Clinicomycological pattern of dermatomycosis – A two-year retrospective study in a tertiary care hospital of north India

Abstract

Fungal infections are a growing cause of concern in both hospital and non-hospital settings all over the world. Fungal infections are often characterized by the location of the infection. These may be referred to as superficial, subcutaneous, or systemic, which is also referred to as deep-seated. Dermatomycosis are superficial fungal infections of the skin & or its appendages.This study was undertaken to determine: 1) The predominant dermatophytes and non dermatophytes causing dermatomycosis. 2) The clinicomycological profile of dermatomycosis.641 samples from clinically suspected cases of dermatomycosis including the skin, hair, and nail samples were collected. All the relevant clinical, demographic, and epidemiological details were noted. Samples were then subjected to direct microscopy and fungal culture.Of the total 641 cases, 337 (52.6%) were males and 304 (47.4) were females (Table 1). The most commonly affected age group was 20–39 years (51%). Out of total, 340 (53%) were nail samples, 283 (44.1%) were skin samples, and 18 (2.9%) were hair samples. Onychomycosis was the commonest clinical presentation (48.8%) followed by Scaly skin lesions (13.1%). Moreover, Tinea corporis was seen in 10.3%, Tinea cruris in 5.3% cases. KOH wet mount was performed on all 641 samples with 230 (35.9%) showing positive results. Whereas, 312 (48.7%) were positive by culture. the most common Fungi isolated in our study were Dermatophytes n=154 (49.4%), followed by Non-dermatophyte molds (NDMs) n=93 (29.8%) and Yeasts n=65 (20.8%).A combination of direct microscopy and culture was found to be superior than direct microscopy and culture alone. The recovery of NDMs and yeasts from routine dermatological samples in addition to the usual suspects, dermatophytes, also increases the awareness and suspicion among clinicians and mycologists to look beyond dermatophytes as the lone cause of superficial skin infections. Additionally, given the geographical location of Kashmir valley and its temperate climate with extremely cold winters (November to March) and a relatively milder summer with moderate humidity levels, when compared to the rest of northern Indian states doesn’t make it a suitable environment for fungal infections, more so the superficial mycosis. That said, people at risk are always vulnerable to develop fungal infections.