A study on etiologic agents and clinical manifestations of dermatophytosis in Yazd, Iran

Abstract

Background and Purpose:Dermatophytosis is one of the most common infections of skin, hair, and nails, caused by a group of keratinophilic fungi known as dermatophytes. Species identification of these fungi is of great significance from epidemiological and therapeutic points of view. The objective of the present study was to investigate dermatophytosis and its causative agents in patients, referring to the Central Mycology Laboratory of Yazd University of Medical Sciences, Yazd, Iran.Materials and Methods: In total, 139 clinically suspected cases of dermatophytosis were examined during 12 months from February 2014 to February 2015. Skin scrapings were assessed through direct microscopic examinations and culture studies. Dermatophyte isolates were identified based on colony morphology on potato dextrose agar and dermatophyte test medium, nutritional requirements, urease and hair perforation tests, and microscopic characteristics on slide cultures. Results:Dermatophytosis was mycologically confirmed in 26 (18.70%) out of 139 cases. Although there was a statistically insignificant difference between male and female subjects, men were dominantly affected. Infection was significantly common in the age group of ≤ 29 years (P<0.043). The most common clinical manifestation of dermatophytosis was tinea corporis (69.2%), followed by tinea cruris (15.4%), tinea manuum (11.5%), and tinea pedis (3.8%). Trichophyton mentagrophytes complex was the main etiologic agent (38.5%), followed by T. rubrum (23%), T. violaceum (15.5%), T. verrucosum (11.5%), Microsporum canis (7.7%), and Epidermophyton floccosum (3.8%).Conclusion:In comparison with previous research, epidemiology of dermatophytosis has changed in Yazd over the past decades. Therefore, periodical investigations on the epidemiological aspects of this infection are required for efficient control and prevention of this cutaneous dermatophytic disease.

Major challenges and perspectives in the diagnostics and treatment of dermatophyte infections

“…Dermatophytosis usually has variable clinical pictures depending on the location of the infection process, the ecological type and species of the etiological factor, and the immune state of the host (Tainwala and Sharma 2011;Gnat et al 2019e). The clinical features of dermatophytosis such as itching, maceration, pain, scaling, formation of vesicles or plaster, and erythema rate are variable between a mild to moderate degree and may be mistaken for other dermatological diseases as contact dermatitis, bacterial folliculitis, psoriasis and eczema (Andrews and Burns 2008;Moriarty et al 2012;Rashidian et al 2015;Dogra and Narang 2017). Moreover, one lesion can be caused by a single strain or species of dermatophyte, but it is also possible to identify many various types, strains and species of fungi in the same lesion (Gnat et al 2019d).…”

Tinea manuum: A report of 18 cases observed in the metropolitan area of Milan and review of the literature

“…Epidemiological studies on tinea manuum have been carried out in several countries: Denmark, 3 Poland, 8,34 Greece, 22,27,48 Libya, 13,14 Senegal, 51 Nigeria, 40 Syria, 52 Iran, 9,16,20,23,30,32,36,37,44,45,47,50,53,55 China, 24,35,46 Japan 33,42 and the United States. 1,2 Incidence of tinea manuum is extremely changeable: 4.4% of all superficial mycoses in Poland, 8 .5% in Greece, 27 .6% in Libya, 13,14 in Syria, 52 from 4.2 37 to 16.4% 50 in Iran, 13.5% in China.…”

“…1,2,4,11,13,14,17,27,[33][34][35]39,40,42,46,48,53,55 Also, in our patients Trichophyton rubrum was the most frequently involved dermatophyte (6 out of 18 patients), followed by Microsporum canis (4 patients). Other dermatophytes responsible for tinea manuum are Epidermophyton floccosum, 20 Microsporum canis, 45 Trichophyton interdigitale, 37,47,50 Trichophyton mentagrophytes, 23,44 Trichophyton tonsurans, 3,28 Trichophyton verrucosum 21,36 and Trichophyton violaceum. 22 Microsporum gypseum, isolated in 3 of our patients, has been rarely reported in the literature as cause of tinea manuum.…”

“…Tinea manuum is a superficial mycosis of the dorsum and/or palm and/or interdigital folds of one or both hands …”

Proteolytic activity and cooperative hemolytic effect of dermatophytes with different species of bacteria

“…There is a wide range of studies on epidemiology of dermatophytosis and its causative agents across Iran and other countries indicating different agents and clinical manifestations. T. mentagrophtes in Yazd [ 13 ], T. rubrum in Turkey [ 14 ], T. sudanensis in Nigeria [ 15 ], E. floccosum in Karaj [ 16 ], T. verrucosum in Isfahan [ 17 ], and T. interdigital in Tehran [ 18 ] were the most common etiological agents of dermatophytosis in those studies. Human skin is a large, heterogeneous organ that protects the body against pathogens while sustaining microorganisms that influence human health and disease [ 19 ].…”