Trichophyton tonsurans, an anthropophilic dermatophyte, causes dermatophytosis such as tinea corporis showing erythema with/ without central healing tendency, tinea capitis showing black dots, scaliness, hair loss and purulent follicular inversion known as kerion celsi, and tinea unguium. Large scale studies have reported that cultural practices influence the transmission of particular mycoses, with more than 95% of tinea capitis infections caused by T. tonsurans. 1,2 In Japan, an epidemic has been ongoing among contact sports athletes since the early 2000s. 3,4 Mycological surveys conducted by the Japanese Society for Medical Mycology revealed a nationwide spread of T. tonsurans infection among school judo, wrestling, and sumo teams. [5][6][7][8] Oral terbinafine (TBF) and itraconazole (ITZ) are recommended to treat this infection. 9 However, there are patients who remain uncured or are re-infected after treatment; therefore, the possibility of the presence of drug-resistant isolates is of great dermatological interest.We conducted screening for T. tonsurans infection among groups engaged in contact sports around the year 2000 to inform prevention of an epidemic. [10][11][12][13] We reported the trend of infection by the pathogen, and examined molecular types of isolates using restriction enzyme fragment length polymorphism (RFLP) in the nontranscription spacer (NTS) region of ribosomal RNA gene in years 2000 and 2015. [10][11][12][13] In the present study, we discuss the 20-year trend of T. tonsurans infection in Japan. During the past two decades,