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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Main Authors: 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
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Journal of Fungi
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Online Access:https://www.mdpi.com/2309-608X/11/7/523
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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.
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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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