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Epidermophyton floccosum, an etiological agent of tinea pedis and tinea unguium: about two cases

Summary

Two elderly patients with toenail and foot fungal infections caused by Epidermophyton floccosum were diagnosed using modern molecular testing methods. Traditional microscopic examination alone was difficult, but real-time PCR provided accurate identification. Both patients were treated with terbinafine, a common antifungal medication. The study highlights how modern DNA testing improves diagnosis compared to older methods.

Background

Dermatophytia is an infection caused by keratinophilic filamentous fungi. Epidermophyton floccosum has experienced a downward trend in recent years as an anthropophilic dermatophyte causing mainly skin infections in humans. The distribution of dermatophytes varies by country and geographic area.

Objective

To report two rare observations of tinea pedis and tinea unguium caused by Epidermophyton floccosum in elderly patients and demonstrate the contribution of molecular biology in accurate species identification.

Results

Case 1: 70-year-old diabetic patient with scaly plantar keratoderma and intertrigo confirmed as E. floccosum by real-time PCR and treated with terbinafine ointment. Case 2: 70-year-old patient with bilateral subungual hyperkeratosis and nail damage identified as E. floccosum, treated with terbinafine 250 mg daily for 6 months.

Conclusion

Real-time PCR provides rapid and accurate identification of dermatophytes with high sensitivity and specificity compared to conventional morphological methods. Molecular biology approaches are valuable for improving diagnostic accuracy, particularly when morphological similarities between species complicate identification. Terbinafine demonstrates effectiveness against E. floccosum infections.
  • Published in:Pan African Medical Journal,
  • Study Type:Case Report,
  • Source: PMID: 40656143, DOI: 10.11604/pamj.2025.50.102.40580
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