In November 2022, the WHO renamed monkeypox to Mpox to reduce stigma. Now, dermatologists in India and other countries are urging a name change for the fungus Trichophyton indotineae, currently named after India
Published Jan 15, 2025 | 7:00 AM ⚊ Updated Jan 15, 2025 | 7:00 AM
Infection caused by T indotineae. (Uhrlaß, S et al)
Do you remember when the highly severe Mpox was once known by a different name—Monkeypox?
In November 2022, the World Health Organization (WHO) renamed it Mpox, citing that the term “monkeypox” had been associated with negative stereotypes and stigma, particularly targeting certain communities.
Now, dermatologists in India, along with experts in a few other countries, are advocating to change the name of a skin-disease-causing fungus—Trichophyton indotineae— currently named after India.
Trichophyton indotineae is a type of fungus that causes stubborn skin infections, often appearing as red, itchy, and scaly patches. It doesn’t respond well to many common antifungal medicines, making it harder to treat.
Epidemiological studies show that T. indotineae has largely replaced T. rubrum and other similar fungi, accounting for a significant majority of clinical cases. Reports suggest that T. mentagrophytes (including T. indotineae) now cause approximately 76 percent of fungal infections in India.
“It is a form of dermatophytosis, commonly known as a fungal or ringworm infection. This infection often leads to red, itchy, and scaly patches on the skin, particularly on areas like the body, groin, face, and trunk. In severe cases, the infection spreads to multiple areas and keeps coming back,” said Hyderabad based Dermatologist Dr Kaushik Kumar to South First.
He said that resistance to antifungal treatments is a significant challenge in managing T. indotineae infections. Many strains of this fungus have developed mutations, making them resistant to terbinafine, which is a commonly used first-line antifungal medication. Recent research has also identified strains resistant to azole antifungals, further complicating treatment options.
“Standard treatments, particularly topical antifungal medications, are often ineffective against T. indotineae infections. While systemic antifungal therapies like itraconazole have shown some success, they typically require longer treatment durations, often exceeding six weeks, and higher doses compared to treatments for other similar fungal infections,” he said.
Doctors typically perform a clinical examination to look for symptoms like red, itchy, and scaly patches. They may collect skin scrapings, hair, or nail samples for microscopic examination to spot fungal elements. A culture test can be done to grow the fungus and confirm its presence. Molecular testing, such as PCR or DNA sequencing, helps accurately identify the species.
Dermatologists across the country as well as from 13 foreign countries, have now proposed to rename, arguing that it has been reported from more than 40 nations without any confirmation on India being the country of origin.
The name Trichophyton indotineae was introduced in 2020 by a Japanese research group based on two isolates from patients in India and Nepal. This naming convention follows the academic practice of naming new pathogens after the region where they were first identified.
The term “indotineae” specifically references India. The species was initially categorised under the T. mentagrophytes complex, specifically as genotype VIII, before being designated as T. indotineae. This change arose from genetic studies that confirmed its distinct characteristics and clinical significance.
Proposals have been made to revert to a more neutral nomenclature, such as T. mentagrophytes genotype VIII, to avoid stigmatisation and ensure scientific accuracy regarding its origins.
The Dermatologists, in an article published in Indian Journal of Indian Journal of Dermatology, Venereology and Leprology (IJDVL) said that while India and many other nations across the world grapple with the rise in recalcitrant dermatophytic skin infections, another pressing concern that has risen out of this situation is the inappropriate naming of the novel species as Trichophyton (T.) indotineae.
“The region-specific nomenclature prejudicially impacts the perceptions of clinicians and public alike, ignoring the exhortations of World Health Organisation (WHO), American Society of Microbiology and others,” said the article.
They stated that in many cases, such names have been proven to be factually incorrect and often lead to significant misinformation, stigma, and racial prejudice. This not only politicises science, but also unfairly tarnishes entire countries or regions and their populations, especially when the true origin of the species is unclear.
“In a landmark and welcome decision, scientists attending the International Botanical Congress in Madrid in July 2024, proposed renaming more than 200 plants, fungi, and algae species that contain words with negative racial connotations. They also voted to establish a committee to address the ethical considerations of naming newly discovered plants, fungi, and algae,” the authors stated.
Their argument rests on the fact that the origin of this fungus is unknown. It was identified in countries like Australia, Oman, and Iran well before it began causing widespread, treatment-resistant skin infections in the mid-2010s. Today, not only India, but also countries like Bangladesh, Nepal, Sri Lanka, the UAE, Iraq, and Iran are grappling with persistent and severe infections caused by this resistant fungus.
“This species has now been detected in 42 countries, further undermining the accuracy of its current name,” the authors noted.
They highlighted that even the term “Indian genotype” had been used in the past to describe T. mentagrophytes ITS genotype VIII but was later discontinued after concerns were raised about its geopolitical implications and potential for stigmatization, even if unintended.
In recent years, especially as the number of countries reporting cases of T. indotineae (also known as T. mentagrophytes ITS genotype VIII) continues to rise, there has been growing opposition to the use of the term indotineae due to its negative connotations.
Authors also pointed out that when naming a new species with clinical implications, it’s essential to provide a clear explanation of its origin and previously used names to avoid confusion.
“Unfortunately, this was not done when naming T. indotineae, leaving many dermatologists around the world—who are not experts in microbiology—struggling to understand its classification and background,” said the authors.
Previously, the fungus was referred to as T. mentagrophytes ITS genotype VIII, a name that was widely recognised and used. While naming conventions can be complex, it’s suggested that until a better system is in place, terms like T. mentagrophytes genotype VIII or similar neutral alternatives should be used to ensure fairness and clarity.
They also argued that to prevent future issues, there’s a growing call for an international committee to oversee and evaluate contentious names. This would help maintain scientific neutrality, avoid regional bias, and ensure the accurate communication of critical medical information across the globe.
(Edited by Ananya Rao)
