Fungal Skin/Nail Infestation
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þ ketoconazole (Nizoral)
 - can rarely cause fulminant liver failure and death.
 - dose: 200 mg once daily

þ itraconazole (Sporanox)
 - is better than ketoconazole
 - for tinea on scalp, pulse therapy 200 mg BID for one week (one pulse),
   that's it.
 - If under finger nail, use 1 week on, 3 weeks off, then repeat.
 - Don't use without checking for interactions with Warfarin, Rifampin, etc.

þ fluconazole
 - good but problems similar to itraconazole with medication interactions.
 - for vaginal candidiasis: 150 mg. once
 - for esophagitis, 200 mg PO stat + 100 mg PO daily.

þ Lamasil
 - for toenails.

þ Griseofulvin for Tinea Capitus
 - Headache, gastrointestinal discomfort, and photosensitization
   are common side effects.
 - Need to treat for 1-2 months.
 - Very well tolerated by kids if give the liquid.

þ Kerion
 - Treat with Griseo, high-dose, 6 weeks.
 - No need for LFTs.
 - +/- steroids for it; anecdotal only
 - Don't need to I and D.