# New and Investigational Treatment Options for Dermatomycosis in the Era of Antifungal Resistance

## TL;DR

This paper reviews new and investigational treatments for fungal skin infections, focusing on novel drugs, repurposed medications, and emerging technologies like nanotechnology.

## Contribution

A scoping review of recent (past 10 years) novel antifungal treatments and platforms for dermatomycoses.

## Key findings

- Olorofim and ME1111 are new drug classes targeting intracellular metabolism.
- New azole agents like oteseconazole and fosravuconazole offer improved pharmacokinetics and broader antifungal activity.
- Nanotechnology and antimicrobial peptides are promising for enhancing antifungal therapy and vaccine development.

## Abstract

Superficial mycoses (dermatomycoses) are a growing healthcare concern due to antifungal resistance, particularly among aging and immunocompromised populations. Multiple efforts are underway to develop novel antifungals, including discovering new compounds with known or new mechanisms of action, extending indications or repurposing existing medications, and utilizing vaccination and nanotechnology platforms. Herein, we conducted a scoping review of novel antifungals for the treatment of dermatomycoses. An electronic literature search restricted to the past 10 years was performed in January 2026 using PubMed and Embase (Ovid). Olorofim and ME1111 represent novel drug classes that target intracellular metabolism. New agents belonging to the azole class demonstrate reduced drug–drug interactions (oteseconazole), a broader antifungal spectrum (voriconazole), and reduced pharmacokinetic complexity (fosravuconazole, super-bioavailable itraconazole). Other investigational compounds include allicin, a phytocompound, and miltefosine, a repurposed antileishmanial drug. Based on our current understanding of dermatophyte immunity, antimicrobial peptides and vaccines targeting virulence factors (e.g., subtilisins) represent novel strategies. Nanotechnology platforms also show promise in introducing new antifungal agents (e.g., metal nanoparticles, nitric oxide-releasing nanoparticles), as well as developing topical formulations to enhance the bioavailability and safety profiles of existing antifungals (amphotericin B, ketoconazole, voriconazole).