A Clinico- Mycological study of dermatophytes in tertiary care centre.

Background: Dermatophytosis are a group of superficial fungal infection of keratinized tissues, such as the epidermis, hair, and nails.1 Dermatophytosis causes 16–75% of all the mycological infections worldwide and severe diseases in immunocompromised patients. Frequency, distribution, and their etiologic agents of dermatophytosis vary based on the age, topography, socioeconomic status, climate, and domestication of animals.2 It is more prevalent in tropical countries such as India, due to climate & living condition. 3. Method: It was a cross-sectional study of 110 patients attending the Dermatology outpatient of the Tertiary care center for 18months from March 2021 to September 2022. Clinically suspected cases of dermatophytosis with informed consent were included in the study. A pre structured proforma was used to collect data on history, clinical examination, KOH Mount, SDA Culture & Calcoflour stain. Patients on antifungals for >4 weeks & whose KOH or Culture showed organisms other than dermatophytes were excluded. Result: Among 110 patients of the study population, mean age group affected was 34.2 years. Males are more affected than females (54.55%) who were daily wage workers from lower socioeconomic strata. [Table 1]. Most common site of infection was Groin (54.54%) followed by buttocks (44.54%). The risk factors associated are poor hygiene & fomites among subjects [Table 2]. Most common clinical variant of dermatophytosis was Tinea corporis with cruris (42.73%). (Figure 1) Commonest organism isolated from the culture was Trichophyton mentagrophytes (24.55%) [Figure 3], followed by Trichophyton rubrum (22.73%) [Figure 4]; Trichophyton tonsurans (2.73%) and Trichophyton violaceum (1.81%) [Figure 5] with average time taken for the culture to grow was around 14 to 21 days. KOH & Calcofluor positivity was seen in 84 (98.82%) whereas KOH & culture positive was seen in 43 (75.43%). We found calcofluor with KOH could pick up faint fungal elements which was missed in culture. Conclusion: The study highlights Tinea corporis and Tinea cruris as the predominant clinical variant, with Trichophyton mentagrophytes emerges as the most frequently isolated organism, emphasizing its significance rampant & resistant dermatophytosis in this topography. Furthermore, the findings suggest Calcofluor staining as a superior method for microscopy in diagnosing dermatophytosis compared to KOH, potentially due to its enhanced sensitivity in detecting fungal elements. These observations provide valuable insights into the epidemiology and diagnostic methods of dermatophytosis but also emphasize the importance of accurate and efficient diagnostic techniques in clinical practice. This contributes to understanding of dermatophytosis & associated risk factors aiding in improved management of these infections. [ABSTRACT FROM AUTHOR]