Clinico-Mycological Study of dermatophytosis in a Tertiary Care Hospital

ABSTRACT

Dermatophytes are fungi that infects the skin, hair and nails. They are hyaline septate moulds with more than hundred species described. Of these, 42 species are considered as valid and less than half are associated with human diseases. Dermatophytoses are infections produced by these and are common in tropical and subtropical areas of the country with high humidity.1 We wanted to speciate dermatophytes using phenotypic methods, analyze the risk factors, and study their clinical correlation.METHODSThe study was conducted in a tertiary care hospital in South India over a period of one year. All newly suspected cases of dermatophytosis attending Dermatology Outpatient Department were selected for the study. Thus, a total of 113 patients were enrolled in the study. Samples from these patients were subjected to direct microscopy and culture was done on Sabouraud Dextrose Agar with antibiotics. Potato dextrose agar was used for enhancement of pigment production. Culture confirmation and speciation were done by tease mount, slide culture and supplemental tests like urease test and hair perforation test. RESULTSThe present study was carried out on 113 clinically diagnosed cases of dermatophytoses. Maximum number of cases occurred in the 11-20 years age group and slight female preponderance was noted. Tinea corporis was the most common type of dermatophytosis, 68 cases (60.2%) followed by mixed type (tinea corporis + tinea cruris) 14 cases (12.4%) and tinea cruris 13 cases (11.5%). Overall positivity by culture was 39% and by direct microscopy 96%. Trichophyton rubrum was the most predominant species - 18 isolates (38.3%) and most of them were isolated from tinea corporis. Trichophyton verrucosum (25.5%) and Trichophyton mentagrophyte (21.3%) were also obtained as major isolates.CONCLUSIONSThis study highlighted that tinea corporis is the commonest clinical type. Trichophyton rubrum is the most predominant species. But we got a fairly good number of Trichophyton verrucosum and Trichophyton mentagrophyte also. Exposure to predisposing factors were present in almost half of the cases. Dermatophytosis is a trivial disease and antifungal agents are the drugs of choice for treatment but identification of predisposing factors and avoidance of these can decrease the incidence of the disease to some extent