What is the first-line treatment for a round, itchy patch with central clearing and hyphae visualized on examination?

The appropriate first-line treatment for a round, itchy patch with central clearing and visible hyphae is topical clotrimazole 1% cream. This presentation is characteristic of tinea corporis, a fungal infection of the skin. Clotrimazole is an antifungal agent that works effectively against dermatophytes, making it ideal for treating superficial fungal infections.

In this case, the appearance of the lesion—with its central clearing and itchy nature—suggests that a topical antifungal would be the most effective course of action to alleviate symptoms and eradicate the infection. Topical agents like clotrimazole are preferred in localized cases because they provide direct action at the site of infection with fewer systemic side effects.

Other treatments listed may not address the fungal component as effectively. For example, while oral terbinafine is a strong antifungal, it is typically reserved for more extensive infections or cases that do not respond to topical treatments. Topical hydrocortisone acts as a corticosteroid and may reduce inflammation but does not treat the underlying fungal infection. Lastly, topical pyrithione zinc is primarily used for seborrheic dermatitis and dandruff treatment, which is not suited for a fungal infection like tinea corporis. Thus, topical clotrim