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Volume 28, Number 1—January 2022
Dispatch

Emergence of Difficult-to-Treat Tinea Corporis Caused by Trichophyton mentagrophytes Complex Isolates, Paris, France

Sarah Dellière1Comments to Author , Brune Joannard1, Mazouz Benderdouche, Anselme Mingui, Maud Gits-Muselli, Samia Hamane, Alexandre Alanio, Antoine Petit, Germaine Gabison, Martine Bagot, and Stéphane Bretagne
Author affiliations: Hôpital Saint Louis Laboratoire de Parasitologie-Mycologie, Assistance Publique des Hôpitaux de Paris, Paris, France (S. Dellière, B. Joannard, M. Benderdouche, A. Mingui, M. Gits-Muselli, S. Hamane, A. Alanio, S. Bretagne); Université de Paris, Paris (S. Dellière, M. Gits-Muselli, A. Alanio, M. Bagot, S. Bretagne); Centre National de Référence Mycoses Invasives et Antifongiques Unité de Mycologie Moléculaire, Paris (A. Alanio, S. Bretagne); Hôpital Saint-Louis Service de Dermatologie, Assistance Publique des Hôpitaux de Paris, Paris (A. Petit, G. Gabison, M. Bagot); INSERM U976 (M. Bagot)

Main Article

Table 1

Clinical characteristics and treatment for patients with difficult-to-treat tinea corporis caused by Trichophyton mentagrophytes complex isolates, Paris, France*

Patient no. Age, y/sex Geographic origin Medical history Clinical presentation First-line treatment Second-line treatment Third-line treatment
1
 28/F
 Bangladesh
 None
 Erythematous scaly plaques of trunk and arms; pruritus ([[ANCHOR###F1###Figure 1###Anchor]], panel A)
 TBR 250 mg/d; outcome (9 wk): partial healing, positive culture of skin sample
 GSF 500 mg x 2/d; outcome (4 wk): no healing
 ITZ 200 mg/d; outcome (12 wk): improvement, negative culture of skin sample; relapse 5 mo after ending ITZ
2
 47/F
 India
 Diabetes mellitus, psoriasis
 Erythematous scaly plaques of groins and axillary pits; pruritus
 TBR 250 mg/d; outcome: no improvement, positive culture of skin sample
 ITZ 200 mg/d; outcome (12 wk): healing and negative culture of skin sample; relapse 1 y later
 NA
3†
 20/M
 India
 None
 Erythematous scaly plaques of groins trunk, buttocks, and legs; pruritus ([[ANCHOR###F1###Figure 1###Anchor]], panel B)
 TBR 250 mg/d; outcome (12 wk): no improvement, positive culture of skin sample
 ITZ 200 mg/d;
outcome (8 wk): healing and negative culture of skin sample
 NA
4
 46/M
 Bangladesh
 Diabetes mellitus, dyslipidemia
 Plaques with strong pruritic erythema and vesicles with surrounding papulae of groins, buttock, thigh, arms, and face‡
 TBR 250 mg/d; outcome (8 wk): no improvement, positive culture of skin sample
 ITZ 200 mg/d + topical bifonazole; outcome (12 wk): complete healing
 NA
5
 44/F
 Bangladesh
 Diabetes mellitus, dyslipidemia
 Erythematous scaly plaques of groins and axillary pits with secondary extension to trunk and limbs‡ ([[ANCHOR###F1###Figure 1###Anchor]] panel D)
 TBR 250 mg/d + topical ciclopirox; lost-to-follow up
 NA
 NA
6
 39/F
 India
 Chronic hepatitis B
 Centrifuge annular erythema of trunk and arms;‡ pruritus ([[ANCHOR###F1###Figure 1###Anchor]] panel C)
 FCZ 200 mg/wk + topical TBR; outcome (16 wk): improvement; relapse 1 y later
 NA
 NA
7 57/M Sri Lanka Crohn’s disease, psoriasis Erythematous scaly plaques of groins, buttocks, knees, shoulders, and neck Topical bifonazole; outcome (8 wk): no improvement TBR 250 mg/d + topical steroids (for severe associated psoriasis lesions); outcome (8 wk): partial improvement TBR 250 mg/d; outcome (8 wk): improvement; relapse 1 year later

*FCZ, fluconazole; GSF, griseofulvine; ITZ, itraconazole; NA, not applicable; TBR, terbinafine. †Patient 2’s son. ‡Had applied topical steroids.

Main Article

1These authors contributed equally to this article.

Page created: December 08, 2021
Page updated: December 20, 2021
Page reviewed: December 20, 2021
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