Title: A Study of Clinical Profile of Dermatophytosis with a Changing Clinical Pattern at a Tertiary Care Centre
Authors: Dr Asha S. Khade, Dr Shreyas R. Burute, Dr Sushma S. Deogude, Dr Pradeep Jadhav, Dr Sunita J Ramanand
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.105
Abstract
Introduction: Dermatophytosis have always been among the commonest infective dermatoses affecting nails, hairs and skin and is one of the common problem for which dermatology consultation is sought. The prevalence of dermatophytosis has been increasing since last decade because of environmental factors, irrational use of topic steroids and irregular systemic anti-fungal treatment. It is a well-known fact that most of the studies on clinical features, complications and management of dermatophytosis comes from western world. In many instances these treatment protocols are unrealistic in Indian setup and dermatologists usually treat these infections on the basis of personal experience which is proving to be more effective than guidelines as laid down in western literature. We conducted this observational study to find out demographic details, clinical features and management of patients with dermatophytosis.
Materials and Methods: This was an observational, cross sectional study done in the department of Dermatology, Venereology and Leprosy at a tertiary care center. Total 318 patients with clinical diagnosis of dermatophytosis were included in the study depending upon a predefined inclusion and exclusion criteria. Data including age, sex, chief complaints, any significant past, present and family history, drug history and cutaneous examination findings were recorded. Fungal scraping and KOH mount was done for confirmation of the diagnosis. Patients were managed according to standard protocol and outcome was studied. For statistical comparisons P value less than 0.05 was taken as significant. The data was analyzed using Minitab version 17.
Results: A total of 335 patients with superficial cutaneous fungal infections were examined out of which dermatophytosis was seen in 318 patients. Out of the patients diagnosed to be having dermatophytosis there were 176 (55.34%) males 142 (44.65 %) females with a M:F ratio of 1:0.80. Youngest patient to be having dermatophytosis was found to be 1year old infant. The most common age group affected by dermatophytosis was found to be 21-30 years (107/318). Majority of the patients (36.47%) had history of infection for 1-3 months while 30.50% patients had history since more than 3 months. Comorbidities like immunosuppression, diabetes, hypertension and atopy was found to be present in 39 (12.28%) patients. Groin (80.81%) followed by trunk (47.16%) were the common sites of involvement. T. Corporis and T. Cruris were found to be most common types of dermatophytosis and were seen in 81.6% and 80.81% patients respectively. T Cruris was more common in males while T. Corporis was found to be more common in females. Majority of the patients (78.93%) had previous history of taking treatment for dermatophytosis. Most patients were young and free of apparent risk factors indicating a change in trend of dermatophytic infections. Studies to understand the cause are required.
Conclusion: Dermatophytosis is a very common infection and one of the common reasons for patients to seek dermatology opinion. It is more commonly seen in males, pregnant females and patients with diabetes mellitus and immunosuppression. It can be successfully treated by a combination of topical and oral antifungal drugs.
Keywords: Dermatophytosis, T.Corporis, T.Cruris, Anti-fungal treatment, Outcome.
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