A report from the Centers for Disease Control and Prevention (CDC) has revealed the presence of a drug-resistant strain of ringworm in New York City. Ringworm, also known as tinea, is a common and highly contagious superficial infection of the skin, hair, or nails caused by dermatophyte molds. It manifests as an itchy, red rash that can appear on various parts of the body. This particular treatment-resistant strain has emerged from South Asia.
In 2021 and 2022, two women in New York City experienced symptoms associated with this drug-resistant strain. CDC officials reported that these patients, aged 28 and 47, presented lesions on their neck, abdomen, buttocks, and thighs. These women did not respond to conventional treatments, indicating the arrival of a drug-resistant fungus strain that has not been previously recorded in the United States.
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The first woman developed a widespread and itchy rash during the summer of 2021. She sought dermatological evaluation in December 2021, during her third trimester of pregnancy. With no underlying medical conditions, no known exposure to individuals with similar rashes, and no recent international travel history, she was diagnosed with tinea. She began oral terbinafine therapy in January 2022, following the birth of her baby. However, her condition did not improve after two weeks, leading to a switch to itraconazole treatment. The rash completely resolved after completing a four-week course of itraconazole, although she continues to be monitored for potential recurrence.
The second patient, a 47-year-old woman, travelled to Bangladesh in the summer of 2022 and returned with a broad, itchy rash. Topical lotions containing steroids and antifungal agents were used to treat her. Upon returning to the United States, she visited an emergency department multiple times during the autumn of 2022. Various treatments, including a four-week course of oral terbinafine, showed no significant improvement.
In December 2022, dermatologists observed extensive, scaly, annular, and itchy plaques on her thighs and buttocks. Subsequently, Griseofulvin therapy resulted in 80% improvement. Itraconazole therapy is being considered pending further evaluation due to the recent confirmation of suspected T. indotineae infection.
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While ringworm cases were initially reported in South Asia, they have since been identified in European countries. The CDC is advising medical professionals to instruct patients on how to stop the spread of ringworm, a fungal condition caused by skin-to-skin contact. While antifungal creams are typically used to treat cases, oral antifungal medication may be necessary in some instances.
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