Which treatment is indicated for a scalp lesion characterized by itchiness?

• A. Topical corticosteroids
• B. Oral terbinafine
• C. Oral antibiotics
• D. Medicated shampoo

Answer: (B)

For a scalp lesion characterized by itchiness, the most appropriate treatment option is oral terbinafine, particularly when considering conditions such as tinea capitis, which is a fungal infection of the scalp. Tinea capitis often presents with symptoms like itching, scaling, and hair loss due to fungal invasion of the hair follicles.

Oral terbinafine is an antifungal medication that works effectively against dermatophytes, which are the most common cause of tinea capitis. This systemic treatment helps to eradicate the infection more completely than topical agents and is essential for cases where lesions are widespread or persistent.

While topical corticosteroids can help alleviate inflammation and itching associated with various dermatoses, they are not effective against fungal infections. Medicated shampoos, while beneficial for certain scalp conditions like seborrheic dermatitis or mild tinea, may not sufficiently penetrate the hair follicles to treat tinea capitis effectively. Oral antibiotics would be indicated if there were a secondary bacterial infection, but they do not address the fungal component when the primary issue is a fungal infection. Thus, oral terbinafine stands out as the most appropriate treatment for an itchy scalp lesion suspected to be caused by a fungal infection.