Antifungal Resistance on the Rise.

Terbinafine is a major antifungal compound for the treatment of dermatophyte onychomycosis. Drug resistance resulting from mutations in the enzyme targeted by terbinafine is spreading worldwide. In this issue of the Journal of Investigative Dermatology, Gupta et al. propose a multiplex PCR assay for the direct search of resistance-conferring mutations in dermatophytes in infected nails. The overall mutation rate revealed by Gupta et al. is surprising and disturbingly high (3.7%).