Difficult Dermatophytosis

Dogra, Sunil; Ramam, M

doi:10.1001/jamadermatol.2022.3736

Cited by 10 publications

(12 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Traditionally, dermatophytosis is not a life-threatening infection and its health impact can be relatively low, and thus it represents a rather neglected infection in many regions. It is of concern that an increasing number of difficult-to-treat and invasive dermatophytosis have been reported in the last two decades ( 3 ), especially in Patients with CARD9 or STAT3 mutations where a mortality rate as high as 17.4% has been noted ( 4 ). More attention has been drawn in the last five years by the emergence of terbinafine (TBF) -resistant population in the Trichophyton mentagrophytes complex in India ( 2 , 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

The epidemic of the multiresistant dermatophyte Trichophyton indotineae has reached China

Jia

Long

et al. 2023

Front. Immunol.

View full text Add to dashboard Cite

Due to its high degree of natural resistance to terbinafine in vitro and its tendency to spread globally from the Indian subcontinent, the emerging dermatophyte Trichophyton indotineae has become a major concern in dermatology. Herein, we present the first report of T. indotineae from mainland China. The transmission of the fungus to Guizhou Province in central China and eventual host susceptibilities were investigated. We studied 31 strains of the T. mentagrophytes complex from outpatient clinics of our hospital collected during the past 5 years. The set comprised four ITS genotypes, two of which were T. mentagrophytes genotype VIII, now known as Trichophyton indotineae; the earliest isolation in the Guiyang area appeared to date back to 2018. The isolate was derived from an Indian patient, while local Chinese patients had no dermatophytosis caused by this genotype. Reports from around the world indicated that almost all of the globally reported T. indotineae cases originated from the Indian subcontinent and surrounding countries without transmission among native populations, suggesting deviating local conditions or racial differences in immunity against this fungus.

show abstract

Section: Introductionmentioning

confidence: 99%

The epidemic of the multiresistant dermatophyte Trichophyton indotineae has reached China

Jia

Long

et al. 2023

Front. Immunol.

View full text Add to dashboard Cite

show abstract

“…Dermatophytic infections are one of the most common cutaneous diseases encountered globally, and there has been an alarming trend of recalcitrant dermatophytosis over the last few years in different parts of India 5 . This scourge is now spreading to other Asian countries, Europe and North America 3 . In the present study, the mean age of the patients affected was 35.8 years with male preponderance.…”

Section: Discussionmentioning

confidence: 47%

“…5 This scourge is now spreading to other Asian countries, Europe and North America. 3 In the present study, the mean age of the patients affected was 35.8 years with male preponderance. The higher prevalence in this age group and male gender might be due to an increase in physical and outdoor activities leading to excessive sweating, which provides a favourable environment for the growth of dermatophytes.…”

Section: Ta B L Ementioning

confidence: 45%

“…According to the World Health Organization, dermatophytes affect about 25% of the world population 1 . Recalcitrant dermatophytosis has emerged as a major health problem in India 2,3 . Various factors such as deregulation of host defensive immune system, atopy or selective anergy in the host, and increasing minimum inhibitory concentration (MIC) of antifungal drugs, changing clothing trends, use of topical steroid combinations with antifungal and antifungal resistance are being incriminated as causes for recalcitrant dermatophytes 4 .…”

Section: Introductionmentioning

confidence: 99%

“…1 Recalcitrant dermatophytosis has emerged as a major health problem in India. 2,3 Various factors such as deregulation of host defensive immune system, atopy or selective anergy in the host, and increasing minimum inhibitory concentration (MIC) of antifungal drugs, changing clothing trends, use of topical steroid combinations with antifungal and antifungal resistance are being incriminated as causes for recalcitrant dermatophytes. 4 Inappropriate use of antifungal agents, genetic mutations and biofilms productions by fungi are various causes that may lead to the development of antifungal resistance among dermatophytes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Correlation of plasma levels of itraconazole with treatment response at 4 weeks in chronic dermatophytosis: Results of a randomised controlled trial

Bhalavi

Shaw

Mehta

et al. 2022

Mycoses

Self Cite

View full text Add to dashboard Cite

Background Itraconazole in varying doses and duration is being frequently used for the management of dermatophytosis. There is a scarcity of studies on the bioavailability of various itraconazole brands available in the market. Aims and Objectives The aim of this study was to determine the plasma concentration of itraconazole of various brands and its correlation with clinical efficacy in chronic dermatophytosis. Materials and Methods One hundred patients with chronic dermatophytosis with age >18 years were studied at the outpatient clinic of our tertiary care hospital. Plasma itraconazole level was estimated on Week 2 and Week 4 after randomly dividing the patients into Groups A, B and C who received cap itraconazole 100 mg twice a day of innovator, multinational and local generic brands, respectively, for 4 weeks. Both efficacy (cure, partial cure or no cure), safety and recurrence were compared between the three groups. Results At 4 weeks, number of patients classified as ‘cured’ were 10/26 (38.4%) in Group A, 5/22 in Group B (22.7%) and 3/21 (14.2%) in Group C (p = .002). Mycological cure rates at Week 4 in Groups A, B and C were 21 (80.8%), 17 (81.0%) and 5 (26.3%), respectively (p = .006). Plasma levels of itraconazole were comparable between the three groups at Week 2 and Week 4. No statistically significant correlation was found between itraconazole levels and treatment response in any of the groups at 4 weeks. Incidence of adverse effects and recurrence rates was also similar among the three groups. Conclusion Cure rates for chronic dermatophytosis were poor with all three itraconazole brands at 4 weeks of treatment. Higher cure rates were obtained with innovator drug as compared to multinational and local generic brands at 4 weeks. Plasma levels of the three drugs were however similar, indicating that factors other than serum bioavailability are at play in determining response of chronic dermatophyte infections to oral itraconazole.

show abstract

Expert Panel Review of Skin and Hair Dermatophytoses in an Era of Antifungal Resistance

Hill,

Caplan,

Elewski

et al. 2024

Am J Clin Dermatol

View full text Add to dashboard Cite

Difficult Dermatophytosis

Abstract: Reported estimates of adverse pregnancy outcomes among women with and without syphilis: a systematic review and meta-analysis.

Cited by 10 publications

References 17 publications

The epidemic of the multiresistant dermatophyte Trichophyton indotineae has reached China

The epidemic of the multiresistant dermatophyte Trichophyton indotineae has reached China

Correlation of plasma levels of itraconazole with treatment response at 4 weeks in chronic dermatophytosis: Results of a randomised controlled trial

Expert Panel Review of Skin and Hair Dermatophytoses in an Era of Antifungal Resistance

Contact Info

Product

Resources

About