Speciation and clinical classification of dermatophytosis in tertiary care hospital

Introduction: The incidence of superficial dermatophytosis in India has notably increased over the past 5-6 years, posing a significant public health concern. According to Emmons Morphological criteria, dermatophytes fall into three anamorphic genera based on conidial morphology: Trichophyton (affecting skin, hair, and nails), Microsporum (infecting skin and hair but not nails), and Epidermophyton (infecting skin and nails but not hair). These fungi are further classified based on their habitat association into anthropophilic (affecting humans exclusively), zoophilic (infecting domestic and wild animals as well as birds), and geophilic (isolated from soil) species.

Zoophilic species typically induce highly inflammatory reactions, while anthropophilic species tend to cause milder but chronic lesions. Common dermatophyte infections include athlete’s foot (Tinea pedis) and barbers itch (Tinea barbae). Dermatomycoses refer to diseases caused by non-dermatophytic fungi affecting the skin, with piedra and onychomycoses affecting the hair and nails, respectively. Athlete’s foot and jock itch (Tinea cruris) are prevalent examples, causing severe itching and lesions in sensitive areas, often leading to social embarrassment and reduced quality of life.

The epidemiology of dermatophytes varies across countries and regions, necessitating surveillance studies to comprehend changing clinicoepidemiology and identify prevalent pathogens for effective treatment strategies. Aims: This present study was conducted to identify the clinical profile and species of dermatophytic infection at our tertiary care centre IIMSR Lucknow Uttar Pradesh India. Study design: The present study was a hospital based observative prospective study. Statistical Analysis: Statistical analysis was done using SPSS version 29.0.1.1. Chi square test and appropriate tests of significance were applied. Method: It was a hospital based observational study of 156 clinically diagnosed case of dermatophytosis during five months duration. Sociodemographic details, clinical history and detailed examination were conducted from all patients. Skin scrapings were sent to microbiology department of our hospital for direct microscopy and culture. Results: Among 156 patients enrolled males were commonly affected than females, male to female ratio was 2.6:1. Incidence was maximum in rural area 56% as compared to urban. Multiple site infection (35.9%) was found to be commonest clinical type followed by Tineacruris (16.67%). Trichophytontonsuran was the commonest isolate obtained (35.2%) followed by Trichophyton mentagrophytes (22%).The outdoor activities, such as farming, labour work and poor personal hygiene in rural area were identified as risk factor for infection. Conclusion: The present study has provided recent data on etiological agent of dermatophytosis and risk factor in tertiary care Centre. Microscopy with and without culture is an important diagnostic tool in dermatophytosis. It is important to develop measurement for disease prevention and controlalong with effective therapy.

Speciation and Clinical Classification of Dermatophytosis in Tertiary Care Hospital

Introduction: There is a significant increase in the incidence of superficial dermatophytosis in India for last 5-6 years. Dermatophytosis poses a significant public health concern. According to Emmons Morphological criteria, dermatophytes are classified into three anamorphic genera (based on conidial morphology). Trichophyton (mainly infect skin, hair and nails) Microsporum (infect skin and hair not the nails) & Epidermophyton (infect skin as well as nails but not the hair). As a result of the variety of species and their habitat association, dermatophytes have long been classified as anthropophilic, zoophilic and geophilic, species that exclusively affect human are known as Anthropohilic while those inhabiting domestic and wild animals as well as birds are called zoophilic and third group isolated from the soil is known as geophilic. Zoophilic species tend to produce highly inflammatory reaction and anthropophilic species produce mild but chronic lesions. These include Tinea pedis (foot) or athlete’s foot and Tinea barbae or barbers itch (bearded area of the face and neck). The disease caused by non Dermatophytic fungi infecting skin are called as dermatomycoses, where hair and nail are known as piedra and onychomycoses respectively. An example of a very common dermatophyte infection is the athlete’s foot also called as Tinea Pedis. Another common dermatophyte infection affecting the groin area is jock itch, also known as tinea cruris. In these infections itching is severe and disabling lesions on the genitals and other area because social embarrassment and impair quality of life also. The epidemiology of dermatophytes varies among countries and even within different regions in the country. Surveillance studies are required to understand the changing clinicoepidemiology and prevalence of culprit agent for the effective treatment. Aims: This present study was conducted to identify the clinical profile and species of dermatophytic infection at our tertiary care centre IIMSR Lucknow Uttar Pradesh India. Study design: The present study was a hospital based observative prospective study. Statistical Analysis: Statistical analysis was done using SPSS version 29.0.1.1. Chi square test and appropriate tests of significance were applied. Method: It was a hospital based observational study of 156 clinically diagnosed case of dermatophytosis during five months duration. Sociodemographic details, clinical history and detailed examination were conducted from all patients. Skin scrapings were sent to microbiology department of our hospital for direct microscopy and culture. Results: Among 156 patients enrolled males were commonly affected than females, male to female ratio was 2.6:1. Incidence was maximum in rural area 56% as compared to urban. Multiple site infection (35.9%) was found to be commonest clinical type followed by Tinea cruris (16.67%). Trichophyton tonsuran was the commonest isolate obtained (35.2%) followed by Trichophyton mentagrophytes (22%). The outdoor activities, such as farming, labour work and poor personal hygiene in rural area were identified as risk factor for infection. Conclusion: The present study has provided recent data on etiological agent of dermatophytosis and risk factor in tertiary care ORGINAL ARTICLE OPEN ACCESS Rajeev Agarwal et al., Speciation and Clinical Classification of Dermatophytosis in Tertiary Care Hospital. Int. J Med. Pharm. Res., 5(5): 169‐173, 2024 170 Centre.Microscopy with and without culture is an important diagnostic tool in dermatophytosis. It is important to develop measurement for disease prevention and control along with effective therapy.