or fluconazole 200 mg once weekly for a total treatment duration of 3 weeks.


METHODS
Symptom scores, lesion measurements, and fungal cultures were followed to assess treatment efficacy.


RESULTS
Eleven wrestlers received clotrimazole and six wrestlers finished the full course of fluconazole. The extrapolated time to 50% improvement in symptom scores was 11.9 days in the clotrimazole group and 10.1 days in the fluconazole group. The extrapolated time to 50% lesion reduction was 18.7 days in the clotrimazole group and 17.2 days in the fluconazole group. The extrapolated time to 50% culture eradication was 22.7 days in the clotrimazole group and 11.1 days in the fluconazole group.


CONCLUSIONS
Both clotrimazole and fluconazole produce similar improvement in clinical parameters. Fluconazole showed arithmetically, but not statistically, superior culture eradication. Fluconazole in a weekly dosing schedule should be considered in the first-line treatment of tinea gladiatorum.
Kohl
T D
TD
Reading Hospital and Medical Center, Family Health Care Center, Pennsylvania 19612-6052, USA.
Martin
D C
DC
Berger
M S
MS
D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000935:Antifungal Agents / Q000008:administration & dosage*; D003022:Clotrimazole / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D015725:Fluconazole / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D014005:Tinea / Q000188:drug therapy* / Q000209:etiology; D014952:Wrestling
D000935:Antifungal Agents; D015725:Fluconazole; D003022:Clotrimazole