A patient with recalcitrant tinea corporis caused by Trichophyton indotineae is being evaluated. This strain is characterized by its resistance to which first-line antifungal?
- A Terbinafine ✓
- B Fluconazole
- C Griseofulvin
- D Amphotericin B
Correct answer: A. Terbinafine
Explanation
Trichophyton indotineae is a recently characterized dermatophyte species (identified 2019–2020 from South Asia, particularly India) notable for terbinafine resistance, which is mediated by mutations in the SQLE (squalene epoxidase) gene, the target enzyme of terbinafine. This explains the epidemic of recalcitrant tinea in India. Itraconazole remains effective and is the preferred systemic treatment. The condition also shows frequent use/misuse of topical combination steroids (FLU/CLIB) as a contributing factor to its spread.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.