Tinea Corporis and SGLT2 Inhibitors
Tinea corporis is NOT a common side effect of SGLT2 inhibitors; genital mycotic infections (primarily candida vaginitis and balanitis) are the predominant fungal infections associated with this drug class, not dermatophyte infections of the body trunk.
Primary Fungal Infection Risk with SGLT2 Inhibitors
The most common fungal infections with SGLT2 inhibitors are genital mycotic infections, not tinea corporis 1, 2:
- Genital candida infections occur in approximately 6% of users versus 1% on placebo, typically presenting as candida vaginitis in women and balanitis in men 2
- These infections affect females at 10-14% and males at 3-9% across clinical trials 3
- The mechanism relates to increased urinary glucose excretion creating a favorable environment for candida growth in the genitourinary area, not systemic dermatophyte infections 4
Clinical Characteristics of SGLT2 Inhibitor-Associated Fungal Infections
Location specificity is critical to understand 1:
- Infections are localized to the genitourinary tract, not the trunk or extremities where tinea corporis typically occurs
- The American College of Cardiology specifically identifies these as "genital mycotic infections (mostly candida vaginitis in women, balanitis in men)" 1
- These are generally mild to moderate in intensity, none were serious in pooled analyses, and few led to discontinuation 3
Management of Fungal Infections
When fungal infections do occur with SGLT2 inhibitors 1, 2:
- They resolve with a brief course of antifungal agents and rarely recur 1, 2
- Most events are treated with standard antifungal therapies, with median symptom duration following treatment initiation being brief 3
- The majority of events occur within the first 4 months in females and first year in males 3
Risk Factors for Fungal Infections
Specific patient characteristics increase risk 5, 6:
- Female sex (adjusted OR 4.22,95% CI 2.48-7.19) 5
- Prior history of genital fungal infection (adjusted OR 2.41,95% CI 1.04-5.57) 5
- Diabetic patients have higher odds of genital infections compared to non-diabetic patients taking SGLT2 inhibitors 6
- Non-diabetic patients still have increased risk (OR 3.01,95% CI 1.93-4.68) but to a lesser extent than diabetics 6
Important Clinical Distinction
Tinea corporis (dermatophyte infection of the trunk) is not mentioned in any major guidelines or cardiovascular outcomes trials as an adverse effect of SGLT2 inhibitors 1. The fungal infection profile is distinctly limited to candida species affecting the genitourinary tract, not dermatophytes affecting body surfaces.