When Fungal Infections Just Won’t Go Away: The Hidden Challenges of Dermatophyte Infections

Persistent skin, hair, or nail infections are more than just an annoyance—they might signal a deeper, growing problem in infectious disease management. Many people don’t realize that up to 25% of the global population is affected by dermatophyte infections, making these some of the most common infectious diseases worldwide.^[1][2]

The Usual Suspects

The majority of cases are caused by just two culprits:

• Trichophyton rubrum — This species is estimated to be responsible for 50-90% of infections globally. It often leads to chronic skin and nail conditions and spreads easily through direct contact or shared items.
• Trichophyton interdigitale — The second most common dermatophyte, particularly associated with athlete’s foot and other skin or nail infections. It thrives in both humans and animals.^[2]

^‍Rising Resistance and Diagnostic Hurdles

The primary dermatophyte driving the current antifungal resistance crisis is Trichophyton indotineae (a.k.a. Trichophyton mentagrophytes type VIII), an emerging species known for widespread resistance to terbinafine, one of the most commonly used antifungals. Originally identified on the Indian subcontinent,  
‍T. indotineae has rapidly spread globally, causing hard-to-treat, recurrent infections that often fail standard therapies.

This resistance issue is now extending to other key dermatophyte species, including Trichophyton rubrum and Trichophyton interdigitale, compounding treatment challenges worldwide. Traditional diagnostics struggle to keep pace, delaying effective treatment and contributing to the significant economic burden of fungal infections, with dermatophytosis alone responsible for over $1.3 billion annually in out patient medical costs in the U.S. alone. ^[3][4][5]

Modern Solutions: DermaGenius® Multiplex real-time PCR Kits

DermaGenius® Multiplex real-time PCR kits from PathoNostics are revolutionizing fungal infection management. With a PCR run-time of under 2 hours, the DermaGenius® Multiplex real-time PCR and DermaGenius® Resistance kits provide highly accurate species-level identification and resistance profiling, enabling clinicians to prescribe precisely targeted treatments. This increased diagnostic precision supports faster patient relief and improved long-term outcomes.

Explore our DermaGenius® product range for detailed information on how these advanced molecular tools can enhance diagnosis and treatment of dermatophyte infections.

References

1)    Barac A, Stjepanovic M, KrajisnikS, Stevanovic G, Paglietti B, Milosevic B. Dermatophytes: Update on ClinicalEpidemiology and Treatment. Mycopathologia. 2024 Nov 21;189(6):101. doi:10.1007/s11046-024-00909-3. PMID: 39567411.   https://pubmed.ncbi.nlm.nih.gov/39567411/

2)    Martinez-Rossi, N.M.; Peres, N.T.A.;Bitencourt, T.A.; Martins, M.P.; Rossi, A. State-of-the-Art Dermatophyte Infections: Epidemiology Aspects, Pathophysiology, and Resistance Mechanisms. J. Fungi 2021, 7, 629. https://doi.org/10.3390/jof7080629

3)    Saunte DML, Hare RK, Jørgensen KM, Jørgensen R, Deleuran M, Zachariae CO, Thomsen SF, Bjørnskov-Halkier L, Kofoed K, Arendrup MC2019. Emerging Terbinafine Resistance in Trichophyton: Clinical Characteristics, Squalene Epoxidase Gene Mutations, and a Reliable EUCASTMethod for Detection. Antimicrob agents Chemother 63:10.1128/aac.01126-19. https://doi.org/10.1128/aac.01126-19

4)    Mechidi P, Holien J, Grando D, Huynh T, Lawrie AC. New Sources of Resistance to Terbinafine Revealed and Squalene Epoxidase Modelled in the Dermatophyte Fungus Trichophyton interdigitale From Australia. Mycoses. 2024 Sep;67(9):e13795. doi:10.1111/myc.13795. PMID: 39304967.

5)    Benedict K, Gold JAW, Chiller T,Lyman M. Economic burden of fungal diseases in the United States. Med Mycol.2025 Jun 5;63(6):myaf049. doi: 10.1093/mmy/myaf049. PMID: 40455586; PMCID:PMC12281149.

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