Therapeutic Updates on the Management of Tinea Corporis or Cruris in the Era of Trichophyton Indotineae Separating Evidence from Hype—A Narrative Review

The emergence and spread of Trichophyton indotineae (T. indotineae) has led to a sea change in the prescription practices of clinicians regarding the management of dermatophytic skin infections. An infection easily managed with a few weeks of antifungals, tinea corporis or cruris, is now often chron...

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Published in:Indian journal of dermatology Vol. 68; no. 5; pp. 525 - 540
Main Authors: Khurana, Ananta, Sharath, Savitha, Sardana, Kabir, Chowdhary, Anuradha, Panesar, Sanjeet
Format: Journal Article
Language:English
Published: India Medknow Publications and Media Pvt. Ltd 01.09.2023
Medknow Publications & Media Pvt. Ltd
Wolters Kluwer - Medknow
Wolters Kluwer Medknow Publications
Subjects:
Antifungal agents
antifungals
Drug resistance
Fungal infections
Gene mutations
Genetic aspects
griseofulvin
Health aspects
IJD Symposium
Infection
Itraconazole
ketoconazole
Mutation
mutations
resistance
Ringworm
Skin
Skin diseases
squalene epoxidase
terbinafine
tinea corporis
tinea cruris
treatment
trichophyton indotineae
voriconazole
India
Antifungals
tinea cruris
treatment
voriconazole
terbinafine
itraconazole
resistance
Trichophyton indotineae
mutations
griseofulvin
ketoconazole
squalene epoxidase
tinea corporis
ISSN:0019-5154, 1998-3611, 1998-3611
Online Access:Get full text
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Summary:The emergence and spread of Trichophyton indotineae (T. indotineae) has led to a sea change in the prescription practices of clinicians regarding the management of dermatophytic skin infections. An infection easily managed with a few weeks of antifungals, tinea corporis or cruris, is now often chronic and recurrent and requires prolonged treatment. Rising resistance to terbinafine, with documented squalene epoxidase (SQLE) gene mutations, and slow clinical response to itraconazole leave clinicians with limited treatment choices. However, in these testing times, it is essential that the tenets of antifungal stewardship be followed in making therapeutic decisions, and that the existing armamentarium of antifungals be used in rationale ways to counter this extremely common cutaneous infection, while keeping the growing drug resistance among dermatophytes in check. This review provides updated evidence on the use of various systemic antifungals for dermatophytic infection of the glabrous skin, especially with respect to the emerging T. indotineae species, which is gradually becoming a worldwide concern.
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ISSN:0019-5154
1998-3611
1998-3611
DOI:10.4103/ijd.ijd_832_23