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      Dermatophytoses and spectrum of dermatophytes in patients attending a teaching hospital in Western Rajasthan, India

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          Abstract

          Introduction:

          About 20–25% of the world's populations are infected with dermatophyte and the incidence of the disease is increasing steadily. In India, the cause of dermatophytoses is adversely influenced by economic factors such as poverty, poor hygiene and social conditions like overcrowding. The main objective of this study was to determine the prevalence, etiological agents, and distribution patterns of the disease among the patients attending a teaching hospital, Jodhpur.

          Materials and Methods:

          This is a retrospective study conducted in the Department of Microbiology and Department of Dermatology of a teaching hospital, Jodhpur from January 2017 to May 2018. The microbiological records of potassium hydroxide (KOH) mount examination and the fungal culture report of skin, hair, and nail samples during the study period were analyzed.

          Results:

          A total 363 skin, hair, and nail samples were received for fungal culture as investigations requested by dermatologist. Out of total 363 samples, KOH mount was positive in 58.4% and the culture was positive in 44.07% cases. Dermatophyte was isolated in 40.22% cases. Trichophyton mentagrophytes was the predominant dermatophyte (55%) isolated followed by T. tonsurans (22.5%) and T. rubrum (6.25%).

          Conclusion:

          The present study gives an insight about the prevalence and distribution pattern of dermatophytoses in Jodhpur, India. Tinea corporis was the most commonly diagnosed clinical condition followed by Tinea cruris. T. mentagrophytes was implicated as the predominating species.

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          Most cited references18

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          Epidemiological studies on Dermatophytosis in human patients in Himachal Pradesh, India

          Dermatophytes are among the common fungal agents implicated in superficial skin infections worldwide. They include species of Trichophyton, Microsporum and Epidermophyton. In hot and humid climates of tropical and subtropical regions, the incidence of these pathogens is higher. We present in this article, the epidemiological data regarding the prevalence of different dermatophyte species involved in superficial mycoses in human patients in the state of Himachal Pradesh (India) and different clinical conditions, age and sex of the patients. A total of 202 samples in the form of skin and nail scrapings, hair follicles were collected from different ringworm/tinea conditions which included: Tinea corporis, T. capitis, T. cruris, T. pedis, T. unguium, T. faciei, T. manuum and T. gladiatorum. On culturing, 74 samples (36.6%) were found positive for dermatophyte spp. Trichophyton spp. was the predominant one (98.65% cases) followed by Microsporum gypseum (1.35% cases). However, we did not recover any Epidermophyton spp. Among the Trichophyton spp., T. mentegrophyte was the predominant spp. (63.5%) followed by T. rubrum (35.1%). The male to female ratio of the positive cases was recorded as 63:11. The most effected age group was 21–50 years (64.9%) followed by 1–20 years (28.4%) and above 50 years (6.8%).
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            Diagnosis and management of tinea infections.

            Tinea infections are caused by dermatophytes and are classified by the involved site. The most common infections in prepubertal children are tinea corporis and tinea capitis, whereas adolescents and adults are more likely to develop tinea cruris, tinea pedis, and tinea unguium (onychomycosis). The clinical diagnosis can be unreliable because tinea infections have many mimics, which can manifest identical lesions. For example, tinea corporis can be confused with eczema, tinea capitis can be confused with alopecia areata, and onychomycosis can be confused with dystrophic toenails from repeated low-level trauma. Physicians should confirm suspected onychomycosis and tinea capitis with a potassium hydroxide preparation or culture. Tinea corporis, tinea cruris, and tinea pedis generally respond to inexpensive topical agents such as terbinafine cream or butenafine cream, but oral antifungal agents may be indicated for extensive disease, failed topical treatment, immunocompromised patients, or severe moccasin-type tinea pedis. Oral terbinafine is first-line therapy for tinea capitis and onychomycosis because of its tolerability, high cure rate, and low cost. However, kerion should be treated with griseofulvin unless Trichophyton has been documented as the pathogen. Failure to treat kerion promptly can lead to scarring and permanent hair loss.
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              Clinico-mycological study of dermatophytic infections and their sensitivity to antifungal drugs in a tertiary care center.

              Worldwide, dermatophytic infections are running a chronic course either due to ineffective treatment or emerging drug resistance. In the past three decades, there has been an increase in incidence and non-responsiveness to conventional antifungals, which suggests that there is a need of antifungal sensitivity testing.
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                Author and article information

                Journal
                J Family Med Prim Care
                J Family Med Prim Care
                JFMPC
                Journal of Family Medicine and Primary Care
                Medknow Publications & Media Pvt Ltd (India )
                2249-4863
                2278-7135
                April 2019
                : 8
                : 4
                : 1418-1421
                Affiliations
                [1 ] Department of Microbiology, All India Institute of Medical Sciences, Rajasthan, India
                [2 ] Department of Dermatology and Venereology, All India Institute of Medical Sciences, Rajasthan, India
                Author notes
                Address for correspondence: Dr. Anuradha Sharma, Department of Microbiology, All India Institute of Medical Sciences, Rajasthan, India. E-mail: asharma3170@ 123456gmail.com
                Article
                JFMPC-8-1418
                10.4103/jfmpc.jfmpc_159_19
                6510104
                31143732
                21ae5c4c-b52a-4195-abf1-2a086268aecd
                Copyright: © 2019 Journal of Family Medicine and Primary Care

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

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                Original Article

                dermatophytoses,tinea corporis,trichophyton mentagrophytes

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