Clinicomycological study of dermatophytosis in adults at rural tertiary care hospital: A cross- sectional study

• Author Details:   
• Namratha Govindaraju ^*
• Mukunda Ranga Swaroop
• Yogesh Devaraj
• Richin Anna Johnson
• Shubhashree Panigrahi
• Shubhashree Panigrahi
• Greeshma Jagadish
• J Harshini
• Balijepalli Sai Vamsi

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Background: Dermatophytosis is a common fungal infection affecting skin, hair, and nails, is a significant public health concern in India, with a rising trend of recurrent, recalcitrant, and chronic cases. Despite its high prevalence, dermatophytosis remains a neglected disease, with limited understanding of its epidemiology, clinical profile, and pathogenetic behavior. The lack of evidence-based approaches to diagnosis and management has contributed to the emergence of dermatophytosis as a major public health concern, necessitating early prioritization among dermatologists.
Objectives: The present study was conducted to isolate, speciate, and analyze the clinicoepidemiological patterns of dermatophytosis in newly diagnosed, recurrent, and steroid-modified cases in adults.
Materials and Methods: It was a cross-sectional descriptive study among 100 clinically diagnosed dermatophytosis cases conducted on an out-patient basis over a period of 18 months in a rural tertiary care hospital in Karnataka, India. We collected detailed information on epidemiology, clinical parameters, treatment history, and other host factors. Potassium hydroxide (KOH) mount and fungal culture were done from samples of skin scrapings and were analyzed.
Results: Females slightly outnumbered males with a male-to-female ratio of 0.96:1. The mean age was 39.02 ± 12.71 years, with young to middle-aged adults primarily affected. Most patients were from a lower socioeconomic background. Recurrent cases were most common (41%), followed by steroid-modified (33%) and newly diagnosed cases (26%). Tinea corporis (33%) and Tinea corporis et cruris (33%) were the predominant diagnoses. KOH mount and culture positivity rates were 64% and 69%, respectively. Trichophyton mentagrophytes was the most common causative organism overall, particularly in newly-diagnosed and steroid-modified cases, while Trichophyton rubrum was most common in recurrent cases.
Conclusion: For optimal treatment outcomes and prevention of antifungal resistance, an evidence-based approach for fungal species identification is necessary. Positive family history, fomite transmission, and misuse of topical corticosteroids can contribute to recurrent and steroid-modified infections.

Keywords: Dermatophytosis, Recurrent dermatophytosis, Steroid modified Tinea, Trichophyton, Tinea.