Clinical and Mycological Profile of Dermatophytosis

Clinical and Mycological Profile of DermatophytosisA CLINICAL AND MYCOLOGICAL compose OF DERMATOPHYTOSIS IN KLES DR PRABHAKAR KORE HOSPITAL AND MEDICAL RESEARCH CENTRE, BELGAUMDolly M.B.B.S. subdivision of Dermatology, J.N. Medical College, Belgaum, IndiaB. S. Manjunathswamy M.D .Department of Dermatology, J.N. Medical College, Belgaum, IndiaS.G.Karadesai M.D. Department of Microbiology, J.N. Medical College, Belgaum, IndiaABSTRACTAim To plain the clinical and mycological indite of dermatophytosis in tertiary care hospital. orbit and objectives Dermatophytosis, a group of taxonomically closely related keratinophilic fungus kingdom called dermatophytes varies with geographic area as well as climatic conditions and there is vide stochastic variable in the spectrum of dermatophytic isolates. This get a line was aimed to understand the clinical and mycological pen of dermatophytosis.Methodology The array one course cross sectional study from January 2013 to December 2013 was make in the Department of Dermatology, Venereology and Leprosy, KLES Dr. Prabhakar Kore Hospital and Medical look Centre, Belgaum A be of one hundred twenty-five patients presenting with dermatophyte skin infection were subjected to clinical examination and KOH examination for fungi and stopping point.Results The commonest clinical forms noned were nematode worm corporis (52%) and nematode worm cruris (43.2%). Most of the patients were males (67.2%) (male to female symmetry 21) and nematode worm corporis was the commonest clinical diagnosis (48.81%). The commonest climb on group was 21 to 30 old age (36%) and had nematode corporis (56%) commonly. 36.8% of the patients had duration of 35 weeks. The commonest morphological stock was remark as annular (37.6%). The KOH examination was confident(p) in 78.4% cases and acculturation was positive for fungus in 64.8% of the cases. In patients with positive culture, T. mentagrophyte was the commonest isolate (48.15%). The co mmonest dermatophyte isolated was genus Trichophyton (88.64%).Conclusion There is grand variation in the clinical and mycological profile of dermatophytosis. The detection of emerging organisms may be help in the word and adequacy of current pharmacologic regimens.Key wordsDermatophytosis Mycological profile Skin infection Tinea corporis Tinea crurisIntroductionDermatophytosis is characterized by the infection of keratinized tissues such as the epidermis, hair and nails. Distribution of dermatophytes varies with geographical area. Further, there is wide variation in the spectrum of dermatophytic isolates. To understand the burden and trend of dermatophytosis, surveillance of the illness plays an important role. Considering the above facts the present study was designed to acknowledge the clinical and mycological profile of dermatophytosis so as to elaborate the epidemiological data in the region which will help in taking into custody the disease pattern and burden which may n ot only maintenance in taking adequate measures to prevent the transmission but likewise help in preventing spread of infection thereby reducing the disease burden.Materials and methodThis one year cross sectional study of 125 patients presenting with dermatophytes skin infection was conducted in the Department of Dermatology, Venereology and Leprosy, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from January 2013 to December 2013. Patient who are on antifungal treatment and cases who did not provide informed consent were excluded from the study. A detailed history was interpreted regarding duration and progress of lesion in past age, sex, and occupation. A complete dermatologic examination for type of the lesion, morphology and distribution was done along with command physical examination. Clinical material was collected for KOH examination and culture employ standard mycological techniques. SDA (Sabourauds Dextrose Agar) with cycloheximide and chloramp henicol were used for culture. The media were incubated at 250C and 370C for a lower limit period of one-third weeks. Positive cultures were examined both macroscopically and microscopically for species identification.Results ground on the clinical examination findings the commonest clinical forms noted were Tinea corporis, Tinea cruris, Tinea pedis, Tinea unguim, Tinea capitis, Tinea faciei, Tinea mannum and Tinea barbae. multiplex clinical forms were present in almost one fifth of the study population and the commonest clinical form was noted as Tinea cruris with Tinea corporis. Most of the patients were males (67.2%) with male to female ratio of 21 and 48.81% of the males had clinical type of Tinea corporis. The commonest age group was 21 to 30 geezerhood (36%) and had Tinea corporis (56%) commonly. Most of the patients (36.8%) inform duration of 35 weeks. Maximum cases were noted in the month of August (16%). The commonest morphological variant was noted as annular (37.6% ). The KOH examination for fungus was positive in 78.4% of the cases and culture was positive for fungus in 64.8% of the cases. Among the patients with positive culture, T. mentagrophyte was the commonest isolate noted in 48.15% of the patients. The commonest dermatophyte isolated was noted as Trichophyton (88.64%).DiscussionIn our study various clinical forms dermatophytic infections were noted. The commonest clinical form was Tinea corporis (52%) followed by Tinea cruris (43.2%), Tinea pedis (9.60%), Tinea unguim (7.2%), Tinea capitis (2.40%), Tinea faciei and Tinea mannum (1.60% each), and Tinea barbae (0.8%). A recent study from Mysore Karnataka by Surendran KAK et al1 also observed Tinea corporis (44.3%) as the most common clinical pattern.In our study multiple sites were involved among 23 cases. Of these, Tinea cruris and Tinea corporis were present in 17 (73.91%) and Tinea corporis and Tinea pedis in three (13.04%) cases. In the present study males were commonly affected that is, almost 2 third of the patients (67.2%) were males with male to female ratio of 21. Tinea corporis was the commonest clinical type of dermatophytosis among males (48.81%) while in females it accounted among 58.54% of the patients. Sen SS et al2 and Jain N et al3 inform 48% and 37% of the male with Tinea corporis while Bindu V et al4 reported 54.6% of males.In this study, maximum patients belonged to age between 21 to 30 years (36%) and the next common age group was 31 to 40 year (19.2%). This was in accordance with a recent study from Mysore by Surendran KAK et al,1 Karnataka where maximum number of cases encountered in the age group of 16-30 years (44%) followed by the age group of 31-45 years (26%). Other studies by Sen SS et al2 from Guwahati in 2006 and Sahai S et al5 from Lucknow in 2011 also reported commonest age group as 21 to 30 years (44% and 32.4% respectively). Among them 45 patients with age between 21 to 30 years, 25 (56%) had Tinea corporis and 8 (18%) had Tin ea cruris. Similar findings were noted by Bindu V et al,4 Singh S et al,2 Sen SS et al2 and Jain N et al.3 In this study maximum cases were noted between June to September (37.6%) with peak in the month of August (16%) which is resembling to the findings of Kalla G et al57 and Sumana V et al.6In this study the commonest morphological variant was noted as Annular (37.6%). The present study KOH examination for fungus and culture was positive in 78.4% and 64.8% of the cases respectively. Of the 98 cases with positive KOH examination for fungus, 81 (82.65%) cases had positive culture. A study by Belukar et al.7 showed culture positivity of 71%, which was much high and close to the present study. In this study, T. mentagrophyte was the commonest isolate noted in 48.15% of the patients followed by T. Rubrum (43.21%). In a study recent study from Mysore by Surendran KAK et al,1 T. rubrum was the brain organism isolated with a percentage of 67.5% while T. mentagrophytes (20%) isolates we re found game in frequency. T. mentagrophytes are relatively more prevalent in sulfur India.1ConclusionThe KOH examination for fungus was positive in 78.4% of the cases and culture was positive for fungus in 64.8% and in patients with positive culture, T. mentagrophyte was the commonest isolate followed by T. rubrum (43.21%). Overall there is wide variation in the clinical and mycological profile of dermatophytosis. Further KOH examination for fungus and culture play an important role in the diagnosis of dermatophytosis.References1.Surendran K, Bhat RM, Boloor R, Nandakishore B, Sukumar D. A clinical and mycological study of dermatophytic infections. Indian J Dermatol 201459262-72.Sen SS, Rasul ES. Dermatophytosis in Assam. Indian J Med Microbiol 20062477-8.3.Jain N, Sharma M, Saxena VN. Clinico-mycological profile of dermatophytosis in Jaipur, Rajasthan. Indian J Dermatol Venereol Leprol 200874(3)274-5.4.Bindu V, Pavithran K. Clinico-mycological study of dermatophytosis in Calicu t. Indian J Dermatol Venereol Leprol 200268(5)259-61.5.Sahai S, Mishra D. Change in spectrum of dermatophytes isolated from superficial mycoses cases First report from central India. Indian J Dermatol Venereol Leprol 2011 77(3) 335-6.6.Sumana V, Singaracharya MA. Dermatophytosis in Khammam (Khammam district, Andhra Pradesh, India). Indian J Pathol Microbiol 200447(2)287-9.7.sBelukar DD, Barmi RN, Karthikeyan S, Vadhavkar RS. A Mycological study dermatophytosis in Thane. Bombay Hosp J 2004462.