Increasing Incidence of Dermatophytic Infection among Patients

Dermatophytes can digest keratin and other proteinaceous substrates present in skin and its appendages such as nail, hair, and feather and use it as its sole source of carbon and nitrogen. Despite the availability of effective antifungal agents, dermatophytic infections continue to be one of the principal dermatological diseases throughout the world, especially in tropical countries. A cross- sectional descriptive study in the K R Hospital, Mysore, India, which is one of the main tertiary care centre in central part of Mysore so all referred patients samples were collected and prossed from November 2010 to September 2012. This study was done to study the clinical variants, species of fungus causing dermatophyte infection and epidemiological factors responsible for the disease in Central Mysore. The prospective observational analysis of clinically suspected 920 positive cases out of 1418 dermatophytic infection attended at the Dermatology department of K R Hospital, Mysore, India, was selected for our study. All the cases were evaluated by us and patients data were recorded as per pre-designed proforma. Skin scraping, hair and nail samples were collected and processed according to standard protocol. Maximum numbers of cases with dermatophytosis were observed between June to September and almost half of the cases were farmer by occupation. Dermatophytosis was common in male (55.7 %) as compared to female (44.3 %) and the youngest patient was 27 days old and oldest was 77 years old. Majority of the cases in this study were between 26-30 years of age 243 (26.4 %). Most common clinical type observed in this study was tinea corporis 289 (31.4 %) followed by t. capitis 187 (20.3 %), t. cruris 130 (14.1 %), t. pedis 99 (10.7 %), t. manum 51 (5.5 %), t. faciae 32 (3.4 %) and t. barbae 21 (2.2 %). Cases with tinea capitis were less than 10 years of age and male preponderance was observed. Direct microscopic examination (KOH) of the samples revelled overall 72.1 % (1023 out of 1418) positive for KOH, while (64.8 %) cases were culture positive. High positivity was found in cases of tinea corporis 289 (31.4 %) followed by t. capitis 187 (20.3 %) by direct microscopy. The predominant species of dermatophyte isolated was T. rubrum 223 (24.3 %) followed by T. tonsurans 206 (22.3 %), T. verrucosum 159 (17.2 %), T. mentagrophytes 147 (15.9 %), T. violaceum 128 (13.9 %), E. floccosum 40 (4.3 %) and T. schoenleinii 11 (1.1 %). The study highlighted tinea corporis as the most common clinical pattern of dermatophytosis followed by tinea capitis in Central Mysore. The predominant causative fungal species isolated was Trichophyton rubrum followed by T. tonsurans and T. verrucosum. Clinical evaluation and fungal species identification is mandatory for proper management of dermatophytosis rather than empirical treatment