First case of Trichophyton indotineae in Brazil: clinical and mycological criteria and genetic identification of terbinafine resistance
John Verrinder Veasey, Renata Diniz Jacques Gonçalves, Guilherme Camargo Julio Valinoto, Gustavo de Sá Menezes Carvalho, Giovanna Azevedo Celestrino, Ana Paula Carvalho Reis, Ana Paula Cordeiro Lima, Antônio Charlys da Costa, Márcia de Souza Carvalho Melhem, Gil Benard, Maria Glória Teixeira Sousa
Abstract
Brazil with dermatophytosis caused by terbinafine-resistant T. indotineae.A 40-year-old male individual, without comorbidities, originally from Brazil and living in London, reported pruritic erythematous-desquamative lesions on the lower limbs and buttocks that began in January 2024 (Fig. 1).He reported frequent short trips during the second half of 2023; to Austria, Slovakia, Hungary, and Poland in August, and to Scotland and Turkey in November and December.He sought dermatological care in Piracicaba (state of So Paulo, Brazil), where direct mycological examination revealed the presence of hyaline septate hyphae, and the culture using Sabouraud agar and Mycosel showed growth of T. mentagrophytes.He was diagnosed with dermatophytosis and in March 2024 he was prescribed 500 mg/day of terbinafine for 14 days.Although there was no clinical improvement, the patient returned to London; in May 2024 he came back presenting lesions in the same locations (Fig. 2).