Consensus-based Guideline on tinea capitis.

Abstract

The consensus-based guideline developed under the auspices of the German Dermatological Society (DDG) is intended to provide physicians with a structured framework for clinical decision-making in the management of patients with tinea capitis and to contribute to improved diagnostic accuracy, treatment adherence, and prevention. Tinea capitis is a dermatophyte-induced infection of the scalp that predominantly affects children and represents a common dermatological condition worldwide. In recent years, a marked shift in the epidemiology of causative dermatophytes has been observed in Europe, driven by migration, tourism, and socioeconomic factors, with an increasing prevalence of anthropophilic species, particularly Trichophyton tonsurans and Trichophyton violaceum. From a therapeutic perspective, a combination of systemic and topical antifungal treatment is recommended, as topical monotherapy is generally insufficient. In pediatric patients, the choice of systemic antifungal therapy is primarily guided by the identified pathogen, with Trichophyton infections preferably treated with terbinafine (off-label) and Microsporum/Nannizzia infections with itraconazole (off-label) or griseofulvin. In adult patients, terbinafine is recommended as first-line therapy irrespective of the causative species. In addition, the guideline addresses measures to interrupt chains of infection, including the treatment of asymptomatic carriers, implementation of hygiene measures, and management of outbreak situations in community settings.