Profile of dermatophytosis in a tertiary care center in Kerala, India

Abstract

Background: The incidence of dermatophytosis is increasing over the last few years and there are many cases which are recurrent and chronic. Aim: The aim was to study the host and pathogen factors in dermatophytosis, to identify the species responsible, and to study the histopathological features of chronic dermatophytosis. Materials and Methods: It was a descriptive study conducted in the Department of Dermatology for a period of 1 year and all patients who were clinically diagnosed as dermatophytosis were included. Isolated hair, and nail involvement were excluded from the study. Epidemiological parameters and treatment history were analyzed, scrapings, and fungal culture were done in all patients. Histopathological examination was done in patients with chronic dermatophytosis who had applied topical steroids. Results: Chronic dermatophytosis was seen in 68%; tinea corporis was the most common presentation; topical steroid application was seen in 63%; azoles were the most common antifungals used; varied morphologies such as follicular and nonfollicular papules, arciform lesions, pseudoimbricata were seen in steroid modified tinea. Trichophyton rubrum and Trichophyton mentagrophytes were the most common species isolated in culture, but rare species such as Trichophyton tonsurans, Trichophyton schoenleinii, Epidermophyton floccosum, and Microsporum audouinii were also isolated from chronic cases. Histopathology showed perifolliculitis in steroid modified tinea. Minimal inhibitory concentration was lowest for itraconazole in susceptibility studies. Conclusion: Chronicity in dermatophytosis is due to various factors such as topical steroid application, noncompliance, and change in predominant species.

Keywords

• Chronic dermatophytosis
• perifolliculitis
• pseudoimbricata