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[Persistent dermatomycosis due toTrichophyton indotineae]
Jochem B Buil1,2, Eelco F J Meijer3, Martijn den Reijer4
1Radboudumc, afd. Medische Microbiologie, Nijmegen.
Abstract:
Trichophyton indotineae is a recently identified dermatophyte that frequently causes extensive and persistent dermatomycosis, particularly tinea corporis, tinea cruris, and tinea faciei. The infection is frequently encountered in countries of the Indian subcontinent and surrounding areas. In Europe, T. indotineae has mainly been detected in patients with an epidemiological link to the aforementioned regions. Unlike dermatomycoses caused by other dermatophyte species, infections caused by T. indotineae often exhibit treatment failure with commonly prescribed antifungal drugs. Reduced susceptibility to terbinafine is often observed in T. indotineae. In addition, reduced susceptibility to itraconazole has also been reported. Due to the extensive and persistent nature of the infection, as well as the reduced susceptibility to antifungal drugs, international experts recommend aggressive treatment of T. indotineae using a combination of oral and topical antifungals. Susceptibility testing may be warranted to guide treatment decisions. Early recognition of T. indotineae infections is crucial to prevent prolonged recurrences.
Insights
Trichophyton indotineae causes persistent fungal skin infections, often resistant to standard treatments like terbinafine. Aggressive combination therapy and susceptibility testing are recommended for effective management.
Area of Science:
- Medical Mycology
- Dermatology
- Infectious Diseases
Context:
- Trichophyton indotineae is an emerging dermatophyte causing widespread and persistent dermatomycosis.
- Commonly observed in the Indian subcontinent, it is increasingly detected in Europe, often linked to travel history.
- Infections present as tinea corporis, tinea cruris, and tinea faciei.
Purpose:
- To highlight the clinical characteristics and treatment challenges associated with Trichophyton indotineae.
- To inform healthcare professionals about the reduced susceptibility of this pathogen to common antifungal agents.
- To emphasize the need for early recognition and aggressive treatment strategies.
Summary:
- Trichophyton indotineae infections are characterized by extensive and persistent skin lesions.
- Treatment failures are common due to reduced susceptibility to terbinafine and itraconazole.
- Aggressive combination therapy (oral and topical antifungals) and susceptibility testing are advised.
Impact:
- Facilitates earlier and more accurate diagnosis of recalcitrant dermatomycoses.
- Guides clinicians in selecting appropriate and effective antifungal treatments.
- Aims to reduce treatment failures, recurrences, and the overall burden of these infections.
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