Cutaneous Infections Caused by Trichophyton indotineae: Case Series and Systematic Review

Area of Science:

• Mycology
• Dermatology
• Infectious Diseases

Background:

• Dermatophytosis caused by Trichophyton indotineae is a globally spreading fungal infection.
• Emerging drug resistance in T. indotineae poses significant treatment challenges.

Purpose of the Study:

• To report four cases of T. indotineae dermatophytosis.
• To conduct a systematic review of T. indotineae case reports.
• To identify clinical, demographic, and treatment patterns of T. indotineae infections.

Main Methods:

• Systematic literature search of PubMed up to December 6, 2024, adhering to PRISMA guidelines.
• Inclusion of English-language case reports/series of human T. indotineae infections confirmed by internal transcribed spacer sequencing.
• Analysis of 30 selected articles, encompassing 64 patients, alongside four new case reports.

Main Results:

• The majority of patients (65.52%) were healthy or immunocompetent, with infections often presenting as long-lasting lesions on multiple body sites, particularly lower extremities.
• Itraconazole emerged as the most frequent final treatment, achieving complete remission in three of the reported cases.
• Patients were predominantly from the Asian continent, with the reported cases originating from South Asia.

Conclusions:

• T. indotineae infections should be suspected in extensive or recalcitrant dermatophytosis, especially in individuals with travel history to Asia.
• There is a critical need for advanced diagnostic tools to rapidly identify T. indotineae and its drug-resistant strains.
• Further research is essential to establish optimal preventive measures and treatment strategies for T. indotineae infections.