Emerging antifungal treatment failure of dermatophytosis in Europe: take care or it may become endemic

Background: Dermatophytosis is a world-wide distributed common infection. Antifungal drug resistance in dermatophytosis used to be rare, but unfortunately the current Indian epidemic of atypical widespread recalcitrant and terbinafine-resistant dermatophytosis is spreading and has sporadically been reported in Europe. Objectives: To explore the occurrence of clinical and mycological proven antifungal drug resistance in dermatophytes in Europe. Methods: A standardized questionnaire was distributed through the EADV Task Force of Mycology network to dermatologists in Europe. Results: Representatives from 20 countries completed the questionnaires of which 17 (85 %) had observed clinical and/or mycological confirmed antifungal resistance, two countries published cases of antifungal resistance and one country had no known cases. Conclusions: This pilot study confirms that both clinical and mycological antifungal resistance exist in Europe.