IADVL consensus recommendations on Trichophyton indotineae infections: Using modified Delphi method
In brief
Expert panel recommends itraconazole first for emerging Trichophyton indotineae infections
A 17-member expert panel recommends itraconazole as the first-choice systemic treatment for Trichophyton indotineae, with higher-dose terbinafine as a second option. If response is inadequate after 4 weeks, the panel advises switching antifungals and continuing treatment until cure; these are consensus recommendations, not results from a comparative treatment trial.
- Journal
- Journal of the European Academy of Dermatology and Venereology : JEADV (Q1)
- Published
- 1 October 2026
- Study design
- Practice guideline / consensus
- Evidence level
- Level 1, High (CEBM 1c)
- Authors
- Ananta Khurana, Jyothi Jayaraman, Mohammad Adil, Anuradha Chowdhary, Deblina Bhunia, Kabir Sardana, et al.
- PMID
- 42820589
- DOI
- 10.1111/jdv.70693
Why clinicians should know about it
- Picked for Dermatology (paper of the day, 4 October 2026): IADVL consensus recommendations on Trichophyton indotineae infections
Abstract
BACKGROUND: Trichophyton indotineae has emerged as a significant novel species causing tinea corporis/cruris/faciei, with established endemicity in a few regions and potential for expanding endemic zones in future. OBJECTIVES: We aimed to develop consensus on disease definitions, diagnosis and treatment of T. indotineae infection. METHODS: Relevant literature from 2017 onwards was analysed and presented to the panel of dermatology experts, followed by circulation of a structured Google questionnaire encompassing various aspects of systemic and topical treatment, including special scenarios. Repeat rounds with modified questions were conducted in domains where (75%) consensus was not achieved, till a maximum of three rounds. Disease definitions were arrived at by discussion among clinical experts. Mycological (diagnostic) guidelines were formulated by the expert mycology members through peer review of each other's drafts. RESULTS: The panel comprised 14 dermatologists, 2 mycologists and 1 pharmacologist. Disease definitions for clinical and research use are presented. KOH smear testing is recommended in clinically doubtful cases, whereas culture, antifungal susceptibility testing and sequencing are recommended for monitoring trends of prevalent species and drug susceptibility in specialized mycology laboratories. A total of 87 therapeutic questions were put to the 14 dermatologists. Key therapeutic recommendations include the use of itraconazole (ITZ) as a first-line systemic agent and terbinafine (TRB) (higher dose) as a second line, switching systemic antifungal in case of inadequate response at 4 weeks, use of prolonged treatment (till cure) and treatment of relapses with the same regimen as used for initial treatment. Recommendations for treatment monitoring and treatment in special scenarios such as paediatric patients, pregnancy, lactation, renal or hepatic dysfunction, cardiac failure and patients on topical/systemic steroids or immunosuppressives are presented. CONCLUSIONS: The panel has made recommendations on clinical and diagnostic aspects of T. indotineae infections, which would improve patient outcomes and foster academic communication and research.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.