The unprecedented epidemic-like scenario of dermatophytosis in India: I. Epidemiology, risk factors and clinical features

Abstract

Dermatophytosis has attained unprecedented dimensions in recent years in India. Its clinical presentation is now multifarious, often with atypical morphology, severe forms and unusually extensive disease in all age groups. We hesitate to call it an epidemic owing to the lack of population-based prevalence surveys. In this part of the review, we discuss the epidemiology and clinical features of this contemporary problem. While the epidemiology is marked by a stark increase in the number of chronic, relapsing and recurrent cases, the clinical distribution is marked by a disproportionate rise in the number of cases with tinea corporis and cruris, cases presenting with the involvement of extensive areas, and tinea faciei.

Two examples of Renbök phenomenon in dermatophytosis sparing congenital nevi

“…Editor Studies from the USA 1-3 and UK 4 have shown an underrepresentation of skin of color in dermatology educational resources, but to our knowledge this has not been investigated in Scandinavia. This matters because skin conditions can look different in different skin types, and conditions common in some ethnic groups may be overlooked.…”

“…2,3 The current scenario of dermatophytosis in India with a predominance of T. mentagrophytes ITS genotype VIII has gained epidemic proportions in the past 5-6 years. 4 One of the commonest causes implicated in this phenomenon is creams containing potent topical steroids like clobetasol propionate mixed with antifungal and antibacterial agents. Lesions treated with such creams show several morphological peculiarities including phenomena involving development of secondary unrelated dermatoses occurring on skin with active or healed tinea.…”

Pilzinfektionen der Haut und Nägel

“…An erster Stelle, wahrscheinlich auch zahlenmäßig, betreffen die Terbinafin-Resistenz und das Therapieversagen von Terbinafin jedoch Indien [ 18 ]. Dort hat sich inzwischen ein neuer Genotyp der Spezies T .…”

“…Ein Großteil der Isolate von T . indotineae ist in vitro resistent gegenüber Terbinafin [ 5 ] und spricht auch nicht mehr auf eine topische oder orale Behandlung mit diesem Allylamin an [ 16 ].…”

State-of-the-Art Dermatophyte Infections: Epidemiology Aspects, Pathophysiology, and Resistance Mechanisms

“…In recent years, an epidemic-like dermatophytosis scenario has been observed in India. The prevalence of dermatophytosis ranges from 6.09% to 61.5%, depending on the region, with the highest prevalence reported in the North [ 15 ]. In a review of cases in India, the authors reported that the most prevalent clinical manifestations were tinea corporis and tinea cruris, with the main causative agents being Trichophyton mentagrophytes , T. rubrum, and Trichophyton interdigitale [ 15 ].…”