Clinical Course, Antifungal Susceptibility, and Genomic Sequencing of Trichophyton indotineae

Trichophyton indotineae is an emerging dermatophyte causing extensive tinea infections, often unresponsive to terbinafine. A retrospective cohort study in New York City found that 11 patients with T indotineae infections had widespread lesions, diagnostic delays, and terbinafine treatment failure. Fluconazole and griseofulvin improved outcomes in 2 of 4 and 2 of 5 instances, respectively. Itraconazole was generally effective, and the acquisition of infection was likely in Bangladesh. The study suggests that disease severity, diagnostic delays, and lack of response to typically used doses and durations of antifungals for tinea were common in this primarily immunocompetent patient cohort.