Tinea corporis — RACGP Fellowship MCQ

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HardDermatologyTinea corporisRACGP Fellowship

A 50‑year‑old woman presents with an itchy annular rash on the trunk with an active scaly edge and central clearing. She applied a potent topical corticosteroid borrowed from a friend and the rash has since spread. Skin scraping shows hyphae. What is the most appropriate management?

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Correct answer: A — Use topical antifungal therapy and stop the inappropriate topical corticosteroid

Explanation lettering: D = shown as A · E = shown as C · C = shown as D · A = shown as E

This presentation is classic tinea corporis confirmed by positive microscopy. Potent topical corticosteroids have worsened and masked the infection (“tinea incognito”). Local immunosuppression by steroids allows fungal spread. First‑line management in Australian primary care is to cease inappropriate corticosteroid use and initiate topical antifungal—such as terbinafine 1% cream once or twice daily for 1–2 weeks—according to RACGP Therapeutic Guidelines. Continuing steroids (A) perpetuates immunosuppression; aciclovir (B) is an antiviral irrelevant to fungal infection; diagnosing psoriasis and starting methotrexate (C) is incorrect given confirmed fungal aetiology; topical antibiotic alone (E) has no antifungal action and would not treat dermatophyte infection.

Reference: RACGP Therapeutic Guidelines: Superficial fungal infections – first‑line topical terbinafine for tinea corporis (2019); RACGP case study, A progressive pruritic buttock eruption (2026)