Superficial fungal infections
Fungal lesions of skin, nails and mucosa that do not involve deep tissues or internal organs. Mostly treated with topical antifungals; systemic therapy reserved for extensive or resistant disease.
ICD-10 B353 drugs
Also known as: Dermatomycoses, Onychomycosis, Cutaneous candidiasis
Drugs used for this condition
- ACiclopiroxFirst line · Topical antifungal (hydroxypyridone class)First-line topical antimycotic for onychomycosis, dermatophytosis of glabrous skin, tinea versicolor and skin candidiasis. 8% nail lacquer once daily for 6–12 months in onychomycosis with under 50% nail involvement and no matrix involvement. AEMPS positions it as an alternative to systemic terbinafine when contraindicated.
- ATerbinafineFirst line · Allylamine antifungal (systemic and topical)Superficial dermatophyte infections (tinea pedis, corporis, cruris, capitis) are treated with terbinafine according to site. Tinea pedis and corporis: 1% cream once or twice daily for 1–2 weeks. Tinea capitis in children: oral tablets for 4–6 weeks, AAD 2023 lists terbinafine as first line (replacing griseofulvin). Tinea unguium and persistent widespread forms: systemic tablets, as for onychomycosis. AEDV notes that tinea cruris and corporis usually respond to topical therapy; oral tablets are used when more than 5% of body surface is involved or topical therapy fails.
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit