SynthesisJournal of the European Academy of Dermatology and Venereology : JEADV2026
Deep and disseminated dermatophytosis in immunocompromised populations-A systematic review.
Synthesis in Journal of the European Academy of Dermatology and Venereology : JEADV, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Antifungal Susceptibility Patterns in Respiratory Tract Candidiasis and Risk Factors Among HIV-Infected Adults in South West Cameroon.Antibiotics (Basel, Switzerland) · 2026Article
- The natural history and evolution of dermatophytosis: Host immunity in acute and chronic infection.PLoS pathogens · 2026Article
- New and Investigational Treatment Options for Dermatomycosis in the Era of Antifungal Resistance.Journal of fungi (Basel, Switzerland) · 2026Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDermatophytes-a group of obligate keratinophilic fungi that infect the skin, hair and nails-represent the most common cause of fungal infections worldwide. In immunocompromised individuals, a growing body of literature has documented rare instances of dermatophyte infections of the dermis and subcutaneous tissue, which can lead to deep dermatophytosis with systemic dissemination and pseudomycetoma as secondary complications.
objectivesTo assess patient characteristics, risk factors, diagnostic evidence and treatment options for deep dermatophytosis.
methodsA systematic review was conducted in June 2025 to identify patients presenting with deep dermatophytosis of the glabrous skin; all cases were validated by confirmatory testing per histopathologic examination and fungal culture. Majocchi's granuloma diagnoses were excluded.
resultsThe search yielded 96 studies (1954-2025) documenting 134 patients. The number of reports has notably increased since the 21st century; however, diagnosis remains challenging due to possible dermatophyte adaptation in the dermal/subcutaneous environment. Trichophyton rubrum is the most frequently isolated pathogen. Acquired immunodeficiencies (e.g. renal transplant recipients) and primary immunodeficiencies (e.g. CARD9, STAT3 mutations) elevate the risk of deep dermatophytosis. Systemic dissemination, often accompanied by lymphadenopathy, was reported in 24 patients, with the most common being infection of the axillary and inguinal lymph nodes. Infections of the bones, lungs, and brain were also reported. Terbinafine (125-1000 mg/day) and itraconazole (100-400 mg/day), with adjunctive topical antifungals and surgical interventions, have been tried for deep dermatophytosis. The use of newer triazoles (voriconazole, posaconazole) should follow the principles of antifungal stewardship and therapeutic drug monitoring recommendations. Multidrug resistance is a potential concern in immunocompromised patients who will often require extended or lifelong treatment.
conclusionsHealthcare providers should be cognizant that dermatophytosis may become invasive and disseminated in immunocompromised populations. Testing and early treatment should not be overlooked in these patients.
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