RESUMEN
Antifungal-resistant dermatophytes (ARD) infection is a hotspot issue in clinical microbiology and the dermatology field. Trichophyton indotineae as the dominant species of dermatophyte with terbinafine-resistance or multidrug resistance, is easy to be missed detection clinically, which brings severe challenges to diagnosis and treatment. ARD infection cases have emerged in China, and it predicts a risk of transmission among human. Based on the existing medical evidence and research data, the Mycology Group of Combination of Traditional and Western Medicine Dermatology and Chinese AntifungalâResistant Dermatophytoses Expert Consensus Group organized experts to make consensus on the management of the infection. Here, the consensus formulated diagnosis and treatment recommendations, to raise attention to dermatophytes drug resistance problem, and expect to provide reference information for the clinical diagnosis, treatment, prevention and control.
Asunto(s)
Antifúngicos , Consenso , Farmacorresistencia Fúngica , Tiña , Humanos , Antifúngicos/uso terapéutico , Antifúngicos/farmacología , Arthrodermataceae/efectos de los fármacos , China , Tiña/tratamiento farmacológico , Tiña/microbiología , Tiña/diagnóstico , Trichophyton/efectos de los fármacos , Trichophyton/aislamiento & purificaciónAsunto(s)
Quiste Epidérmico , Granuloma , Tiña , Humanos , Tiña/microbiología , Tiña/tratamiento farmacológico , Granuloma/microbiología , Granuloma/patología , Quiste Epidérmico/patología , Quiste Epidérmico/microbiología , Masculino , Trichophyton/aislamiento & purificación , Antifúngicos/uso terapéutico , Biopsia , Microscopía Electrónica de Transmisión , Femenino , Resultado del Tratamiento , ArthrodermataceaeRESUMEN
This case describes a 58-year-old woman who presented to the dermatology outpatient clinic with progressive skin lesions on the hands. Physical examination showed erythematosquamous plaques. The diagnosis zoonotic dermatomycosis was made based on fungal cultures, which showed a Trichophyton erinacei. This dermatophyte is particularly transmitted through hedgehogs. The patient appeared to have taken care of an infected hedgehog.
Asunto(s)
Erizos , Tiña , Trichophyton , Humanos , Femenino , Persona de Mediana Edad , Erizos/microbiología , Tiña/diagnóstico , Tiña/tratamiento farmacológico , Tiña/microbiología , Animales , Trichophyton/aislamiento & purificación , Zoonosis/diagnóstico , Antifúngicos/uso terapéuticoRESUMEN
The Trichophyton mentagrophytes complex comprises a group of dermatophyte fungi responsible for various dermatological infections. The increasing drug resistance of this species complex, especially terbinafine resistance of Trichophyton indotineae, is a major concern in dermatologist practice. This study provides a comprehensive analysis of T. mentagrophytes complex strains isolated from patients in Hue City, Vietnam, focusing on their phenotypic and genetic characteristics, antifungal susceptibility profiles, and molecular epidemiology. Keratinophilic fungi from dermatophytosis culture samples were identified morphologically and phenotypically, with species and genotypes confirmed by internal transcribed spacer sequencing and phylogenetic analysis. Antifungal susceptibility testing was carried out to evaluate their susceptibility to itraconazole, voriconazole, and terbinafine. The 24% (n = 27/114) of superficial mycoses were phenotypically attributed to T. mentagrophytes complex isolates. Trichophyton interdigitale, mainly genotype II*, was predominant (44.4%), followed by T. mentagrophytes genotype III* (22.2%), T. indotineae (14.8%), T. tonsurans (11.2%), and T. mentagrophytes (7.4%). While all isolates were susceptible to itraconazole and voriconazole, half of T. indotineae isolates exhibited resistance to terbinafine, linked to the Phe397Leu mutation in the SQLE protein. This study highlighted the presence of terbinafine-resistant T. indotineae isolates in Vietnam, emphasizing the need to investigate dermatophyte drug resistance and implement effective measures in clinical practice.
Species diversity within the Trichophyton mentagrophytes complex isolated from dermatophytosis in Hue City, Vietnam, was observed. Terbinafine-resistant T. indotineae isolates were detected for the first time in Vietnam, emphasizing the importance of implementing antifungal susceptibility testing to effectively manage and prevent the spread of resistant isolates.
Asunto(s)
Antifúngicos , Farmacorresistencia Fúngica , Genotipo , Pruebas de Sensibilidad Microbiana , Filogenia , Terbinafina , Tiña , Humanos , Vietnam , Antifúngicos/farmacología , Terbinafina/farmacología , Tiña/microbiología , Arthrodermataceae/efectos de los fármacos , Arthrodermataceae/genética , Arthrodermataceae/clasificación , Arthrodermataceae/aislamiento & purificación , Masculino , Análisis de Secuencia de ADN , Itraconazol/farmacología , ADN Espaciador Ribosómico/genética , Femenino , Persona de Mediana Edad , ADN de Hongos/genética , Epidemiología Molecular , Adulto , TrichophytonRESUMEN
BACKGROUND: Over the past decades, the increasing incidence of recurrent dermatophytosis associated with terbinafine-resistant Trichophyton has posed a serious challenge in management of dermatophytosis. Independent reports of failure of treatment and high minimum inhibitory concentrations (MIC) of antifungals are available, but data correlating MIC and clinical outcomes is still sparse. Therefore, the present study was conducted to evaluate the outcomes of systemic treatment of dermatophytosis and its correlation with MIC of the etiological agents isolated from such patients. METHODS: Retrospective analysis of 587 consecutive patients with dermatophytosis was done from March 2017 to March 2019. Demographic and clinical details of the patients were noted, along with the results of direct microscopy and fungal culture. The isolates were identified by sequencing the internal transcribed spacer region of rDNA. Antifungal susceptibility testing was performed following the CLSI M38 protocol. Mutation in the squalene epoxidase (SE) gene was detected by DNA sequencing and ARMS-PCR. Based on the culture-positivity and prescribed systemic antifungal, patients were categorised into Group I culture-positive cases treated with systemic terbinafine and Group II culture-positive cases treated with systemic itraconazole, each for a total period of 12 weeks. RESULTS: In the present study, 477 (81.39%) were culture-positive; however, 12 weeks follow-up was available for 294 patients (Group I-157 and Group II-137) who were included for statistical analysis. In both groups [Group I-37/63 (51.4%) and Group II-14/54 (58.3%)], a better cure rate was observed if the initiation of therapy was performed within <6 months of illness. Treatment outcome revealed that if therapy was extended for 8-12 weeks, the odds of cure rate are significantly better (p < .001) with either itraconazole (Odd Ratio-15.5) or terbinafine (Odd Ratio-4.34). Higher MICs for terbinafine were noted in 41 cases (cured-18 and uncured-23) in Group I and 39 cases (cured-16 and uncured-23) in Group II. From cured (Group I-17/18; 94.4% and Group II-14/16; 87.5%) and uncured (Group I-20/23; 86.9% and Group II-21/23; 91.3%) cases had F397L mutation in the SE gene. No significant difference in cure rate was observed in patients with Trichophyton spp. having terbinafine MIC ≥ 1or <1 µg/mL (Group I-p = .712 and Group II-p = .69). CONCLUSION: This study revealed that prolonging terbinafine or itraconazole therapy for beyond 8 weeks rather than the standard 4 weeks significantly increases the cure rate. Moreover, no correlation has been observed between antifungal susceptibility and clinical outcomes. The MIC remains the primary parameter for defining antifungal activity and predicting the potency of antifungal agents against specific fungi. However, predicting therapeutic success based solely on the MIC of a fungal strain is not always reliable, as studies have shown a poor correlation between in vitro data and in vivo outcomes. To address this issue, further correlation of antifungal susceptibility testing (AFST) data with clinical outcomes and therapeutic drug monitoring is needed. It also highlights that initiation of the treatment within <6 months of illness increases cure rates and reduces recurrence. Extensive research is warranted to establish a better treatment regime for dermatophytosis.
Asunto(s)
Antifúngicos , Itraconazol , Mutación , Escualeno-Monooxigenasa , Terbinafina , Tiña , Trichophyton , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Antifúngicos/uso terapéutico , Antifúngicos/farmacología , Farmacorresistencia Fúngica/genética , Itraconazol/farmacología , Itraconazol/uso terapéutico , Pruebas de Sensibilidad Microbiana , Estudios Retrospectivos , Escualeno-Monooxigenasa/genética , Terbinafina/uso terapéutico , Terbinafina/farmacología , Tiña/tratamiento farmacológico , Tiña/microbiología , Resultado del Tratamiento , Trichophyton/efectos de los fármacos , Trichophyton/genéticaRESUMEN
BACKGROUND: Dermatophytosis is a common skin infection of cats and many other animals. A reliable diagnosis is crucial because of the zoonotic potential of dermatophytes. The routine mycological diagnostic procedures for dermatophytosis are widely known, but in the case of some isolates, identification based on phenotypic characteristics may be incorrect. Infections caused by Chrysosporium spp. are usually described in reptiles, but in other animals they are uncommon. CASE PRESENTATION: This study presents a description of a cat with dermatological lesions, that was mistakenly diagnosed with Trichophyton spp. dermatophytosis. Clinical material for mycological examination was collected from alopecic areas on the back of the neck, the ventral abdomen, and the hindlimbs. The initial identification based on phenotypic properties indicated Trichophyton spp. The result of the MALDI-ToF MS allowed the exclusion of the Trichophyton genus. Ultimately, the correct identification as Chrysosporium articulatum was obtained based on the sequencing of ribosomal genes. CONCLUSIONS: Interpretation of the results of the mycological examination of samples collected from animals' skin or hair shafts is always challenging. Thus, careful consideration of the primary cause of the clinical lesions observed on the skin is mandatory, and the culture results are worth supporting by molecular methods.
Asunto(s)
Enfermedades de los Gatos , Chrysosporium , Tiña , Trichophyton , Gatos , Animales , Enfermedades de los Gatos/microbiología , Enfermedades de los Gatos/diagnóstico , Tiña/veterinaria , Tiña/diagnóstico , Tiña/microbiología , Chrysosporium/aislamiento & purificación , Chrysosporium/genética , Trichophyton/aislamiento & purificación , Diagnóstico Diferencial , Masculino , Dermatomicosis/veterinaria , Dermatomicosis/diagnóstico , Dermatomicosis/microbiologíaRESUMEN
A 20-year-old man had developed dermatitis on his scalp and facial hair between his lower lip and chin, his 'soul patch', for one month. He initially presented to urgent care, where the dermatitis was attributed to Herpes simplex infection, for which he was treated with both oral valacyclovir and topical acyclovir. When no change was observed, he consulted his pediatrician, who prescribed oral clindamycin and referred him to dermatology. Physical examination revealed a crusted plaque on an erythematous and edematous base at the lower cutaneous border of the lower lip (Figure 1). Examination additionally revealed an erythematous scaling plaque on the left temporal area with associated flaking, tenderness, and hair loss and left-sided cervical lymphadenopathy. A fungal culture grew Trichophyton mentagrophytes, but a bacterial culture did not grow. Further investigation revealed that he had a dog; however, no other animal contact to account for a fungal reservoir was present. He was successfully treated with oral terbinafine for 6 weeks, plus ketoconazole 2% shampoo and ketoconazole 2% cream with complete reso-lution (Figure 2).
Asunto(s)
Antifúngicos , Humanos , Masculino , Antifúngicos/uso terapéutico , Antifúngicos/administración & dosificación , Adulto Joven , Cetoconazol/uso terapéutico , Cetoconazol/administración & dosificación , Terbinafina/uso terapéutico , Terbinafina/administración & dosificación , Tiña/tratamiento farmacológico , Tiña/diagnóstico , Animales , Perros , Naftalenos/uso terapéutico , Naftalenos/administración & dosificación , Preparaciones para el Cabello , Trichophyton/aislamiento & purificaciónRESUMEN
Trichophyton indotineae is a recently identified dermatophyte that frequently causes extensive and persistent dermatomycosis, particularly tinea corporis, tinea cruris, and tinea faciei. The infection is frequently encountered in countries of the Indian subcontinent and surrounding areas. In Europe, T. indotineae has mainly been detected in patients with an epidemiological link to the aforementioned regions. Unlike dermatomycoses caused by other dermatophyte species, infections caused by T. indotineae often exhibit treatment failure with commonly prescribed antifungal drugs. Reduced susceptibility to terbinafine is often observed in T. indotineae. In addition, reduced susceptibility to itraconazole has also been reported. Due to the extensive and persistent nature of the infection, as well as the reduced susceptibility to antifungal drugs, international experts recommend aggressive treatment of T. indotineae using a combination of oral and topical antifungals. Susceptibility testing may be warranted to guide treatment decisions. Early recognition of T. indotineae infections is crucial to prevent prolonged recurrences.
Asunto(s)
Antifúngicos , Tiña , Humanos , Antifúngicos/uso terapéutico , Tiña/tratamiento farmacológico , Tiña/diagnóstico , Trichophyton/aislamiento & purificación , Trichophyton/efectos de los fármacos , Dermatomicosis/tratamiento farmacológico , Dermatomicosis/diagnósticoAsunto(s)
Antifúngicos , ADN de Hongos , Farmacorresistencia Fúngica , Análisis de Secuencia de ADN , Tiña , Trichophyton , Humanos , Tiña/microbiología , Tiña/tratamiento farmacológico , Tiña/diagnóstico , Trichophyton/genética , Trichophyton/efectos de los fármacos , Trichophyton/aislamiento & purificación , Trichophyton/clasificación , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Farmacorresistencia Fúngica/genética , ADN de Hongos/genética , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana EdadAsunto(s)
Tiña del Cuero Cabelludo , Trichophyton , Humanos , Masculino , Tiña del Cuero Cabelludo/complicaciones , Tiña del Cuero Cabelludo/diagnóstico , Tiña del Cuero Cabelludo/tratamiento farmacológico , Tiña del Cuero Cabelludo/microbiología , Trichophyton/aislamiento & purificación , Lactante , Alopecia/microbiología , Cuero Cabelludo , Hiperpigmentación/microbiología , Terbinafina/administración & dosificación , Terbinafina/uso terapéutico , Antifúngicos/administración & dosificación , Antifúngicos/uso terapéuticoRESUMEN
Over the past few years, a recalcitrant dermatophytosis has been observed on the Indian subcontinent, including Sri Lanka, which has caused a major public health issue in the region. An emerging species, Trichophyton indotineae, first described as Trichophyton mentagrophytes ITS genotype VIII, is thought to be responsible for this fast-spreading, mostly terbinafine-resistant dermatophytosis. Recalcitrant dermatophytosis is a challenge to dermatologists, and knowing the causative species and antifungal sensitivity in the earlier stage of management would be invaluable. We report a case series of patients with dermatophytosis caused by T. indotineae in Sri Lanka. This is the first detection of this highly terbinafine-resistant strain in Sri Lanka, and existence of this species should be taken seriously by dermatologists and healthcare policymakers for better management of tinea infections and antifungal stewardship in the country.
Asunto(s)
Antifúngicos , Genotipo , Terbinafina , Tiña , Humanos , Tiña/tratamiento farmacológico , Tiña/microbiología , Sri Lanka , Antifúngicos/uso terapéutico , Antifúngicos/farmacología , Masculino , Femenino , Terbinafina/uso terapéutico , Adulto , Persona de Mediana Edad , Farmacorresistencia Fúngica , Trichophyton/genética , Trichophyton/aislamiento & purificación , Trichophyton/efectos de los fármacos , Trichophyton/clasificación , Arthrodermataceae/genética , Arthrodermataceae/aislamiento & purificación , Arthrodermataceae/efectos de los fármacos , Arthrodermataceae/clasificaciónAsunto(s)
Antifúngicos , Tiña , Trichophyton , Humanos , Masculino , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Australia , Farmacorresistencia Fúngica , Tiña/tratamiento farmacológico , Tiña/diagnóstico , Tiña/microbiología , Trichophyton/efectos de los fármacos , Trichophyton/aislamiento & purificación , AdultoAsunto(s)
Antifúngicos , Farmacorresistencia Fúngica , Personal Militar , Onicomicosis , Terbinafina , Tiña del Pie , Humanos , Terbinafina/uso terapéutico , Tiña del Pie/tratamiento farmacológico , Tiña del Pie/microbiología , Tiña del Pie/diagnóstico , Antifúngicos/uso terapéutico , Onicomicosis/tratamiento farmacológico , Onicomicosis/microbiología , Onicomicosis/diagnóstico , Japón/epidemiología , Masculino , Adulto , Trichophyton/aislamiento & purificación , Trichophyton/efectos de los fármacos , Pueblos del Este de AsiaRESUMEN
The therapeutic potential of medicinal plants is known as an alternative in treatment of human affections; in effect, the conventional application of these medicinal sources has several limitations like low bioavailability, solubility and stability, which affect its pharmacological efficacy. In recent decades, extraordinary advances have been made in new drug delivery systems using nanocarriers. This work consisted in determining the in vitro antifungal activity of the methanolic extract of Euphorbia tirucalli formulated in polymeric nanoparticles. The antifungal activity was determined by the microdilution method in 96-well microplates, applying nanoparticles loaded with plant extract (NP-Ext) obtained by nanoprecipitation on clinical isolates of Trichophyton rubrum and T. interdigitalis. Regarding the nanoparticles, the lots used did not present significant differences in their physicochemical characteristics, with a size of 91.885 ± 1.621nm, polydispersity index of 0.152 ± 0.025 and Z-potential of -6.047 ± 0.987. The quantification of the extract in the polymeric matrix was determined by infrared spectroscopy (FTIR), where an efficiency and encapsulation percentage of 22.15 ± 0.82 and 2.95 ± 0.11, respectively, were obtained. The in vitro antifungal activity of the crude and formulated extract was obtained calculating the Minimum Inhibitory Concentration (MIC) of each one; a MIC of 125 µg/mL was obtained against T. rubrum and T. interdigitalis with the crude extract, while a MIC value of 55.55 and 0.1 µg/mL was obtained with NP-Ext, respectively, against these same. Conclusions: biological activity is closely linked to the phytochemical profile of the extract; while the improvement of said potential with the NP-Ext with the dosage form was directly related to the physicochemical characteristics of the nanocarrier.
Asunto(s)
Antifúngicos , Euphorbia , Pruebas de Sensibilidad Microbiana , Nanopartículas , Extractos Vegetales , Euphorbia/química , Antifúngicos/farmacología , Antifúngicos/química , Extractos Vegetales/farmacología , Extractos Vegetales/química , Nanopartículas/química , Espectroscopía Infrarroja por Transformada de Fourier , Trichophyton/efectos de los fármacos , Polímeros/farmacología , Polímeros/química , ArthrodermataceaeRESUMEN
Onychomycosis, a fungal nail infection, is primarily caused by dermatophytes, yeasts, and non-dermatophyte moulds (NDMs). The incidence of this disease and the predominance of specific pathogens vary across different regions and evolve. This study aimed to elucidate the epidemiology of onychomycosis and the pattern of causative pathogens in Beijing, and to ascertain the in vitro antifungal susceptibility profiles of Trichophyton rubrum against itraconazole (ITR), terbinafine (TER), and fluconazole (FLU). Involving 245 patients of onychomycosis with positive fungal culture results, the study implemented internal transcribed spacer (ITS) sequencing of ribosomal DNA (rDNA) on all collected samples. The mean age of the participants was 37.93 ± 13.73 years, with a male-to-female ratio of 1.53:1. The prevalence of toenail infections was significantly higher than that of fingernails. Distal and lateral subungual onychomycosis (DLSO) were the most frequent clinical classifications. PCR results indicated that dermatophytes were the most prevalent pathogens, followed by yeasts and NDMs, among which T. rubrum was the most dominant dermatophyte. TER demonstrated high sensitivity to T. rubrum. However, in clinical settings, some patients with onychomycosis exhibit a poor response to TER treatment. The relationship between in vitro antifungal sensitivity and clinical effectiveness is complex, and understanding the link between in vitro MIC values and clinical efficacy requires further investigation.
Asunto(s)
Antifúngicos , Fluconazol , Dermatosis del Pie , Itraconazol , Pruebas de Sensibilidad Microbiana , Onicomicosis , Terbinafina , Humanos , Onicomicosis/microbiología , Onicomicosis/tratamiento farmacológico , Onicomicosis/epidemiología , Masculino , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Femenino , Adulto , Persona de Mediana Edad , Terbinafina/farmacología , Terbinafina/uso terapéutico , Dermatosis del Pie/microbiología , Dermatosis del Pie/tratamiento farmacológico , Itraconazol/farmacología , Itraconazol/uso terapéutico , Fluconazol/farmacología , Arthrodermataceae/efectos de los fármacos , Adulto Joven , Dermatosis de la Mano/microbiología , Dermatosis de la Mano/tratamiento farmacológico , Dermatosis de la Mano/epidemiología , China/epidemiología , Prevalencia , Trichophyton/efectos de los fármacos , Anciano , AdolescenteRESUMEN
An unambiguous identification of dermatophytes causing dermatophytoses is necessary for accurate clinical diagnosis and epidemiological implications. In the current taxonomy of the Arthrodermataceae, the etiological agents of dermatophytoses consist of seven genera and members of the genera Trichophyton are the most prevalent etiological agents at present. The genera Trichophyton consists of 16 species that are grouped as clades, but the species borderlines are not clearly delimited. The aim of the present study was to determine the discriminative power of subtilisin gene variants (SUB1-SUB12) in family Arthrodermataceae, particularly in Trichophyton. Partial and complete reads from 288 subtilisin gene sequences of 12 species were retrieved and a stringent filtering following two different approaches for analysis (probability of correct identification (PCI) and gene gap analysis) conducted to determine the uniqueness of the subtilisin gene subtypes. SUB1 with mean PCI value of 60% was the most suitable subtilisin subtype for specific detection of T.rubrum complex, however this subtype is not reported in members of T. mentagrophytes complex which is one of the most prevalent etiological agent at present. Hence, SUB7 with 40% PCI value was selected for testing its discriminative power in Trichophyton species. SUB7 specific PCR based detection of dermatophytes was tested for sensitivity and specificity. Sequences of SUB7 from 42 isolates and comparison with the ITS region showed that differences within the subtilisin gene can further be used to differentiate members of the T. mentagrophytes complex. Further, subtilisin cannot be used for the differentiation of T. benhamiae complex since all SUB subtypes show low PCI scores. Studies on the efficiency and limitations of the subtilisin gene as a diagnostic tool are currently limited. Our study provides information that will guide researchers in considering this gene for identifying dermatophytes causing dermatophytoses in human and animals.
Asunto(s)
Arthrodermataceae , Arthrodermataceae/genética , Arthrodermataceae/aislamiento & purificación , Humanos , Tiña/microbiología , Tiña/diagnóstico , Subtilisina/genética , Trichophyton/genética , Trichophyton/aislamiento & purificación , Filogenia , Proteínas Fúngicas/genéticaRESUMEN
Trichophyton indotineae is an emerging species of the Trichophyton mentagrophytes complex (TMC), responsible for an epidemic of widespread hairless skin infections that is frequently (50-70%) resistant to terbinafine. In order to initiate appropriate treatment as quickly as possible without waiting for culture positivity (10-15 days) and molecular identification from the strain, we developed a dual quantitative PCR (qPCR) for the direct detection of T. indotineae in clinical samples. We first designed a T. indotineae-specific qPCR assay (TI-qPCR) targeting a single specific polymorphism in the internal transcribed spacer region. Although none of the 94 non-dermatophyte and 7 dermatophyte species were amplified, this TI-qPCR allowed amplification of other TMC species at a lower yield. With equal amounts (0.1 ng) of DNA per reaction, the mean quantitative cycle (Cq) values for T. indotineae and non-indotineae TMC were 27.9 (±0.1) and 38.9 (±0.3), respectively. Therefore, we normalized this assay against a previously validated pan-dermatophyte qPCR assay (PD-qPCR) and relied on the ΔCq [(TI-qPCR) - (PD-qPCR)] to identify T. indotineae versus other TMC species. Dual assay was validated using 86 clinical samples of culture-confirmed T. indotinea and 19 non-indotineae TMC cases. The mean ΔCq for non-indotineae TMC was 9.6 ± 2.7, whereas the ΔCq for T. indotinea was -1.46 ± 2.1 (P < .001). Setting the ΔCq at 4.5 as a cutoff value resulted in 100% specificity for the detection of T. indotineae. This dual qPCR assay quickly detects T. indotineae from skin scrapings, aiding in early diagnosis and treatment for patients with suspected infection.
Identifying the emerging species Trichophyton indotineae is long and requires to wait for culture positivity. We developed a dual qPCR strategy to detect T. indotineae directly from clinical sample with a 100% sensitivity.