Management of onychomycosis in children.

Onychomycosis is less common in children than in adults. When onychomycosis is suspected, appropriate mycologic tests should be carried out for confirmation. Tinea pedis may be associated with onychomycosis. Family members also may have onychomycosis or tinea pedis. Oral antifungal therapy is required, particularly when the extent of onychomycosis is moderate or severe. The longest clinical experience with antifungal therapy is with griseofulvin, a drug that has to be administered for several months. The newer oral antifungal agents for the treatment of onychomycosis in children include itraconazole, terbinafine, and fluconazole. Pulse therapy with itraconazole given either in oral solution or capsule form, is the preferred regimen. Terbinafine (continuous) or fluconazole (intermittent) regimens are other treatment options. It is important to take steps to reduce the risk of reinfection and to treat tinea pedis at an early stage.