Update on the epidemiology of dermatophytosis in Isfahan, Iran over the past decade.

Background: Dermatophytes, keratinolytic fungi causing tinea (ringworm), are a major global cause of skin infections, affecting 20-25% of the population. This study updates the epidemiological profile of dermatophytosis in Isfahan, Iran, from 2013 to 2023, focusing on prevalence, and species distribution.

Methods: This retrospective study analyzed 22,198 clinical samples from 2013 to 2023 at a reference medical mycology laboratory in Isfahan, Iran. Patient data, including demographics and infection sites, were recorded. Samples from skin, nails, and hair were examined using KOH direct microscopy and cultured on Sabouraud agar media with chloramphenicol and cycloheximide.

Results: Over the decade, 22,198 clinical samples were analysed, of which 5,038 (22.7%) were confirmed by microscopy as dermatophytosis. Tinea corporis (22.79%) and tinea capitis (21.3%) were the most prevalent infections. Most cases occurred in females (58.57%) and individuals aged 41-50 years. High-risk groups included housewives, farmers, and livestock handlers. Among 770 cultured samples, Trichophyton mentagrophytes complex was the most common species.

Conclusion: This study provides valuable insights into the epidemiology and clinical trends of dermatophytosis in Isfahan, Iran, over the past decade. Among the cultured cases, the T. mentagrophytes complex was the most frequently isolated species, suggesting a possible shift in the causative agents of tinea infections. However, since most confirmed cases were not cultured, the species distribution in the broader population remains uncertain. Further research using molecular identification and investigation of environmental factors will help improve our understanding and management of these infections.