Template
Tinea
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TypeChoose oneFirst line
TestingChoose any
TreatmentChoose one
Capitis treatmentChoose oneNot in the note with these choices
Capitis adjunctsChoose anyNot in the note with these choices
KerionChoose anyNot in the note with these choices
Versicolor treatmentChoose oneNot in the note with these choices
Follow-upChoose one
Capitis follow-upChoose oneNot in the note with these choices
Follow-up reasonChoose anyJoins the line aboveNot in the note with these choices
Counseling
Apply the cream to the rash and a little beyond its edges, and keep using it for a couple of weeks after the rash clears. Do not use combination antifungal-steroid creams. Recommended supportive care with an emphasis on keeping the area dry and not sharing towels. Return precautions given including a rash that is spreading or not improving, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
Because the rash is widespread or not responding to creams, it needs medicine by mouth for several weeks. Recommended supportive care with an emphasis on keeping the area dry and not sharing towels. Return precautions given including a rash that is spreading or not improving, yellow skin or eyes, dark urine, belly pain, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
Scalp ringworm needs medicine by mouth for several weeks because creams cannot reach the hair roots. Children can stay in school once treatment has started. Recommended supportive care with an emphasis on not sharing hats, combs, or brushes and checking other family members and pets. Return precautions given including a painful boggy swelling, fever, hair loss that is spreading, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
Tinea versicolor comes from a yeast that normally lives on the skin. The scaling clears with treatment, but skin color can take months to even out, and it often comes back, especially in warm weather. Recommended supportive care with an emphasis on a medicated shampoo once a month to keep it from coming back. Return precautions given including a rash that is not improving, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
What the sources cover
- KOH or fungal culture
- Topical first line (clotrimazole all ages; ketoconazole, terbinafine ≥ 12, miconazole)
- Oral for extensive, unresponsive, hair-bearing
- No steroid combinations
- Capitis: systemic (terbinafine, griseofulvin, fluconazole)
- Adjunct shampoo; kerion care
- Capitis: no school exclusion once treated; no shared combs; check family and pets
- Versicolor: shampoo or azole; pigment slow; recurrence; preventive monthly