학술논문

Therapeutic updates on the management of tinea corporis or cruris in the era of Trichophyton Indotineae: Separating evidence from hype—A narrative review
Document Type
article
Source
Indian Journal of Dermatology, Vol 68, Iss 5, Pp 525-540 (2023)
Subject
antifungals
itraconazole
griseofulvin
ketoconazole
mutations
resistance
squalene epoxidase
terbinafine
tinea corporis
tinea cruris
treatment
trichophyton indotineae
voriconazole
Dermatology
RL1-803
Language
English
ISSN
0019-5154
1998-3611
Abstract
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.