High-dose oral terbinafine in the treatment of pediatric tinea capitis under 2 years old

Tinea capitis is the most common pediatric dermatophytosis of the scalp and hair follicles that require oral antifungals therapy. It usually occurs in children between 3 and 7 years old, whereas it is rarely reported in children under 2 years old. Although oral terbinafine has been broadly used to treat tinea capitis, it is not approved for pediatric patients under 2 years old. Previous studies reported that a doubled oral terbinafine dose could improve the cure rates of tinea capitis due to Microsporum canis. However, the doses are all not strictly weight-based. Here, we report four pediatric tinea capitis patients under 2 years of age who were treated with a high, strictly weight-based dose of oral terbinafine therapy (10 mg/kg/day). We determine the efficacy and safety of this novel oral terbinafine therapy schedule. It may be a promising therapy to treat pediatric tinea capitis under 2 years old.