Antifungal Resistance in Dermatophytes: An Emerging Threat to Global Public Health

Purpose of ReviewThis review provides an update search on the status of antifungal resistance in dermatophytosis, emphasizing the geographic distribution of these fungi worldwide, as well as the species primarily associated with this resistance phenomenon and the molecular mechanisms involved.Recent FindingsAntifungal resistance observed in dermatophytes has become a growing public health concern in several countries worldwide. Since the emergence of the first terbinafine-resistant dermatophyte strain in 2003, fungal resistance has diversified both in terms of species involved and the antifungal drugs affected. It is hypothesized that various social factors, including migration, climate change, and prolonged exposure to antifungal agents, contribute to the development of this issue. Dermatophytes of the Trichophyton genus, particularly the recently described Trichophyton indotineae, are primarily associated with this phenomenon, with T. indotineae being linked to the largest known epidemic of superficial mycoses in recent years.SummaryThis review aims to provide a critical analysis of developments in the field, examining other species exhibiting antifungal resistance, countries where this is a public health problem, and current therapeutic options-both effective and ineffective. Additionally, the review explores the molecular mechanisms employed by these fungi that enable their tolerance to treatment.