{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:55Z","timestamp":1787014375966,"version":"build-2736575974"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Recalcitrant dermatophyte infections are being reported from various parts of the world due to varied causes including strain variation, steroid misuse,\n                      <jats:italic>SQLE<\/jats:italic>\n                      mutations, and variable quality of itraconazole pellet formulations. The oral drug preferred in endemic areas is itraconazole, to which MIC levels remain low, and clinical failures to itraconazole reported defy a sound scientific explanation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objective of the study was to conduct a proteomic and genomic analysis on isolates from therapeutically recalcitrant case with isolation of gene mutations and enzymatic abnormalities to explain azole failures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Trichophyton mentagrophyte interdigitale complex<\/jats:italic>\n                      strains were isolated from seven clinically non\u2010responding tinea corporis\/cruris patients, who had failed a sequential course of 6\u2009weeks of terbinafine 250\u2009mg QD and itraconazole 100\u2009mg BID. After AFST 1 strain, KA01 with high MIC to most drugs was characterized using whole genome sequencing, comparative proteomic profiling, and total sterol quantification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sterol quantification showed that the standard strain of\n                      <jats:italic>Trichophyton mentagrophytes<\/jats:italic>\n                      (MTCC\u20107687) had half the ergosterol content than the resistant KA01 strain. Genomic analysis revealed mutations in\n                      <jats:italic>SQLE<\/jats:italic>\n                      ,\n                      <jats:italic>ERG4<\/jats:italic>\n                      ,\n                      <jats:italic>ERG11<\/jats:italic>\n                      ,\n                      <jats:italic>MDR1<\/jats:italic>\n                      ,\n                      <jats:italic>MFS<\/jats:italic>\n                      genes, and a novel\n                      <jats:italic>ERG3<\/jats:italic>\n                      mutation. Proteomic analysis established the aberrant expression of acetyl Co\u2010A transferase in the resistant strain and upregulation of thioredoxin reductase and peroxiredoxin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Our findings demonstrate possible reasons for multidrug resistance in the prevalent strain with mutations in genes that predict terbinafine (SQLE) and azole actions (\n                      <jats:italic>ERG4<\/jats:italic>\n                      ,\n                      <jats:italic>ERG11<\/jats:italic>\n                      ,\n                      <jats:italic>ERG3<\/jats:italic>\n                      ) apart from efflux pumps (\n                      <jats:italic>MDR1<\/jats:italic>\n                      ,\n                      <jats:italic>MFS<\/jats:italic>\n                      ) that can explain multidrug clinical failures.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijd.16622","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T07:11:29Z","timestamp":1679037089000},"page":"637-648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Treatment recalcitrant cases of tinea corporis\/cruris caused\u00a0by\n                    <i>T. mentagrophytes \u2013 interdigitale complex<\/i>\n                    with mutations in ERG11 ERG 3, ERG4, MDR1 MFS genes &amp; SQLE and their potential implications"],"prefix":"10.1111","volume":"62","author":[{"given":"Anamika","family":"Bhattacharyya","sequence":"first","affiliation":[{"name":"Vyome Therapeutics Limited  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh","family":"Sadhasivam","sequence":"additional","affiliation":[{"name":"Vyome Therapeutics Limited  New 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