Dermatophytoses Caused by <i>Trichophyton indotineae</i>: The First Case Reports in Malaysia and the Global Epidemiology (2018–2025)
<i>Trichophyton indotineae</i> is emerging globally from its origin in India, presenting with a terbinafine resistance and causing significant clinical burden. We report herein the first four confirmed cases of <i>T. indotineae</i> dermatophytoses in Malaysia, which were diag...
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2025-07-01
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| author | Yi Xian Er Kin Fon Leong Henry Boon Bee Foong Anis Amirah Abdul Halim Jing Shun Kok Nan Jiun Yap Yuong Chin Tan Sun Tee Tay Yvonne Ai-Lian Lim |
| author_facet | Yi Xian Er Kin Fon Leong Henry Boon Bee Foong Anis Amirah Abdul Halim Jing Shun Kok Nan Jiun Yap Yuong Chin Tan Sun Tee Tay Yvonne Ai-Lian Lim |
| author_sort | Yi Xian Er |
| collection | DOAJ |
| description | <i>Trichophyton indotineae</i> is emerging globally from its origin in India, presenting with a terbinafine resistance and causing significant clinical burden. We report herein the first four confirmed cases of <i>T. indotineae</i> dermatophytoses in Malaysia, which were diagnosed based on the microscopic examination of skin scrapings using potassium hydroxide (KOH) wet mount, followed by confirmation via culture and Internal Transcribed Spacer (ITS1) sequencing. In contrast to conventional <i>Trichophyton</i> infections, <i>T. indotineae</i> dermatophytoses demonstrate extensive cutaneous involvement and marked inflammation with erythematous lesions. All cases exhibited a chronic course lasting more than three months, with evidence of person-to-person transmission. Although one patient reported a travel to Singapore, three had no recent travel history, suggesting possible local transmission. The isolates produced characteristic white, cottony colonies with radial mycelial growth on Mycosel agar after incubation at 30 °C for four days. Three patients responded well to oral itraconazole (200 mg daily), with reduced inflammation and erythematous lesions observed two weeks after treatment initiation. The occurrence of <i>T. indotineae</i> particularly among patients without a travel history, suggests a potential endemic establishment. This fungal pathogen warrants consideration in cases of extensive or recalcitrant dermatophytoses. Further investigations into the diagnostic methods, antifungal susceptibility profiles, and epidemiological risk factors of Malaysian strains are warranted to enhance clinical management and inform public health interventions. |
| format | Article |
| id | doaj-art-174361c8d2674a5cbeb064b81a356508 |
| institution | Kabale University |
| issn | 2309-608X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj-art-174361c8d2674a5cbeb064b81a3565082025-08-20T03:35:28ZengMDPI AGJournal of Fungi2309-608X2025-07-0111752310.3390/jof11070523Dermatophytoses Caused by <i>Trichophyton indotineae</i>: The First Case Reports in Malaysia and the Global Epidemiology (2018–2025)Yi Xian Er0Kin Fon Leong1Henry Boon Bee Foong2Anis Amirah Abdul Halim3Jing Shun Kok4Nan Jiun Yap5Yuong Chin Tan6Sun Tee Tay7Yvonne Ai-Lian Lim8Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, MalaysiaPediatric Institute, Kuala Lumpur General Hospital, Jalan Pahang, Kuala Lumpur 50586, MalaysiaFoong Skin Specialist Clinic, Jalan Kamaruddin Isa, Taman Fair Park, Ipoh 31400, MalaysiaDepartment of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, MalaysiaPediatric Institute, Kuala Lumpur General Hospital, Jalan Pahang, Kuala Lumpur 50586, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia<i>Trichophyton indotineae</i> is emerging globally from its origin in India, presenting with a terbinafine resistance and causing significant clinical burden. We report herein the first four confirmed cases of <i>T. indotineae</i> dermatophytoses in Malaysia, which were diagnosed based on the microscopic examination of skin scrapings using potassium hydroxide (KOH) wet mount, followed by confirmation via culture and Internal Transcribed Spacer (ITS1) sequencing. In contrast to conventional <i>Trichophyton</i> infections, <i>T. indotineae</i> dermatophytoses demonstrate extensive cutaneous involvement and marked inflammation with erythematous lesions. All cases exhibited a chronic course lasting more than three months, with evidence of person-to-person transmission. Although one patient reported a travel to Singapore, three had no recent travel history, suggesting possible local transmission. The isolates produced characteristic white, cottony colonies with radial mycelial growth on Mycosel agar after incubation at 30 °C for four days. Three patients responded well to oral itraconazole (200 mg daily), with reduced inflammation and erythematous lesions observed two weeks after treatment initiation. The occurrence of <i>T. indotineae</i> particularly among patients without a travel history, suggests a potential endemic establishment. This fungal pathogen warrants consideration in cases of extensive or recalcitrant dermatophytoses. Further investigations into the diagnostic methods, antifungal susceptibility profiles, and epidemiological risk factors of Malaysian strains are warranted to enhance clinical management and inform public health interventions.https://www.mdpi.com/2309-608X/11/7/523<i>Trichophyton indotineae</i>dermatophytosesitraconazoleMalaysiaantifungalepidemiological |
| spellingShingle | Yi Xian Er Kin Fon Leong Henry Boon Bee Foong Anis Amirah Abdul Halim Jing Shun Kok Nan Jiun Yap Yuong Chin Tan Sun Tee Tay Yvonne Ai-Lian Lim Dermatophytoses Caused by <i>Trichophyton indotineae</i>: The First Case Reports in Malaysia and the Global Epidemiology (2018–2025) Journal of Fungi <i>Trichophyton indotineae</i> dermatophytoses itraconazole Malaysia antifungal epidemiological |
| title | Dermatophytoses Caused by <i>Trichophyton indotineae</i>: The First Case Reports in Malaysia and the Global Epidemiology (2018–2025) |
| title_full | Dermatophytoses Caused by <i>Trichophyton indotineae</i>: The First Case Reports in Malaysia and the Global Epidemiology (2018–2025) |
| title_fullStr | Dermatophytoses Caused by <i>Trichophyton indotineae</i>: The First Case Reports in Malaysia and the Global Epidemiology (2018–2025) |
| title_full_unstemmed | Dermatophytoses Caused by <i>Trichophyton indotineae</i>: The First Case Reports in Malaysia and the Global Epidemiology (2018–2025) |
| title_short | Dermatophytoses Caused by <i>Trichophyton indotineae</i>: The First Case Reports in Malaysia and the Global Epidemiology (2018–2025) |
| title_sort | dermatophytoses caused by i trichophyton indotineae i the first case reports in malaysia and the global epidemiology 2018 2025 |
| topic | <i>Trichophyton indotineae</i> dermatophytoses itraconazole Malaysia antifungal epidemiological |
| url | https://www.mdpi.com/2309-608X/11/7/523 |
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