Therapeutic Outcomes in Patients With Trichophyton indotineae: A Systematic Review and Meta-Analysis of Individual Patient Data

Abstract

Background: Trichophyton indotineae has emerged as a significant global dermatophyte, associated with recalcitrant dermatophytosis and increasing antifungal resistance. Materials and Methods: This study evaluates therapeutic outcomes in T. indotineae infections. We conducted a systematic review and meta-analysis of individual patient data adhering to PRISMA guidelines, including studies published before December 2023 from six electronic databases. Only studies with confirmed T. indotineae by rDNA sequencing and therapeutic outcome data were included. Results: A total of 27 publications with 81 cases were included. T. indotineae infections affected both genders equally, with 25% having prior steroid use, which was significantly associated with non-improvement. Resistance to terbinafine was observed in 85.3% of cases. Oral itraconazole was significantly associated with a cure. The restricted median time to complete clinical cure was 11.50 weeks, with a recurrence rate of 19.7%. Conclusions: The effective management of T. indotineae infections is essential, given the significant challenges posed by antifungal resistance.