{"title":"Clinico-Mycological Study of Dermatophytosis among Diabetic and Non-Diabetic Patients in a Tertiary Level Hospital: A Comparative Study.","authors":"Abarna Rajagopal, Rangappa Vinutha, Padubidri Kombettu Ashwini, Veeranna Shastry, Chitharagi B Vidyavathi","doi":"10.4103/ijd.ijd_1111_23","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Dermatophytosis is a major public health concern in India, especially in recent years, with an alarmingly rising trend, particularly in relation to recurrent and chronic infection. The number of studies examining the relationship between an individual's glycemic status and the development of dermatophytosis, and a comparison of the evolving species trend between diabetic and non-diabetic patients infected with dermatophytes, is limited.</p><p><strong>Aims and objectives: </strong>To study and compare the clinical and mycological aspects of dermatophytosis among diabetic and non-diabetic patients and to compare the culture isolates in both groups.</p><p><strong>Materials and methods: </strong>The study included 378 patients of clinically suspected dermatophytosis, divided into two groups of 189 known diabetics and non-diabetics each. We subsequently analysed and compared the demographics, clinical data, potassium hydroxide (KOH) mount, calcofluor white (CW) staining and fungal culture results of all patients in both groups.</p><p><strong>Results: </strong>Among the 378 patients, diabetic patients had a significantly greater extent of involvement and higher rates of recurrence when compared to non-diabetics. The overall positivity rate was higher in CW staining (77.8%) as compared to KOH (57.7%) in both non-diabetics and diabetics. <i>Trichophyton mentagrophytes</i> was the most common isolate (47.6%) in both diabetic (55.0%) and non-diabetic (61.4%) patients, followed by <i>Trichophyton rubrum</i> (31.8% and 29.6%, respectively). The positivity percentages of fungal culture, KOH and CW staining increased to 100%, 77.9% and 95.7%, respectively, when scrapings were taken from ≥2 sites.</p><p><strong>Conclusion: </strong>The pattern of dermatophytosis is comparatively more chronic and severe in diabetics compared to non-diabetics. <i>T. mentagrophytes</i> was the most common culture isolate in both groups. CW staining can potentially be used as the initial method of choice for the diagnosis of dermatophytosis as it has significantly outperformed the conventional KOH mount. Scrapings can regularly be taken from ≥2 sites to avoid false negative results.</p>","PeriodicalId":13401,"journal":{"name":"Indian Journal of Dermatology","volume":"69 6","pages":"486"},"PeriodicalIF":1.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642451/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Dermatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/ijd.ijd_1111_23","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/29 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"DERMATOLOGY","Score":null,"Total":0}
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Abstract
Background: Dermatophytosis is a major public health concern in India, especially in recent years, with an alarmingly rising trend, particularly in relation to recurrent and chronic infection. The number of studies examining the relationship between an individual's glycemic status and the development of dermatophytosis, and a comparison of the evolving species trend between diabetic and non-diabetic patients infected with dermatophytes, is limited.
Aims and objectives: To study and compare the clinical and mycological aspects of dermatophytosis among diabetic and non-diabetic patients and to compare the culture isolates in both groups.
Materials and methods: The study included 378 patients of clinically suspected dermatophytosis, divided into two groups of 189 known diabetics and non-diabetics each. We subsequently analysed and compared the demographics, clinical data, potassium hydroxide (KOH) mount, calcofluor white (CW) staining and fungal culture results of all patients in both groups.
Results: Among the 378 patients, diabetic patients had a significantly greater extent of involvement and higher rates of recurrence when compared to non-diabetics. The overall positivity rate was higher in CW staining (77.8%) as compared to KOH (57.7%) in both non-diabetics and diabetics. Trichophyton mentagrophytes was the most common isolate (47.6%) in both diabetic (55.0%) and non-diabetic (61.4%) patients, followed by Trichophyton rubrum (31.8% and 29.6%, respectively). The positivity percentages of fungal culture, KOH and CW staining increased to 100%, 77.9% and 95.7%, respectively, when scrapings were taken from ≥2 sites.
Conclusion: The pattern of dermatophytosis is comparatively more chronic and severe in diabetics compared to non-diabetics. T. mentagrophytes was the most common culture isolate in both groups. CW staining can potentially be used as the initial method of choice for the diagnosis of dermatophytosis as it has significantly outperformed the conventional KOH mount. Scrapings can regularly be taken from ≥2 sites to avoid false negative results.
期刊介绍：
The journal publishes information related to skin-pathology and different modes of therapeutics, including dermatosurgery and cosmetic dermatology. Likewise, it carries articles on leprosy, STI and HIV/AIDS. The editorial board encourages the authors to publish articles addressing emerging techniques and developments in the subject specialty, in the form of Original investigations, Narrative and Systematic Reviews as well as Case Reports. The journal aims at publishing Editorials and Commentaries from eminent personalities on a regular basis.
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