This protocol applies when scalp mycology or culture returns a positive result for Microsporum species and Trichophyton species are not identified. Species-level identification from culture is the basis for antifungal selection in this setting.
As a general rule, terbinafine is more efficacious against Trichophyton species (T. tonsurans, T. violaceum, T. soudanense), and griseofulvin more effective against Microsporum species (M. canis, M. audouinii). Confirming Microsporum — with Trichophyton absent — directly shapes which oral antifungal is appropriate.
An oral antifungal agent is the cornerstone of management, selected on the basis of the confirmed species. The primary endpoint is mycological clearance rather than clinical resolution alone — repeat mycology sampling is recommended until clearance is achieved.