Dermatophytoses or tinea refers to superficial fungal infection of keratinized tissues. Although generally considered easy to treat, recalcitrant infections, presenting as extensive and difficult to treat tinea corporis and cruris, are on the rise in some parts of the world. The situation demands an understanding of the pharmacokinetic and pharmacodynamic properties of the available antifungals against dermatophytes and the possible contribution of drug resistance and other factors to the present scenario. In this review, we provide the readers a comprehensive account of the available literature on in-vitro and in-vivo resistance to clinically used antifungals among dermatophytes. We have also added, in brief, the relevant skin pharmacokinetics of important systemic drugs. The established and postulated mechanisms of drug resistance are discussed and aspects on lack of in vivo correlation of in vitro resistance are presented. Finally, the lacunae in our existing knowledge on the topic and the arenas for future research are highlighted.

中文翻译：

---

皮肤真菌的抗真菌耐药性：最新趋势和治疗意义。

皮肤癣菌或癣是指角化组织的浅表真菌感染。尽管通常被认为易于治疗，但顽固性感染表现为体癣和十字花科动物，广泛存在且难以治疗，但在世界某些地区却在上升。这种情况要求了解可用的针对皮肤真菌的抗真菌药的药代动力学和药效学特性，以及耐药性和其他因素对当前情况的可能贡献。在这篇综述中，我们为读者提供了有关皮肤癣菌对临床使用的抗真菌药物的体外和体内耐药性的现有文献的全面介绍。简要地，我们还添加了重要全身药物的相关皮肤药代动力学。讨论了已建立和假定的耐药性机制，并提出了缺乏体外耐药性的体内相关性方面。最后，重点介绍了我们在该主题的现有知识和未来研究领域中的不足。