Which of the following drugs given orally would be an appropriate treatment for this patient?
A 7-year-old girl is brought to the physician by her mother because she has several
small hairless patches in her scalp. Upon close physical examination, patches look like
black dots on the skin surface. Microscopic examination reveals a dense sheath of spores
around the hair.
A. Acyclovir B. Metronidazole C. Griseofulvin D. Vancomycin E. Amphotericin B F. Flucytosine
the microscopic examination of the hair strongly suggests the diagnosis of black dots tinea
capitis, a cutaneous mycosis cause by trichophyton tonsurans. cutaneous mycoses are
caused by fungi (mainly dermatophytes) that infect only the superficial keratinized tissues.
dermatophytes are sensitive to griseofulvin, terbinafine, antifungal azoles and amphotericin b ,
but the first two agents are the drugs of choice in cutaneous mycoses since they are deposited
in newly forming skin where they bind to keratin, so protecting the skin from the infection.
antifungal azoles are also used orally (they have good affinity for keratin) or topically. a, b, d) these agents are not antifungal drugs.
e) rarely) amphotericin b is given only topically in cutaneous mycoses.
f) flucytosine is a systemic antifungal drug, but is not effective against dermatophytes.