[Profile of fungal species involved in superficial cutaneous mycoses in Lomé (Togo)].

Abstract

Introduction: The diagnosis of superficial cutaneous mycosis (SCM) is very frequently evoked during dermatological consultations in tropical zones, but mycological confirmation is very rarely performed routinely. The aim of this study is to describe the profile of fungal species encountered during dermatology consultations in Lomé (Togo), to establish their relative frequencies and, above all, to discuss their responsibility in the lesions observed.

Method: This was a descriptive study carried out from February 2020 to March 2022, involving patients presenting lesions suspected of MCS, seen in dermatological consultations. Three dermatological consultation centers, all located in the city of Lomé, served as the setting for case enrollment. Each patient consulted who met the inclusion criteria (i.e. presenting a lesion of SCM and not under antimycotic treatment or having respected an adequate therapeutic window) had a sample taken from the suspected lesion(s). Samples were taken on site and analyzed at the Mycology Laboratory of CHU Sylvanus Olympio for biological confirmation.

Results: During the study period, 565 patients were enrolled and sampled, of whom 364 (64.4 %) were women. The median age was 31 years, with interquartile range (IQR) from 22 to 41 years. Direct examination and/or culture were positive in 84.7 % (479/565) of cases. The main fungal species identified were yeasts (63%), including Malassezia sp. (23.8%), other yeasts (39.2%), but also dermatophytes (22.8%), with Trichophyton mentagrophytes as the predominant species (10.8%), and molds (13.1%) including Aspergillus niger and A. fumigatus (3.1% each). Pseudo-dermatophytes were found in only 1% of cases. Fungal associations were also noted in 3.5% of cases. The most frequent associations were C. tropicalis, A. fumigatus and T. mentagrophytes-C. albicans, each found in 0.5% of cases.

Conclusion: The spectrum of fungi isolated in suspected cases of SCMs in Lomé is broad, but not all can be held responsible for the lesions observed. This diversity makes it essential to take a mycological sample for accurate identification of the fungus in any suspected case of SCM. Depending on the species isolated, this will enable treatment to be tailored to the patient's needs.