Recent trend in onslaught of chronic and recurrent dermatophytosis not amenable to conventional dose and duration of antifungal agents has been observed in Nepal and India. The major factor implicated behind this surge is use of over-the-counter fixed drug combination containing topical steroids. This study aimed to examine the health seeking behavior, pattern of drug use and cost of care of chronic dermatophytosis in Nepalese population. Ninety-one patients with the diagnosis of chronic dermatophytosis of skin willing to participate in the study were recruited in a hospital-based, cross-sectional study. Information regarding demographic profile, health seeking behavior and cost incurred in the treatment of their dermatophytosis were recorded in a preset proforma. Mean age of study population was 30.49±13.50 years with M:F ratio of 2.25:1. Mean duration of illness was 20.68±6.44 months, with groin as the initial site of involvement in nearly half of cases. Commonest diagnoses were extensive dermatophytosis, followed by tinea cruris et corporis and tinea cruris. Nearly three-forth of patients reported seeking advice from local pharmacy and two-third reported using steroid containing topical agents for their skin problem. On an average, patients spent NPR 6,488.70 in a six months period and 3.03% of their income in the treatment of chronic dermatophytosis. This study highlighted the tendency of patients to seek advice from pharmacy dispensers, use of topical steroid containing agents in chronic dermatophytosis and substantial financial burden borne by patients in the treatment of the condition.
Pityriasis versicolor (PV) also known as Tinea versicolor is a benign, chronic superficial fungal infection of the skin caused by Malassezia furfur. It is characterized by dyspigmented macules with fine branny scales. The purpose of this study was to assess the epidemiological profile and clinical pattern of PV in a group of patients visiting a tertiary care centre of Nepal. A descriptive cross-sectional study was carried out including 150 patients diagnosed to have PV at the outpatient dermatology department of Nepal Medical College Teaching Hospital. Patients with the diagnosis of PV were included in the study. A detailed history was taken and it was followed by a thorough clinical examination. The findings of history and clinical examinations were documented in a predesigned proforma. Statistical Package for the Social Sciences (SPSS) version 16 was used to tabulate the data and analyze the results. There was a slight male preponderance with maximum patients of the age group 11 -20 years. A majority of patients were students. Forty three (28.7%) patients had similar problem in close contacts and 42% had recurrent disease. Wearing of occlusive synthetic clothing was the commonest predisposing factor. Upper chest and upper back were the most involved sites. Hypopigmented macules were the commonest lesions in 72.7%. Coexisting seborrheic dermatitis (commonly pityriasis capitis ) was present in 44.67% of patients. Clinicoepidemiological profile of PV in our setting is similar to many studies done mostly in India. But few findings differ which indicates the need for further studies in Nepal especially from Terai regions where the prevalence is expected to be more.
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