Infantile tinea faciei caused by Trichophyton indotineae successfully treated with topical ketoconazole: A case report.

BACKGROUND

Dermatophyte infections are increasing worldwide, with shifts in the distribution of causative species. Trichophyton indotineae has gained attention due to its antifungal resistance. Infections caused by Trichophyton indotineae in infants are rarely reported.

CASE PRESENTATION: We report a case of tinea faciei caused by Trichophyton indotineae in a 5-month-old Vietnamese infant, likely infected via maternal transmission. Fungal species identification was confirmed by ITS1-5.8S-ITS2 sequencing. Antifungal susceptibility testing revealed susceptibility to terbinafine (MIC = 0.0313 µg/mL). Sequence analysis of antifungal target genes showed wild-type SQLE and CYP51A, and a novel CYP51B substitution (Tyr444His). The child's lesions resolved after 4 weeks of treatment with 2% ketoconazole cream, with no recurrence at 3 months.

CONCLUSION

This case highlights Trichophyton indotineae as an emerging dermatophyte capable of infecting infants. Further studies on antifungal management in pediatric patients are warranted.