Extensive Tinea Corporis and Tinea Cruris from Trichophyton indotineae

A previously healthy 30-year-old man developed an extensive, itchy rash over six months during migration from Turkey. Despite topical antifungal and corticosteroid creams, his condition worsened. Examination revealed scaly, erythematous plaques on the right shoulder, arm, lower abdomen, groin, and thighs. Skin scraping showed fungal hyphae, and genetic sequencing identified Trichophyton indotineae, a dermatophyte resistant to standard topical antifungals and oral terbinafine, with reduced responsiveness to fluconazole and griseofulvin. After a 6-week course of itraconazole, the rash resolved. The report stresses the importance of species testing for treatment-refractory or extensive tinea infections, especially in patients with South Asian travel history.

A previously healthy 30-year-old man developed an extensive, itchy rash over six months during migration from Turkey. Despite topical antifungal and corticosteroid creams, his condition worsened. Examination revealed scaly, erythematous plaques on the right shoulder, arm, lower abdomen, groin, and thighs. Skin scraping showed fungal hyphae, and genetic sequencing identified Trichophyton indotineae, a dermatophyte resistant to standard topical antifungals and oral terbinafine, with reduced responsiveness to fluconazole and griseofulvin. After a 6-week course of itraconazole, the rash resolved. The report stresses the importance of species testing for treatment-refractory or extensive tinea infections, especially in patients with South Asian travel history.