Tinea corporis caused by terbinafine‐resistant Trichophyton rubrum successfully treated with fosravuconazole
Abstract
Dear Editor, In recent years, there have been outbreaks of terbinafine (TRF)resistantṣTrichophyton spp. in India, Switzerland, and Denmark. We herein report a case of tinea corporis caused by TRFresistant Trichophyton rubrum. A 71yearold Japanese woman presented with erythema on her left lower leg. She had experienced tinea corporis 11 years previously. A direct KOH examination revealed filamentous fungi. The patient had no history of immune deficiency. The symptoms improved with topical luliconazole (LUL) and oral itraconazole (ITCZ) administration (100 mg/day); but recurred after withdrawing the oral medication. She stopped coming to the hospital when her symptoms improved to some extent; thus, the aforementioned treatment continued intermittently for 4 years. For the next 5 years, she was treated intermittently with topical LUL, TRF, or ketoconazole (KCZ), and oral TRF. However, the welldemarcated, irregularshaped erythema of approximately 20 cm in diameter persisted on her left lower leg. Tinea pedis and unguium symptoms were absent. Another direct KOH examination was positive. We cultured a scale from the lesion and obtained a white villus colony with red and yellowish reverse on Sabouraud’s dextrose agar. T. rubrum (IFM 66695) was isolated from this case by culture morphology and internal transcribed spacer (ITS) region sequence analyses. We then started oral fosravuconazole (FRVCZ). After 12 weeks, the symptoms improved, and we ended treatment. No apparent symptoms…
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