A Study of Fungal Isolates in Clinically Diagnosed Patients of Tinea Incognito attending A Tertiary Care Center in Central Uttar Pradesh
Background: Tinea incognito is a dermatophytic infection that lacks the classical features of a typical fungal infection and result from repeated use of immunosuppressive agents like steroids. The aim of this study was to investigate the occurrence of fungal isolates among clinically suspected cases of tinea incognito in the dermatology OPD and to study the association between these fungal isolates and type of disease presented.
Methods: One hundred clinically suspected cases of tinea incognito attending the Dermatology OPD of a tertiary care centre were enrolled and were referred to the Department of Microbiology for the isolation and identification of etiological agent. Skin Scrapings were used as specimens for direct microscopic examination after potassium hydroxide (KOH) mounts and remaining specimen was used to inoculate the culture media.
Results: Among the 100 patients, KOH mount demonstrated fungal elements in 85 patients. Sixty two KOH-positive cases and 9 KOH-negative cases showed growth of fungus on culture. All KOH positive cases except for 2 cases were dermatophytes. Among the total 71 culture positive samples, 86% demonstrated growth of dermatophytes while in the remaining 14% non-dermatophytes were isolated. Trichophyton rubrum was isolated in approximately one-third of the cases. The dermatophytic fungal isolates in decreasing order of occurrence were T. rubrum, T. mentagrophytes, T. tonsurans, T. interdigitale, Microsporum ferrugineum, M. audouinii and T. schoenleineii.
Conclusions: An increased level of awareness along with better government policies regarding the sales of steroid formulations would prevent mismanagement of tinea cases.
2. Chander J: Dermatophytes. In: Textbook of Medical Mycology, 3rd Edn; Mehta publication, New Delhi 2009;pp.134-41
3. Kye H, Kim DH, Seo SH, Ahn HH, Kye YC, Choi JE. Polycyclic annular lesion masquerading as lupus erythematosus and emerging as tinea faciei incognito. Ann Dermatol. 2015;27:322–5
4. Madhavi S, Ramarao MV, Jyotsana K. Mycological Study of Dermatophytosis in rural population. Ann Biol Res 2011;2:88-93
5. S Karmakar, G Kalla, KR Joshi, S Karmakar. Dermatophytoses in a desert district of Western Rajasthan. 1995,61(5):280-3
6. Gupta M, Sharma NL, Kanga AK, Mahajan VK, Tegta GR Onychomycoses: Clinico-mycologic study of 130 patients from Himachal Pradesh, India. Indian J Dermatol Vernereol Leprol. 2007,73(6):389–92.
7. Surendran K, Bhat RM, Boloor R, Nandakishore B, Sukumar D. A clinical and mycological study of dermatophytic infections. Indian J Dermatol 2014;59:262-7
8. Shukla P, Yaqoob S, Shukla V, Garg J , Dar ZP, Haider F. Prevalence of Superficial Mycoses among Outdoor Patients in a Tertiary Care Hospital. National Journal of Medical and Allied Sciences 2013;2(2):19-26
9. Raina D, Gupta P and Roy S. Clinico-Mycological Profile of Dermatophytoses in a Tertiary Care Centre of Uttarakhand, India. Int J Curr Microbiol App Sci 2015;4(12): 130-41
10. Naglot A, Shrimali DD, Nath BK, Gogoi HK, Veer V, Chander J and Tewari R. Recent Trends of Dermatophytosis in Northeast India (Assam) and Interpretation with Published Studies. Int J Curr Microbiol App Sci 2015;4(11):111-20
11. Sahai S, Mishra D. Change in spectrum of dermatophytes isolated from superficial mycoses cases: first report from central India. Indian J of Dermatol Venereol and Leprol 2011;77:335-6
12. Vyas A, Pathan N, Sharma R, Vyas L. A clinicomycological study of cutaneous mycoses in sawai man singh hospital of jaipur, north India. Ann Med Health Sci Res 2013;3(4):593-7
13. Agarwal US, Saran J, Agarwal P. Clinico-mycological study of dermatophytes in a tertiary care centre in northwest India. Indian J Dermatol Venereol Leprol 2014;80:194
14. Singh S, Beena PM. Comparative study of different microscopic techniques and culture media for the isolation of dermatophytes. Indian J Med Microbiol 2003;21:21-4
15. Ranganathan S, Menon T, Sentamil GS. Effect of socioeconomical status on the prevalence of dermatophytosis in Madras. Indian J of Dermatol Venereol Leprol. 1995;61:16–8
16. Dutta B, Rasul ES, Boro B.Clinico-epidemiological study of tinea incognito with microbiologicalcorrelation. Indian J Dermatol Venereol Leprol 2017;83:326-31
17. Nawal P, Patel S, Patel M, Soni S, Khandelwal N. A Study of Superficial Mycoses in Tertiary Care Hospital. NJIRM 2012;3(1):90-3
18. Kim WJ, Kim TW, Mun JH, Song M, Kim HS, Ko HC et al. Tinea incognito in Korea and its risk factor: nine year multicenter survey. J Korean Med Sci 2013;28(1):145-51
19. Gopichand WR, Babulal JU, Madhukar SR. Mycological profile of superficial mycoses in north Maharashtra, India. Int J Health Sci Res 2013;3:90-4
20. Luchsinger I, Bosshard PP, Kasper RS, et al. Tinea genitalis: a new entity of sexually transmitted infection? Case series and review of the literature. Sex Transm Infect 2015;91:493–6
21. Bhavsar HK, Modi DJ, Sood NK, Shah HS. A study of Superficial Mycosis with clinicomycological profile in tertiary care hospital in Ahmedabad, Gujarat. Nat J Med Res 2012;2:160-4
22. Balakumar S, Rajan S, Thirunalasundari T, Jeeva S. Epidemiology of dermatophytosis in and around Tiruchirapalli, Tamil nadu, India. Asian Pac J Trop Dis 2012;2(4):286–9
23. Sharma M, Sharma R. Profile of dermatophytic and other fungal infections in Jaipur. Indian J Microbiol 2012;52(2): 270-4
24. Summana V, Singaracharya MA. Dermatophytes in Khammam (Khammam district, Andra Pradesh, India). Indian J Pathol Microbiol 2004;47:287-9
25. Bindu V, Pavithran K. 2002. Clinico -mycological Study of Dermatophytosis in Calicut. Indian J. Dermatol Venereol Leprol 2002;68:259-61
26. Grover WCS, Roy CP. Clinico-mycological profile Of Superficial Mycoses in a Hospital in North-East India .Medical J Armed Forces India 2003;59:2:114-6
27. Patwardhan N, Dave R. Dermatomycosis in and around Aurangabad. Indian J Pathol Microbiol 1999;42:455-62
Gupta BK, Kumar S, Kumar RA, Khurana S. Mycological aspects of dermatomycosis in Ludhiana. Indian J Pathol Microbiol. 1993;36(3):233-7
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