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.

DESIGN

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

SETTING

Training rooms at two suburban high schools.

PARTICIPANTS

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

INTERVENTIONS: 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.

MAIN OUTCOME MEASURES: 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.

CONCLUSION

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.