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    Dermatomycological Profile of Patients in A Tertiary Care Hospital of Western Maharashtra

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    This study examined 200 skin, hair, and nail samples from patients clinically diagnosed with superficial mycoses at a tertiary hospital in Western Maharashtra, India. Culture analysis found dermatophytes in 75% of samples and non-dermatophytic molds in 25% of samples. The most common clinical presentation was tinea corporis (28.5% of cases), and the most common age group affected was 21-30 years old (50% of cases). Males were more commonly affected than females by a ratio of 2.23:1. The study emphasizes the need to identify the prevalence of fungal species causing superficial mycoses in a given area to help guide appropriate treatment.

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    Dermatomycological Profile of Patients in A Tertiary Care Hospital of Western Maharashtra

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    This study examined 200 skin, hair, and nail samples from patients clinically diagnosed with superficial mycoses at a tertiary hospital in Western Maharashtra, India. Culture analysis found dermatophytes in 75% of samples and non-dermatophytic molds in 25% of samples. The most common clinical presentation was tinea corporis (28.5% of cases), and the most common age group affected was 21-30 years old (50% of cases). Males were more commonly affected than females by a ratio of 2.23:1. The study emphasizes the need to identify the prevalence of fungal species causing superficial mycoses in a given area to help guide appropriate treatment.

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    This study examined 200 skin, hair, and nail samples from patients clinically diagnosed with superficial mycoses at a tertiary hospital in Western Maharashtra, India. Culture analysis found dermatophytes in 75% of samples and non-dermatophytic molds in 25% of samples. The most common clinical presentation was tinea corporis (28.5% of cases), and the most common age group affected was 21-30 years old (50% of cases). Males were more commonly affected than females by a ratio of 2.23:1. The study emphasizes the need to identify the prevalence of fungal species causing superficial mycoses in a given area to help guide appropriate treatment.

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    20 views2 pages

    Dermatomycological Profile of Patients in A Tertiary Care Hospital of Western Maharashtra

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    Apple Idea
    This study examined 200 skin, hair, and nail samples from patients clinically diagnosed with superficial mycoses at a tertiary hospital in Western Maharashtra, India. Culture analysis found dermatophytes in 75% of samples and non-dermatophytic molds in 25% of samples. The most common clinical presentation was tinea corporis (28.5% of cases), and the most common age group affected was 21-30 years old (50% of cases). Males were more commonly affected than females by a ratio of 2.23:1. The study emphasizes the need to identify the prevalence of fungal species causing superficial mycoses in a given area to help guide appropriate treatment.

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    Research Paper

    Volume : 5 | Issue : 2 | February 2016 ISSN No 2277 - 8179

    Medical Science

    Dermatomycological Profile of Patients


    in a Tertiary Care Hospital of Western
    Maharashtra.

    KEYWORDS : dermatomycoses, nondermatophytes

    Nidhi Sharma

    Department of Microbiology, MIMER Medical College ,Talegaon, Pune

    Abhishek Sharma

    Department of Biochemistry, N.S.C.B Medical College, Jabalpur, M.P

    ABSTRACT

    Objective- To find the prevalence of dermatophytes and nondematophytes in cases of clinically diagnosed superficial mycoses
    Material and mathods-The study was conducted on the patients attending OPD of Skin and Venereology department for various dermatological complaints. It is an observational study.
    A total of 200 samples of skin, hair and nail were taken from patients clinically diagnosed as superficial mycoses.
    Results- There were 200 clinically diagnosed cases of superficial mycoses of which male were 138 (69%) and female were 62(31%).Commonest
    age group affected was 21-30 years (50%) followed by 31-40 years (28.5%). Among 200 cases, 20(10%) patients were diabetic.
    Conclusion- Our study emphasizes the need of knowing the prevalence of various fungal species causing superficial mycoses in an area so
    as to treat accordingly and to study the role of non dermatophytes along with dermatophytes in the pathogenesis of superficial mycoses and
    not merely discarding them as contaminants.

    Introduction.
    Infections caused by fungi are called mycoses. Fungal infections
    are very common in human beings. They are assuming greater significance both in developed and developing countries particularly
    due to advent of immunosuppressive drugs and diseases[1].
    Superficial mycoses refers to fungal infections of the outermost layer of skin and its appendages like hair and nails. They are among
    the most prevalent of human infectious diseases.These infections
    are divided into two groups: the Superficial mycoses, which includes Pityriasis versicolor, Piedra and Tinea nigra and the Cutaneous mycoses which includes Dermatophytoses and Candidiasis.[2]
    According to the World Health Organization (WHO), these fungi affect about 25% of the world population. It is estimated that from 30
    to 70% of adults are asymptomatic hosts of these pathogens and that
    the incidence of the disease increases with age.High prevalence of
    nondermatophytic mold onychomycoses has been reported from India (22%) [3,6]. Generally, these fungi exhibit a cosmopolitan profile,
    that is, they are found in different regions of the world with variations in the frequency, as climatic factors, social practices, migration
    and individual characteristics like nutrition ,hygienic habits and individual susceptibility may influence the epidemiology of dermatomyoses[4,7]. Although dermatophytoses does not produce mortality,
    it does cause morbidity and poses a major public health problem,
    especially in tropical countries like India due to the hot and humid
    climate.[5,3] Over the last decades, an increasing number of non dermatophyte filamentous fungi have been recognized as agents of skin
    and nail infections in humans, producing lesions clinically similar to
    those caused by dermatophytes.[6,8]. Though commonly considered
    as contaminants, they have been reported to colonize damaged tissues and cause secondary tissue destruction[7,9,].
    Present study was undertaken with the view to find out prevalence of superficial mycoses in patients attending skin OPD with
    complaints of superficial mycoses,in a tertiary care rural hospital.
    Material and Methods-The study was conducted from January 2013 to June 2014 for a period of one and a half year on the
    patients attending OPD of Skin and Venereology department for
    various dermatological complaints.It is an observational study.
    A total of 200 sample of skin, hair and nail were taken from patients
    clinically diagnosed as superficial mycoses. Before collecting the
    sample, some information concerning the patient like Name, sex,
    age ,address ,occupation ,socio economic status were recorded .Site
    of the lesion and duration of illness were asked .Relevant history

    was taken. To improve the efficiency of mycological examination,


    history was taken of any local or systemic antifungal treatment.
    The lesion area was cleaned with 70% alcohol before sampling to
    remove contaminants .skin, nail and hair were used for isolation .
    Portion of the specimen was examined microscopically using
    10% potassium hydroxide (KOH) with 40% dimethyl sulfoxide.
    Culture methods were used with various combinations of SDA
    with or without antibiotic at various temp., for isolation of dermatophytic and non dermatophytic moulds and yeasts.
    RESULTS200 samples were taken from clinically diagnosed cases of superficial mycoses attending Skin OPD, of which,skin samples were
    145,hair were 36 and nail were 19.
    Out of 200 cases,Male being 138(69%) and female being 62(31%).
    Table -1 Out of 200 cases ,the distribution of patients in various age groups was0-10
    11-20
    21-30 31-40 yrs 41-50 51-60 yrs 61-70
    yrs
    yrs
    yrs
    yrs
    yrs
    12
    12
    100
    57
    8
    7
    4
    (6%)
    (6%)
    (50%) (28.5%)
    (4%)
    (3.5%)
    (2%)
    Most common age group involved was 21-30 yrs(50%) followed
    by 31-40yrs(28.5%).Among 200 cases ,20(10%) patients were diabetic .Among 200 cases,160 cases(80%) were from low socioeconomic status,28 cases(14%) were middle socioeconomic status
    and 12 cases(6%) were from high socioeconomic status.
    Table -2 Clinical types of dermatomycoses in present study
    Sr.No.
    1
    2
    3
    4
    5
    6
    7
    8
    9

    Clinical type
    Tineacruris
    Tineacorporis
    Tineapedis
    Tineacapitis
    Tineabarbae
    Tineamanuum
    Tineaunguium
    Pityriasisversicolor
    Total no. of cases

    No.of cases
    40
    57
    25
    24
    06
    12
    16
    20
    200

    Percentage (%)
    20
    28.5
    12.5
    12
    03
    06
    08
    10
    100

    This Table shows most common clinical presentation was Tineacorporis (28.5%).
    IJSR - INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH

    577

    Research Paper

    Volume : 5 | Issue : 2 | February 2016 ISSN No 2277 - 8179

    Table 3- Dermatomycoses in relation to Age


    Clinical
    presentation
    Tineacruris
    Tineacorporis
    Tine
    pedis
    Tineacapitis
    Tineabarbae
    Tineamanuum
    Tineaunguium
    Pityriasisversicolor
    Total

    0-10 1120

    21-30 31-40

    4150

    5160

    6170

    19

    14

    30

    17

    15

    12

    40
    (20%)
    57
    (28.5%)
    25
    (22.5%)
    24
    (12%)

    6(3%)

    12(6%)

    16(8%)

    20(10%)

    Total

    12 12 100 57
    8
    7
    4
    200
    (6%) (6%) (50%) (28.5%) (4%) (3.5%) (2%) (100%)

    This table shows that most common clinical presentation indermatomycoses as an individual site was Tineacorporis(28.5%) in
    all age groups .
    Table-4 Dermatomycoses in relation to sex
    Clinical presentation
    Tineacruris
    Tineacorporis
    Tineapedis
    Tineacapitis
    Tineabarbae
    Tineamanuum
    Tineaunguium
    Pityriasisversicolor
    Total

    Male

    Female

    Total

    35(25.36%)
    39(28.26%)
    18(13.05%)
    19(13.77%)
    6 (4.35%)
    5 (3.62%)
    5 (3.62%)

    5(8.06%)
    18(29.03%)
    7(11.29%)
    5(8.07%)
    0(0%)
    7(11.29%)
    11(17.74%)

    40(20%)
    57(28.5%)
    25(12.5%)
    24(12%)
    6(3%)
    12(6%)
    16(8%)

    11(7.97%)

    9(14.52%)

    20(10%)

    138(69%)

    62(31%)

    200(100%)

    This table shows that most common clinical presentation indermatomycoses as an individual site was Tineacorporis-(28.26%)
    among males and( 29.03%) among females. Here male affected are
    more than female except in TineaUnguium and TineaManuum.
    Table 5 Distribution of dermatophytes and non dermatophytes according to culture positivity.
    No.of positive
    Total culture
    positive patients
    for derma- No.of
    positive(No. and patients
    for non-dermatophytes
    tophytes
    %)
    (No. and %)
    (No. and %)
    100
    75
    25

    REFERENCE

    This table shows that culture positivity of dermatophytes(75%)


    and non dermatophytes(25%). 4 cases of Aspergillus on first inoculation ,were discarded as contaminant , as none were positive for Aspergillus on repeated inoculation from the same site
    of the patient .
    Discussion:
    In the present study , dermatomycoses was found in around 15%
    of the patients attending the skin OPD for various dermatological
    complaints which is similar to other study by (M Mishra et al(1998)
    [ 8,10]
    in which it was (16.2%) of all patients attending dermatology
    OPD .This low incidence could be due to several factors(,9,10,11)
    [,11,12,13]Out of 200 samples, skin samples were 145(72.5%),hair
    were 36(18%) and nail were 19(9.5%) of total i.e. in accordance with
    study conducted by (Parul Patel et al 2010) (6,7) in which skin sample
    were (79.80%),hair were(11.11%) and nail were (9.09%).
    Among 200 cases ,20(10%) patients were diabetic similar to
    study from (Sweta R Prabhu et al 2013) ( 12,14) in which diabetics
    were 18.67%..
    In Table -1 Out of 200 cases ,the Most common age group involved was 21-30 yrs(50%) followed by 31-40yrs(28.5%).
    In table 2-Among 200 clinically diagnosed superficial mycoses cases, most common clinical presentation was Tineacorporis(28.5%)
    followed by Tineacruris (20%) which is favoured by study from
    (Vikeshkumar Bhatia et al 2014) ( 13,16,), in which it was 39.1% and
    27% respectively,. Unlike this present study,(Sweta R Prabhu et al
    2013) (12,148) found most common clinical presentation as Pityriasisversicolor(31.30%) followed by Candidiasis(18.75%) and 3rd most
    common being Tineacruris(13.5%)..This can be explained by geographical variation and individual susceptibility to various fungal
    species as their study is from coastal region of Karnataka
    According to Table 3-Most common age group involved was
    21-30 yrs(50%) followed by 31-40yrs(28.5%) in accordance
    with (Grover et al 2003)(7,11) in which it was 39.6% and 29.7%
    respectively,whereas in study by (Parul Patel et al 2010 )(6) most
    common was 21-30 yrs(29.30%) followed by 11-20 yrs(20.71%)
    and according to ( Sweta R Prabhu et al 2013) (12,148) most common age group involved is 30-45 yrs(34.37%).
    As per Table 4-Male:Female ratio was 2.23:1 which is in accordance with (Vyomachudasama et al 2014)(14,154) 2.17:1.
    As mentioned in Table 5 - Among total positive 100 isolates
    ,75% were dermatophytes and 25% were non dermatophytes
    which was in accordance with ( PradeepNawal et al 2012)(2) in
    which dermatophytes were 68.4% and non dermatophytes 31.6%
    ,(Parul Patel et al 2010) (6,8)found dermatophytes to be 66.66%
    and non dermatophytes to be 33.34% respectively.
    The rate of isolation of different species varies in different set
    up because of-1)Geographical variation,2)sample size,3)Various
    treatment taken by the patient before coming to OPD.

    1. Kumar Arun Singh, Kumar SudhirSrivastava. Aclinico-cycological study on tineapedis at Ranchi.Ind. J Veneral Dermatol.1994 .V60 :(2 ) : 68-71 |
    2. Dr.PradeepNawal, Dr.Sachin Patel, Dr.Mitesh Patel, Dr.SumitaSoni ,Dr. Neeta Khandelwal.A Study of Superficial Mycoses in Tertiary Care Hospital.NJIRM 2012; Vol. 3(1).January-March:90-93. | 3. Ranthilaka R Ranawaka ,Nelun de Silva , Ramya W Ragunathan. Non-dermatophyte mold onychomycosis in Sri Lanka. Dermatology Online Journal.2012; 18(1):7 | 4. .NaluTeixera de Aguiar Peres et al.Dermatophytes: host-pathogen interaction and antifungal resistance.An. Bras. Dermatol. 2010. v.85 (5) Rio de
    Janeiro | 5. Rippon J. W:Dermatophytosis and dermatomycoses in medical mycology . The pathogenic fungi and the pathogenic actinomycetesPhiladelphia,W B Saunders 1982; 154. |
    | 6. .Parul Patel, SummaiyaMulla, Disha Patel, GaurishankarShrimali. A study of superficial mycosis in south gujarat region.National Journal of Community Medicine 2010;Vol. 1, Issue
    2:85-8 | 7. WgCdrSanjiv Grover, Lt Col P Roy. Clinico-mycological Profile of Superficial Mycosis in a Hospital in North-East India.MJAFI 2003; 59 : 114-116 | | 8. M Mishra, S Mishra, PC
    Singh, BC Mishra. Clinico-mycological profile of superficial mycoses.1998.v64:6:283-85 | 9. TerborghJ.Diversity in the tropical rain forest,Scientific American books,New York.1992:3151. | 10. Dei Cas E. and A. Vernes. Parasitic adaptation of pathogenic fungi to the mammalian hosts.Crit Rev Microbiol 1986; 13(2):173218. | | 11. Ajello L.1977. Taxonomy of the dermatophytes: a review of their imperfect and perfect states ; 289297. InK.Iwata(ed.).Recent advances in medical and veterinary mycology.University of Tokyo Press,Tokyo | 12. Sweta
    R. Prabhuetal.Clinico-mycological study of superficial fungal infections in coastal karnataka, india.. Journal of Evolution of Medical and Dental Sciences 2013; V.2, ( 44) ; 8638-8646. |
    13. Vikesh Kumar Bhatia, Prakash Chand Sharma.Epidemiological studies on Dermatophytosis in human patients in Himachal Pradesh, India.Bhatia and Sharma SpringerPlus 2014,
    3:134 | 14. Dr. Vyomachudasama.A Study of Superficial Mycosis in Tertiary Care Hospital.V 3 (3) 2014 :222-4. |

    578

    IJSR - INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH

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