Extensive or recurrent — treat until every lesion has cleared (3–8 wk or more): Terbinafine, Itraconazole, Fluconazole (alternative; preferred if a systemic drug is unavoidable in pregnancy)
Advice and when to refer
Never: Steroid creams or steroid–antifungal mixtures — they cause the spreading, resistant tinea now common in India (ICMR STW 2022)
Advice: Loose cotton clothes, dry skin folds, wash clothes and towels in hot water, treat family members; never stop when it first looks better; refer if no better after 4 wk (ICMR STW 2022)
Investigations
First visit
KOH mount of skin scraping — Confirms fungus — especially before oral antifungals or if creams have been used.
Only if indicated
Fungal culture and sensitivity — Recurrent or resistant tinea at a higher centre.
LFT — Before and during long courses of oral terbinafine or itraconazole.
Blood glucose — Extensive or recurrent infection.
Locked
The adult dose for each drug
The child dose, where the card gives one
Indian brand names for each drug, with a link to buy
ICU Decoded — original critical-care and internal-medicine pathways by
Dr Javed Akhtar, each cited to a current guideline. For education and quick
reference; verify every dose against local protocols before prescribing.