Epidemiological, clinical and mycological study of dermatomycosis in diabetic patients

Dermatomycosis are fungal infections of the skin and/or phanera, which are often benign but can have an impact on the vital and functional prognosis in diabetic patients.

The aim of our work was to study the epidemiological, clinical and mycological profile of dermatomycosis in diabetic patients.

This was a retrospective descriptive study carried out in the Parasitology-Mycology Laboratory of Charles-Nicolle Hospital over a three-year period (2016-2018). We collected diabetic patients who were referred for suspected dermatomycosis.

Dermatomycosis was confirmed in 799 of the 1007 diabetic patients referred to our laboratory (79.34%) and in 1055 lesions among the 1344 sites sampled (78.50%). Among patients with dermatomycosis, a female predominance was observed with a sex- ratio=0.83. The mean age of the patients was 57.11 [2-82]. The patients with type 2 diabetes were the most affected (86.35%) (p=0.038). The mean duration of lesion progression was 5.0±5.5 years. The most common dermatomycoses were toenail onychomycoses (59.62%), followed by fingernail onychomycoses (15.26%), plantar keratoderma (10.24%), and intertrigo in small skin folds (5.59%). Dermatophytes were the most frequently isolated fungi (80.1%; p<0.001), with predominance of Trichophyton rubrum (78.8%). Candida albicans was the most frequently isolated yeast (11.8%).

Dermatomycosis are common in diabetic patients. Although they are often benign, these fungal infections can engage the functional prognosis or even become life-threatening in case of diabetes. Mycological diagnosis is necessary in case of clinical suspicion in order to confirm the diagnosis, guide the treatment and avoid complications.