Clinical, Epidemiological, and Mycological Characteristics of Dermatophyte Infections: A Cross-Sectional Study From a...

Dermatophyte infection is a prevalent infection of the skin, hair, and nails caused by a fungus of multiple genera. The distribution and frequency of dermatophytosis vary with the geographical region and various epidemiological factors.

This study aimed to describe the clinical-epidemiological and mycological profile of dermatophytosis and observed the response of systemic antifungals in cases of tinea corporis and tinea cruris.

A descriptive cross-sectional study was carried out among 338 patients of clinically diagnosed cases of dermatophyte infection presented to the dermatology outpatient department in a tertiary care hospital between January 2014 and March 2015, considering inclusion and exclusion criteria. Sample collection for fungal elements was done from skin scraping, nail clippings, and hair plucks.

Out of 338 patients included in the study, 212 (62.7%) were males, and 126 (37.3%) were females. The mean age of patients was 30.7 ± 14.5 years. The maximum number of patients (51.8%) was in the age group of 21-40 years. Maximum patients were laborers by occupation (28.7%) and belonged to the lower middle class (53.9%). The majority of 103 (30.47%) patients reported in July. The most common symptom was itching, noted in all 338 (100%) patients, followed by scaling in 294 (87%) of patients. Annular erythematous plaque with scaling (261 (76%)) was the most common clinical finding. Two hundred eighty-two (83.43%) patients reported sharing fomites, while 239 (70.71%) patients had contact with infected family members. Forty-two percent of patients were wearing tight-fitting clothes daily. Two hundred sixty-eight (79.29%) patients had a history of use of different topical medications in the past, and 64 (18.8%) patients reported a history of systemic antifungals taken in the past six months. Comorbid conditions were seen in 80 (23.67%) patients. One hundred twelve (33.13%) were overweight, 54 (15.9%) were obese, and 39 (11.53%) patients were underweight. Tinea corporis was the most common clinical pattern seen in 100 patients (29.5%), followed by tinea cruris in 75 patients (22.3%). Direct microscopy with KOH was positive in 273 (80.76%) patients, whereas culture was positive in 160 (46. 74%) patients. Trichophyton rubrum was the predominant species, isolated in 97 patients (60.6%), followed by Trichophyton mentagrophyte in 58 patients (36.32%). Among the four antifungal drugs, persistence of disease was maximum with the fluconazole group, and mycological cure was seen predominantly in the itraconazole-treated group.

Young male patients of the lower-middle-class family having a positive family history of dermatophytosis were more prone to dermatophytic infections. Overall, these findings highlight the multifactorial epidemiology of dermatophytosis, reaffirm T. rubrum as the predominant pathogen, and support itraconazole as the most effective systemic therapy in achieving sustained mycological cure.