2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T49a,The search yielded 96 studies (1954-2025) documenting 134 patients. The number of reports has notably increased since the 21st century; however, diagnosis remains challenging due to possible dermatophyte adaptation in the dermal/subcutaneous environment. Trichophyton rubrum is the most frequently isolated pathogen. Acquired immunodeficiencies (e.g. renal transplant recipients) and primary immunodeficiencies (e.g. CARD9, STAT3 mutations) elevate the risk of deep dermatophytosis. Systemic dissemination, often accompanied by lymphadenopathy, was reported in 24 patients, with the most common being infection of the axillary and inguinal lymph nodes. Infections of the bones, lungs, and brain were also reported. Terbinafine (125-1000 mg/day) and itraconazole (100-400 mg/day), with adjunctive topical antifungals and surgical interventions, have been tried for deep dermatophytosis. The use of newer triazoles (voriconazole, posaconazole) should follow the principles of antifungal stewardship and therapeutic drug monitoring recommendations. Multidrug resistance is a potential concern in immunocompromised patients who will often require extended or lifelong treatment.31:T89b,Dermatophytes-a group of obligate keratinophilic fungi that infect the skin, hair and nails-represent the most common cause of fungal infections worldwide. In immunocompromised individuals, a growing body of literature has documented rare instances of dermatophyte infections of the dermis and subcutaneous tissue, which can lead to deep dermatophytosis with systemic dissemination and pseudomycetoma as secondary complications. To assess patient characteristics, risk factors, diagnostic evidence and treatment options for deep dermatophytosis. A systematic review was conducted in June 2025 to identify patients presenting with deep dermatophytosis of the glabrous skin; all cases were validated by confirmatory testing per histopathologic examination and fungal culture. Majocchi's granuloma diagnoses were excluded. The search yielded 96 studies (1954-2025) documenting 134 patients. The number of reports has notably increased since the 21st century; however, diagnosis remains challenging due to possible dermatophyte adaptation in the dermal/subcutaneous environment. Trichophyton rubrum is the most frequently isolated pathogen. Acquired immunodeficiencies (e.g. renal transplant recipients) and primary immunodeficiencies (e.g. CARD9, STAT3 mutations) elevate the risk of deep dermatophytosis. Systemic dissemination, often accompanied by lymphadenopathy, was reported in 24 patients, with the most common being infection of the axillary and inguinal lymph nodes. Infections of the bones, lungs, and brain were also reported. Terbinafine (125-1000 mg/day) and itraconazole (100-400 mg/day), with adjunctive topical antifungals and surgical interventions, have been tried for deep dermatophytosis. The use of newer triazoles (voriconazole, posaconazole) should follow the principles of antifungal stewardship and therapeutic drug monitoring recommendations. Multidrug resistance is a potential concern in immunocompromised patients who will often require extended or lifelong treatment. Healthcare providers should be cognizant that dermatophytosis may become invasive and disseminated in immunocompromised populations. Testing and early treatment should not be overlooked in these patients.32:Ta45,AbstractBackgroundDermatophytes—a group of obligate keratinophilic fungi that infect the skin, hair and nails—represent the most common cause of fungal infections worldwide. In immunocompromised individuals, a growing body of literature has documented rare instances of dermatophyte infections of the dermis and subcutaneous tissue, which can lead to deep dermatophytosis with systemic dissemination and pseudomycetoma as secondary complications.ObjectivesTo assess patient characteristics, risk factors, diagnostic evidence and treatment options for deep dermatophytosis.MethodsA systematic review was conducted in June 2025 to identify patients presenting with deep dermatophytosis of the glabrous skin; all cases were validated by confirmatory testing per histopathologic examination and fungal culture. Majocchi's granuloma diagnoses were excluded.ResultsThe search yielded 96 studies (1954–2025) documenting 134 patients. The number of reports has notably increased since the 21st century; however, diagnosis remains challenging due to possible dermatophyte adaptation in the dermal/subcutaneous environment. Trichophyton rubrum is the most frequently isolated pathogen. Acquired immunodeficiencies (e.g. renal transplant recipients) and primary immunodeficiencies (e.g. CARD9, STAT3 mutations) elevate the risk of deep dermatophytosis. Systemic dissemination, often accompanied by lymphadenopathy, was reported in 24 patients, with the most common being infection of the axillary and inguinal lymph nodes. Infections of the bones, lungs, and brain were also reported. Terbinafine (125–1000 mg/day) and itraconazole (100–400 mg/day), with adjunctive topical antifungals and surgical interventions, have been tried for deep dermatophytosis. The use of newer triazoles (voriconazole, posaconazole) should follow the principles of antifungal stewardship and therapeutic drug monitoring recommendations. Multidrug resistance is a potential concern in immunocompromised patients who will often require extended or lifelong treatment.ConclusionsHealthcare providers should be cognizant that dermatophytosis may become invasive and disseminated in immunocompromised populations. Testing and early treatment should not be overlooked in these patients.33:T495,Among 11 patients with T indotineae (6 male and 5 female patients; median [range] age, 39 [10-65] years), 2 were pregnant; 1 had lymphoma; and the remainder were immunocompetent. Nine patients reported previous travel to Bangladesh. All had widespread lesions with variable scale and inflammation, topical antifungal monotherapy failure, and diagnostic delays (range, 3-42 months). Terbinafine treatment failed in 7 patients at standard doses (250 mg daily) for prolonged duration; these patients also had isolates with amino acid substitutions at positions 393 (L393S) or 397 (F397L) in squalene epoxidase that correlated with elevated terbinafine minimum inhibitory concentrations of 0.5 μg/mL or higher. Patients who were treated with fluconazole and griseofulvin improved in 2 of 4 and 2 of 5 instances, respectively, without correlation between outcomes and antifungal minimum inhibitory concentrations. Furthermore, 5 of 7 patients treated with itraconazole cleared or had improvement at the last follow-up, and 2 of 7 were lost to follow-up or stopped treatment. Based on whole-genome sequencing analysis, US isolates formed a cluster distinct from Indian isolates.34:T958,Trichophyton indotineae is an emerging dermatophyte causing outbreaks of extensive tinea infections often unresponsive to terbinafine. This species has been detected worldwide and in multiple US states, yet detailed US data on infections with T indotineae are sparse and could improve treatment practices and medical understanding of transmission. To correlate clinical features of T indotineae infections with in vitro antifungal susceptibility testing results, squalene epoxidase gene sequence variations, and isolate relatedness using whole-genome sequencing. This retrospective cohort study of patients with T indotineae infections in New York City spanned May 2022 to May 2023. Patients with confirmed T indotineae infections were recruited from 6 New York City medical centers. Improvement or resolution at the last follow-up assessment. Among 11 patients with T indotineae (6 male and 5 female patients; median [range] age, 39 [10-65] years), 2 were pregnant; 1 had lymphoma; and the remainder were immunocompetent. Nine patients reported previous travel to Bangladesh. All had widespread lesions with variable scale and inflammation, topical antifungal monotherapy failure, and diagnostic delays (range, 3-42 months). Terbinafine treatment failed in 7 patients at standard doses (250 mg daily) for prolonged duration; these patients also had isolates with amino acid substitutions at positions 393 (L393S) or 397 (F397L) in squalene epoxidase that correlated with elevated terbinafine minimum inhibitory concentrations of 0.5 μg/mL or higher. Patients who were treated with fluconazole and griseofulvin improved in 2 of 4 and 2 of 5 instances, respectively, without correlation between outcomes and antifungal minimum inhibitory concentrations. Furthermore, 5 of 7 patients treated with itraconazole cleared or had improvement at the last follow-up, and 2 of 7 were lost to follow-up or stopped treatment. Based on whole-genome sequencing analysis, US isolates formed a cluster distinct from Indian isolates. The results of this case series suggest that disease severity, diagnostic delays, and lack of response to typically used doses and durations of antifungals for tinea were common in this primarily immunocompetent patient cohort with T indotineae, consistent with published data. Itraconazole was generally effective, and the acquisition of infection was likely in Bangladesh.35:Tc6d,ImportanceTrichophyton indotineae is an emerging dermatophyte causing outbreaks of extensive tinea infections often unresponsive to terbinafine. This species has been detected worldwide and in multiple US states, yet detailed US data on infections with T indotineae are sparse and could improve treatment practices and medical understanding of transmission.ObjectiveTo correlate clinical features of T indotineae infections with in vitro antifungal susceptibility testing results, squalene epoxidase gene sequence variations, and isolate relatedness using whole-genome sequencing.Design, Setting, and ParticipantsThis retrospective cohort study of patients with T indotineae infections in New York City spanned May 2022 to May 2023. Patients with confirmed T indotineae infections were recruited from 6 New York City medical centers.Main Outcome and MeasureImprovement or resolution at the last follow-up assessment.ResultsAmong 11 patients with T indotineae (6 male and 5 female patients; median [range] age, 39 [10-65] years), 2 were pregnant; 1 had lymphoma; and the remainder were immunocompetent. Nine patients reported previous travel to Bangladesh. All had widespread lesions with variable scale and inflammation, topical antifungal monotherapy failure, and diagnostic delays (range, 3-42 months). Terbinafine treatment failed in 7 patients at standard doses (250 mg daily) for prolonged duration; these patients also had isolates with amino acid substitutions at positions 393 (L393S) or 397 (F397L) in squalene epoxidase that correlated with elevated terbinafine minimum inhibitory concentrations of 0.5 μg/mL or higher. Patients who were treated with fluconazole and griseofulvin improved in 2 of 4 and 2 of 5 instances, respectively, without correlation between outcomes and antifungal minimum inhibitory concentrations. Furthermore, 5 of 7 patients treated with itraconazole cleared or had improvement at the last follow-up, and 2 of 7 were lost to follow-up or stopped treatment. Based on whole-genome sequencing analysis, US isolates formed a cluster distinct from Indian isolates.Conclusion and RelevanceThe results of this case series suggest that disease severity, diagnostic delays, and lack of response to typically used doses and durations of antifungals for tinea were common in this primarily immunocompetent patient cohort with T indotineae, consistent with published data. Itraconazole was generally effective, and the acquisition of infection was likely in Bangladesh.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"griseofulvin: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on griseofulvin (generic). Clinician-written summaries and actionable practice insights. 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Dissemination occurred in 24/134 patients (lymph node involvement confirmed in 15), with bone (5 cases) and brain abscesses (4 cases) reported; among therapies, improvement was reported with terbinafine in 64.8% (35/54), itraconazole in 46.5% (33/71), posaconazole in 58.8% (10/17), and voriconazole in 38.5% (5/13).","limitations":"Most included reports were case reports or small series, creating publication bias; antifungal susceptibility testing and therapeutic drug monitoring data were sparse, and some treatment data were incompletely reported.","practice_takeaway":"In immunocompromised patients with atypical nodules, ulcers, abscesses, or lymphadenopathy, obtain histopathology and culture to diagnose deep dermatophytosis and treat concomitant superficial tinea to reduce autoinoculation risk. 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Improvement occurred in 2/4 on fluconazole and 2/5 on griseofulvin (no outcome–MIC correlation); 5/7 on itraconazole cleared or improved (2/7 lost to follow‑up or stopped), and U.S. isolates formed a distinct cluster from Indian isolates; 9/11 reported travel to Bangladesh.","limitations":"Small sample (n=11) and single‑city, multi‑center case series limit generalizability. Uncontrolled, retrospective design with heterogeneous treatments and incomplete follow‑up (2 of 7 on itraconazole lost or stopped) constrains outcome interpretation.","practice_takeaway":"Expect terbinafine failure associated with SQLE mutations and elevated MICs in T indotineae; in this series, itraconazole led to clearance or improvement in 5 of 7 treated patients. Take a travel history—most patients reported travel to Bangladesh—and consider susceptibility testing when terbinafine fails."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"generic","value":"griseofulvin"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Generics","href":"/hub/tag/generic"},{"name":"griseofulvin"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"generic","hub_tag_value":"griseofulvin"}}}]]

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