Title : The rise of Trichophyton indotineae: A public health threat of antifungal-resistant dermatophytes
Abstract:
Dermatophytoses, commonly known as ringworm, are among the most prevalent superficial fungal infections globally. Recently, a novel strain, Trichophyton indotineae, has emerged as a significant dermatological threat due to its resistance to first-line antifungal agents, particularly terbinafine. First identified in India, T. indotineae has now been reported in multiple countries, including the United States, prompting global concern. The fungus primarily affects otherwise healthy individuals and is associated with severe, relapsing infections that are often misdiagnosed or inadequately treated, contributing to further transmission.
This literature-based review explores the microbiological characteristics, transmission pathways, clinical manifestations, and resistance mechanisms of T. indotineae. It reveals that terbinafine resistance is largely driven by mutations in the squalene epoxidase gene, necessitating a shift to alternative agents such as itraconazole or combination therapies. Public health implications include infection control, surveillance, and antifungal stewardship in both community and clinical settings. This calls for heightened clinical awareness, improved diagnostic protocols, and collaborative global action to curb the spread of this.
