Prevalence of Dermatophytic Infection in and around Ahmedabad

Rugved Parmar*

* 3rd year student, B.J.Medical College, Ahmedabad, Gujarat

Corresponding Author E-mail:parmarrugved@gmail.com

ABSTRACT
Dermatophytosis is considered as one of the major public health problems affecting
millions of people in the world and is the most commonly diagnosed skin disease.
Dermatophytes are a group of closely related keratinophilic fungi that can invade keratinized
humans and animals tissues such as skin, hair and nails causing dermatophytosis. They are an
important cause of superficial fungal infection. These infections occur in both healthy and
immune compromised patients. Dermatophytes are responsible for most cutaneous fungal
infections To determine the prevalence of dermatophytic infection and sensitivity of different
diagnostic procedures among the affected skin patients of Ahmedabad district. In present study,
50 samples of skin scrapings/hairs/nail lesions from affected human beings were screened by
standard techniques. Total 50 specimens were collected based on clinical presentations
irrespective of age and sex. The diagnosis was confirmed by microscopic examination using 10-
20% potassium hydroxide (KOH) and culture on Sabouraud’s dextrose agar medium. Out of 50
samples, 29(58.00%) were found positive by culture and microscopic method. Analysis of 50
samples, The prevalence of dermatophytes in humans were recorded. Among the Dermatophytes
the maximum isolates were Trichophyton verrucosum 24.00% (12/50) followed by Trichophyton
rubrum 24.00% (12/50), Trichophyton mentagrophytes 2.00% (4/50) and Microsporum canis
2.00% (1/50). The result of this study shows higher prevalence of dermatophytosis in both
genders in this area. An accurate diagnosis can help in proper and effective treatment of
dermatophytosis. The result of this study shows higher prevalence of dermatophytosis in both
genders in this area. An accurate diagnosis can help in proper and effective treatment of
dermatophytosis.

Key words: Dermatophytes, SDA. Ringworms, Dermatophytic infection, Microscopy, Culture

INTRODUCTION

Dermatophytes are responsible for most cutaneous fungal infections and the estimated
lifetime risk of acquiring dermatophytic infection. The dermatophytosis could be a potential
source of zoonotic infections causing a serious public health problem. The farmers/ pet owners
are more susceptible to get this infection from their Animals/ pets, because of the close contact
with them. Skin infections are common diseases in developing countries, of which
dermatophytosis are of particular concern in the tropics. Dermatophytes consist of three genera,
Trichophyton, Microsporum, and Epidermophyton. Worldwide the most common cause of Tinea
pedis, Tinea unguium (onychomycosis), Tinea cruris, Tinea mannum, tinea corporis, and tinea
faciei is Trichophyton rubrum. Other frequently implicated agents include Trichophyton
mentagrophytes, Microsporum canis, Microsporum gypseum and Epidermophyton
floccosum(Monod et al., 2002; Pal,2017 ). The laboratory diagnosis of dermatophytosis routinely
involves direct microscopic examination of clinical specimen followed by in vitro culture
techniques. Microscopic identification of fungal elements directly from clinical specimen is a
rapid diagnostic method. In vitro culture is a specific diagnostic test, but it is a slow technique.
The advent of molecular technology has enabled the development of techniques like polymerase
chain reaction which is a highly sensitive and specific test and can be used for diagnosis of
fungal infections (Parmar and Dhami, 2007). The prevalence of disease varies in different
geographical areas. The aim of this study was to determine the prevalence of dermatophytic
infections and diagnosis by microscopy and culture methods in and around Ahmedabad.

Materials and Methods: This study was done during a period 2 months of February and March,
2020 in and around Ahmedabad. Total 50 samples were collected from clinically suspected
dermatophytosis patients.

Specimen collection and processing: Skin samples were collected carefully by scraping, after
disinfection with 70% alcohol solution using a sterile scalpel. The scrapings were collected on a
piece of sterile white paper and then folded, labelled and brought to the laboratory for further
processing. Confirmation of the clinical diagnosis was based on microscopic examination and
culture. All necessary precautions were taken to avoid any contamination during collection,
transport, and identification of organisms.

All the collected specimens were examined microscopically using 20% potassium
hydroxide (KOH) for the presence of filamentous, septate, branched hyphae. Isolation of positive
samples were done by using Sabouraud’s dextrose agar medium with antibiotics and incubated at
28°C for 2−3 weeks and examined at 2 to 3 day intervals for fungal growth. Identification of
fungi was made on the basis of phenotypic characteristics of the colonies and microscopic
examination (Murmu et al., 2015; Nasimuddin et al., 2015)

Result and discussion

Out of total 50 specimens 29(58.00%) showed positive growth of dermatophytes. Among
the 42 skin specimens 27 (64.29%) were positive and among the 8 nail specimens 2 (25.00 %)
were positive (Table I). This study found that most (64.29%) of the dermatophyte-infected cases
were in skin specimens of humanbeings followed by 25.00 % were in nail specimens. In this
study, out of 50 specimens, 29(58.00%) were found positive by microscopic examination KOH
test as well as by cultural method on SDA medium (Table II). The overall species wise
prevalence of Dermatophytes in human population were Microsporum canis (27.59%),
Trichophyton mentagrophytes (24.14%), Trichophyton rubrum (27.59%) and Trichophyton
verrucosum (20.69%).
Table I: Prevalence of dermatophytes from skin and nail samples (n=50)
Types of Number Positive growth No growth
specimens (%) n (%) n (%)
Skin 42 (84.00) 27 (64.29) 15 (35.71)
Nail 08 (16.00) 02 (25.00) 06 (75.00)
Total 50 (100.00) 29 (58.00) 21 (42.00)

Skin
Nail

Table II: Prevalence of dermatophytes by culture and microscopy

Methods Positive Negative Total
n (%) n (%) n (%)
Culture 29 (58.00) 21(42.00) 50(100.00)

Microscopy 29 (58.00) 21(42.00) 21(100.00)

Table III: Overall species wise prevalence of Dermatophytes in human

population

Dermatophytes Human Prevalence

(%)
Microsporum canis 08 27.59
Trichophyton mentagrophytes 07 24.14
Trichophyton rubrum 08 27.59
Trichophyton verrucosum 06 20.68
Total 29 100
 30
25
20
15
10
5
0

Dermatophytosis is considered as one of the major public health problems in the world
and is the most commonly diagnosed skin disease in India. The prevalence and characteristics of
Dermatophyte infections vary with climatic conditions, age, and lifestyle and population
migration patterns (Islam et al., 2018). Islam and co-worker studied the prevalence of
Dermatophyte specimen (Nail and skin) collected from the hospital patients. Out of 80 samples
31 (38.75%) were found positive by culture and 21 (26.25%) were found positive by microscopic
method which were also found positive by culture method. Terefe et al. 2017 studied prevalence
of dermatophytosis, skin scabs were collected directly into petridish plates from the clinical
lesions of the animals by using gloves and scalpel blade from the total of 384 animals (Holstein
Frisian) selected. Out of that 167 (43.39%) animals were positive for dermatophytosis by KOH
test as well as by cultural method on SDA. In India Jayanthi et al., 2016 studied the incidence
rate and cultural characteristics of Dermatophytes from human sample. Study involved 60
patients, fungal elements were seen in 20 cases by KOH mount examination test and
dermatophytes grew in 17out of 20 samples. The overall positivity rate was 33%.

Murmu et al., 2015 collected 362 Dermatophyte suspected samples from cat (202), dog
(123) and human beings (37).A total of 285 (78.7%) samples were found to be positively
infected with different dermatophytes. Prevalence of infection was the highest in cats (158,
55.5%) than dogs (108, 37.8%) and human beings (19, 6.7%). The incidence of Microsporum
canis (60.0%) was the highest from affecting dogs, cats, and human beings in comparison to
Microsporum gypseum (22.5%), Trichophyton mentagrophytes (15.8%) and Trichophyton
rubrum (1.7%). The incidence of Microsporum canis (60.0%) was the highest from affecting
dogs, cats, and human beings in comparison to Microsporum gypseum (22.5%), Trichophyton
mentagrophytes (15.8%) and Trichophyton rubrum (1.7%).

Conclusion:
Among all Dermatophytes, maximum isolates were of Trichophyton verrucosum from
cattle and minimum isolates were of Microsporum canis from dogs. Trichophyton verrucosum is
a cosmopolitan zoophilic species of fungi that causes ringworm in cattle and other farm animals,
from which human become infected. In the present work more numbers of isolates were
recovered by use of Dermatophyte Test Medium (DTM). Thus, Dermatophyte Test Medium
(DTM) is advocated for the regular confirmative diagnosis of dermatophytosis.

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Tinea cruris infection(Trichophyton verrucosum )