Tinea capitis in school-age children caused by Trichophyton violaceum (endothrix pattern) is treated with oral antifungals. The FIRST-LINE recommended oral antifungal for tinea capitis in children (per current guidelines) is:

• A Oral griseofulvin for 6–8 weeks
• B Oral terbinafine for 4 weeks ✓
• C Oral fluconazole for 2 weeks
• D Oral ketoconazole for 4 weeks

Explanation

While griseofulvin was historically first-line, current evidence and Indian IADVL guidelines recommend oral terbinafine as first-line for Trichophyton-caused tinea capitis (the dominant endothrix species in India). Terbinafine requires only 4 weeks of treatment versus 6–8 weeks for griseofulvin, has better efficacy against Trichophyton species, and a favourable tolerability profile in children. Griseofulvin retains first-line status for Microsporum-caused ectothrix infections (less common in India). Ketoconazole is no longer recommended due to hepatotoxicity risk.

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.