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Indian Journal of Dermatology, Venereology and Leprology (IJDVL): Clinico - mycological study of dermatophytosis in Calicut : <b>V Bindu¹,

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ORIGINALARTICLE
Year:2002|Volume:68|Issue:5|Page:259261

ClinicomycologicalstudyofdermatophytosisinCalicut
VBindu1,KPavithran2,
1DepartmentofMicrobiology,MedicalCollege,Calicut673008,India
2DepartmentofDermatologyandVenereology,MedicalCollege,Calicut673008,India
CorrespondenceAddress:
KPavithran
DepartmentofDermatologyandVenereology,MedicalCollege,Calicut673008
India

Abstract
Among150patientswithdermatophytosisstudied,tineacorporiswasthecommonestclinicaltype,followed
bytinescruris.Theoverallpositivitybyculturewas45.3%andbydirectmicroscopy64%.T.rubrumwasthe
commonestspeciesisolated(66.2%)followedbyTImentagrophytes(25%)

Howtocitethisarticle:
BinduV,PavithranK.ClinicomycologicalstudyofdermatophytosisinCalicut.IndianJDermatolVenereolLeprol
200268:259261

HowtocitethisURL:
BinduV,PavithranK.ClinicomycologicalstudyofdermatophytosisinCalicut.IndianJDermatolVenereolLeprol[serial
online]2002[cited2015Apr16]68:259261
Availablefrom:http://www.ijdvl.com/text.asp?2002/68/5/259/12485

FullText
Introduction

Dermatophytosisreferstosuperficialfungalinfectionofkeratinisedtissuescausedbydermatophytes.
Althoughcommon,theprecisesizeoftheproblemdefiesmeasurement.Thepresentstudywasundertakento
assesstheclinicoepidemiologicalprofileofderntatophyticinfection,toidentifythespeciesoffungiandto
comparetheclinicaldiagnosiswithKOHsmearpositivityandculturepositivity.

MaterialsandMethods

Thestudypopulationincluded150patients,diagnosedclinicallyashavingdematophytosisrandomlyselected
fromtheoutpatientdepartmentofDermatologyandVenereology,MedicalCollegeHospital,Calicut.Adetailed
historywastakenfromallpatients.Itincludedage,sex,socioeconomicstatus,occupation,durationof
disease,historyofrecurrence,habitsandassociateddiseases.Historyofsimilarillnessinfamilymembersand
contactwithanimalsorsoilwerealsoelicited.Onehundredandfiftycontrolsubjectsmatchedintermsofage,
sexandsocioeconomicstatuswerealsoanalysed.Thepatientswereclassifiedaccordingtothesitesof
involvement.Theskinscrapingswerecollectedfromtheactiveedgeofthelesionsandroofofthevesiclesif
any.Intineacapitisinfectedandlustrelesshairswerecollected.Intineaunguiumnailscrapings,clippingsand
subungualdebriswerecollected.Directmicroscopy(in10%KOH)andcultureweredoneineachcase.For
primaryisolationSabouraud'sdextroseagarslopeswithchloramphenicolandcycloheximidewereused.
SubculturewasdoneinSabouraud'sdextroseagarwithoutantibiotics.Specialtestsweredonewhen
necessaryvizcultureoncornmealagar,bloodagarandhairperforationtest.

Results

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Indian Journal of Dermatology, Venereology and Leprology (IJDVL): Clinico - mycological study of dermatophytosis in Calicut : <b>V Bindu¹,

Outofthe150patients,themaximumwereseenintheagegroup1120(23.3%).Theyoungestpatientwas
a13dayoldboy(withageofonsetat9daysofage)andtheoldesta75yearoldman.Maletofemaleratio
was2.06:1Majorityofthepatientsbelongedtothemiddleincomegroup.
Tineacorporis(54.6%)wasthecommonestclinicaltypefollowedbytineacruris(38.6%).Tineacapitiswas
thepredominantdermatophytosisinchildren.Tineaaxillarisandfineazosterwereseenpredominantlyin
females
andtineafacieiandtineabarbaeinmales.Tineaincognitowasseenin7.3%ofpatients.Mixedclinicaltypes
werealsoseen.Hencethetotalnumberofclinicaltypesishigherthanthetotalnumberofpatientsasshown
in[Table:1].
Theoverallpositivitybyculturewas45.3andbydirectmicroscopywas64%See[Table:2]
Trubrumwasthepredominantspeciesisolated(66.2%)inallclinicaltypesfollowedbyTmentagrophytes
(25%),Ttonsurans(5.9%)andE.floccosum(2.9%)asseenin[Table:3].

Discussion

Inthepresentstudy,maximumnumberofpatientswereseenintheseconddecadewithmalesoutnumbering
females.Similarfindingshavebeenreportedbyotherworkers,[1],[2]althoughmajorityofstudieshave
observedhigherincidenceinthethirddecade.[1],[2],[3],[4],[5],[6]Thehigherincidenceinyoungmales
couldbeduetogreaterphysicalactivityandincreasedsweating.Themajorclinicaltypewastineacorporis
followedbytineacruris.Thisisinagreementwithmajorityofallcasesofrecurrentdisease,extensivedisease
andtineaincognito.ThesecondcommonisolatewasTmentagrophytes.Thisisinkeepingwithotherstudies
fromIndia.[1],[2],[4],[5],[7]Seventeen(11.3%)specimenswerepositivebyculturealone45(30%)by
directmicroscopyalone,highlightingtheimprotanceofbothdirectmicroscopyandcultureinthedefinitive
diagnosisofdermatophytosis.Specimensofnailandhairwerefrequentlynegativeondirectmicroscopy.
Positivitybycultureanddirectmicroscopyofnailswasenhancedbycombiningthethreemethodsofnail
clipping,shavingorcollectionofsubungualdebris.ThishasbeenadvocatedbyHullandcoworkers.[8]
Historyofcontactwithinfectedfamilymemberswasseenin16.6%andwithnonfamilymembersin2.6%.
Therewasonecaseofconjugaltransmission.Useofocclusiveclothingandsyntheticfabricswasseenin64%
ofmalepatientsand80%offemalescomparedto22%and32%incontrolsrespectively.Tineacapitiswas
seenpredominantlyinmalechildren.Frequentshavingofscalpandsharingofcapswasfoundtobea
contributoryfactor.Therewasnosignificantassociationwiththeuseofhairoilsandfootwearincaseoftinea
capitisandtineapedisrespectively.Amongtheassociateddiseases,diabetesmellituswasseenin10.6%,
atopicdiathesisin10%andHIVinfectionin2%.Patientsonimmunosuppresantshadextensivediseasewith
mixedclinicaltypes.Recurrenceofdiseasenotedin32%ofpatientscouldbeduetolackoflocalimmunityor
inadequatetreatmentie,iftreatmentwasstoppedbeforeallfungiareshed,thenthediseasewillreestablish
itself.[9]Uncommonclinicalpresentationsincludedtinealabialis,kerionofupperlip,tineaofscrotumand
penis,proximalsubungualonychomycosisandkerionwithdermatopathies.Thesehavebeenreportedandare
bynomeansrare.[10],[11],[12]

References
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HudaMM,ChakrabortyN,BordoloiJNS.Aclinicomycologicalstudyofsuperficialmycosisinupper

Assam.IndianJDermatolVenerealLeprol199561:329332.
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PrasadPShivanandaPG,SrinivasCR,etal.IndianJDermatolVenerealLeprol198753:217218.
MaheswariAmmaSM,PanikerCKJ,GopinathanT.StudiesondermatomycosisinCalicut(Kerala)Indian

JPatholMicrobial198225:1117.
BhargoviL.StudyontheaetiologiesofdermatophytosisinCalicut.ThesisforMD(Microbiology),
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SentamilselviG,KamalamA,ThambiahAS,etal.Scenarioofchronicdermatophytosis:AnIndianstudy.
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Indian Journal of Dermatology, Venereology and Leprology (IJDVL): Clinico - mycological study of dermatophytosis in Calicut : <b>V Bindu¹,

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LatoucheCJ.Scrotaldermatophytosis.Aninsufficientlydocumentedaspectoftineacruris.BrJDermatol
196779:339334.

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EleswkiB.Clinicalpearl:proximalwhitesubungualonychomycosisinAIDS.JAmAcadDermatol1993
29:631632.

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