# Case Report: From Misdiagnosis to Accurate Identification: Managing a Case Series of Trichophyton rubrum Infections

## TL;DR

This case report details five instances of misdiagnosed Trichophyton rubrum infections and their successful treatment after accurate identification.

## Contribution

The paper presents a case series of misdiagnosed T. rubrum infections and emphasizes the importance of accurate diagnosis for effective treatment.

## Key findings

- Five cases of diffuse T. rubrum dermatophytosis were initially misdiagnosed.
- Systemic terbinafine and topical azoles effectively treated the infections after accurate diagnosis.
- Misdiagnosis can lead to chronic, widespread, and difficult-to-treat dermatophytosis.

## Abstract

In recent decades, despite being well-known, dermatophytosis has seen a resurgence and an increase in the incidence of infections, with dermatophytes such as Trichophyton rubrum being the most common agents. Dermatophytosis pathogenesis involves complex interactions between the host, agent, and environment. In many cases, dermatophytosis can be mistaken for other pathologies, which leads to incorrect therapies and the consequent non-recovery of the patient. In this paper, we describe five previously undiagnosed cases of diffuse T. rubrum dermatophytosis because they represent the clinical manifestations that affect several sites at the same time and that, if not properly diagnosed and treated, can lead to severe, widespread, chronic, and difficult-to-treat dermatophytosis. This case series of five instances of misdiagnosed T. rubrum dermatophytosis was later accurately diagnosed and successfully treated with systemic terbinafine hydrochloride 250 mg/die for at least four weeks up to twelve or sixteen, and topical azoles (sertaconazole nitrate 2%) as well. This case series highlights the need to make an accurate diagnosis and avoid misidentifications while offering insightful information about the clinical presentation and treatment of these illnesses.