Clinical Profile of Patients With Chronic Dermatophytosis- A Descriptive Study From a Tertiary Care Centre in Kerala

Abstract

BACKGROUND Chronic dermatophytosis is increasing in an alarming proportion all over India. This study was undertaken to understand the possible factors predisposing to chronic dermatophytosis in patients attending the OPD of this tertiary care center in Alappuzha district of Kerala. MATERIALS AND METHODS 50 consecutive patients with chronic dermatophytosis attending the OPD of the tertiary care centre in Alappuzha district, Kerala, were enrolled in the study after taking informed consent. Detailed history, physical examination, direct microscopy and culture was done in all patients. RESULTS 50 patients with chronic dermatophytosis were studied. 66% were females. Maximum number (32%) of patients were in the fourth decade. 52% were manual labourers. 64% patients had sun exposure for more than 3 hours per day. 20% patients had contact with animals. 22% had associated diabetes mellitus. 80% patients were using topical steroid as part of treatment. 94% were not compliant to treatment. 56% of patients had both T. cruris and T. corporis. Trichophyton rubrum was the most common species isolated. CONCLUSION Avoidance of topical steroids and strict adherence to the treatment schedule is very important to prevent the development of chronicity in dermatophyte infection. Detailed study about the various aspects of fungal resistance and also the genetic, host and environmental factors is needed further to curtail the occurrence of this menace.

Role of tinea unguium and other factors in chronic and recurrent dermatophytosis: A case control study

“…Similar results were obtained in a study from Zacharia and Kunjukunju (8%). [ 10 ] Higher values were seen in a study by Prasad et al . (28%) but in this study, diagnosis of onychomycosis was clinical leading to the possible misdiagnosis of other nail disorders as onychomycosis.…”

“…Lower incidence of CRD in younger individuals was also reported by Zacharia and Kunjukunju in their study among chronic dermatophytosis patients. [ 10 ] This could be due to age-related suppression of CMI in the elderly and better care given to children by their parents.…”

“…Although there are many studies on dermatophytosis, there is a scarcity of studies pertaining to CRD in India. [ 10 ] Various studies have reported different gender prevalence of dermatophytosis. [ 11 12 13 14 15 16 17 ]…”

“…Manual laborers were frequently affected by chronic dermatophytosis according to one study and in many other studies on dermatophytosis. [ 10 11 12 ] The prevalence of dermatophytosis may depend upon variables such as hygiene, sharing of linen, and family history of tinea. [ 18 ] Sharing of linen was found in 71.3% of the cases as compared to 37.5% of controls which was highly significant ( P = 0.001).…”

“…[ 18 19 ] There is a low incidence of tinea manuum, tinea pedis, tinea capitis, and tinea unguium. [ 10 ] These features indicate that the current scenario of dermatophytosis primarily affects glabrous skin.…”