# Dermatophytosis in a Healthy Adolescent: A Report of Terbinafine-Resistant Trichophyton indotineae Infection in Kuwait

## TL;DR

A 19-year-old man in Kuwait had a fungal skin infection caused by a terbinafine-resistant Trichophyton strain, which was successfully treated with alternative antifungal creams.

## Contribution

Reports a terbinafine-resistant Trichophyton indotineae infection and effective alternative treatment in a healthy adolescent.

## Key findings

- Trichophyton indotineae was identified as the causative agent of the infection.
- The infection was resistant to terbinafine but responded well to clotrimazole and luliconazole.
- The case emphasizes the need for antifungal susceptibility testing in treatment-resistant infections.

## Abstract

Dermatophytosis caused by Trichophyton species is a common fungal infection of the skin, hair, and nails. However, the emergence of antifungal-resistant Trichophyton strains has become an increasing challenge, leading to persistent and recurrent infections that are recalcitrant to treatment.

We present the case of a 19-year-old Yemeni male patient with a dermatophyte infection caused by a terbinafine-resistant Trichophyton species. The patient experienced symptoms for two weeks despite standard antifungal treatment. Fungal culture results showed the growth of Trichophyton indotineae. The patient was subsequently treated with topical clotrimazole 1% twice daily and luliconazole 1% cream at night, which led to the significant clinical improvement and complete resolution of the rash within two weeks.

This case highlights the growing concern of antifungal resistance in dermatophyte infections, particularly against terbinafine, one of the most commonly prescribed treatments. The increasing prevalence of resistant Trichophyton strains underscores the need for antifungal susceptibility testing in refractory cases and the consideration of alternative treatment strategies.