Comparison of topical and oral treatments for tinea gladiatorum.

OBJECTIVE: Little has been published regarding treatment guidelines for tinea gladiatorum in the competitive wresting population, where outbreaks are commonplace. This study compares the efficacy of a first-line topical treatment regimen and an oral treatment regimen. DESIGN: A randomized, prospective, open-label pilot study was conducted during the 1997 to 1998 interscholastic wrestling season. SETTING: Training rooms at two suburban high schools. PARTICIPANTS: Male high school wrestlers with culture-proven tinea corporis were included in the study. There were 22 wrestlers enrolled; 17 finished the study. INTERVENTIONS: Wrestlers were randomized to receive either clotrimazole 1% cream applied twice daily or fluconazole 200 mg once weekly for a total treatment duration of 3 weeks. MAIN OUTCOME MEASURES: Symptom scores, lesion measurements, and fungal cultures were followed to assess treatment efficacy. RESULTS: Eleven wrestlers received clotrimazole and six wrestlers finished the full course of fluconazole. The extrapolated time to 50% improvement in symptom scores was 11.9 days in the clotrimazole group and 10.1 days in the fluconazole group. The extrapolated time to 50% lesion reduction was 18.7 days in the clotrimazole group and 17.2 days in the fluconazole group. The extrapolated time to 50% culture eradication was 22.7 days in the clotrimazole group and 11.1 days in the fluconazole group. CONCLUSION: Both clotrimazole and fluconazole produce similar improvement in clinical parameters. Fluconazole showed arithmetically, but not statistically, superior culture eradication. Fluconazole in a weekly dosing schedule should be considered in the first-line treatment of tinea gladiatorum.