Ancient Science of Life, Vol No. XII Nos.

1 & 2, July – October 1992, Pages 221 - 226

ON THE INCIDENCE OF RAKTAJA KRIMI (DERMATOPHYTES) IN

CHHINDWARA, MADHYA PRADESH
M. K. RAI and K.K.SHRIVASTAVA

Microbiology Research Lab; Danielson College, Chhindwara – 480 001, Madhya Pradesh,
India

Received: 27 January, 1992 Accepted: 10 February, 1992

ABSTRACT: A survey of Raktaja Krimis of Chhindwara was made during July, 1986 to June,
1987. Tinea infections were abundant followed by Tinea cruris, Tinea pedis, Tinear capitis,
Tinea barbae, and Tinea unguinum. Tinea infections were common among the youth between 21
– 30 years. The percentage wise tinea infections were as follows : Trichophyton rubrum
(64.5%), T. mentagrophytes (5.37%), T. violaceum (1.07%), Epidermophyton flocceum
(18.12%), Micrisporum gypseum (7.52%) and M. nanum (5.37%).

INTRODUCTION

The word Krimi has been derived from the
word Kram with suffix in which means
worms rightly called as ring – worms or
dermatophytes. These are members of
form-class deuteromycetes of fungi.
However, some of species of dermatophytes
which produce ascospores have been
included in family Gymnoascaceae class
Ascomycetes. All the dermatophytes show
keratinolytic activity which helps them to
parasitizenalis, hair and skin causing
diseases known as dermatophytosis, tineas
or commonly called as ring worm1-3. Ring
worm can be differentiated by other skin
diseases by its characteristic raised scale
edge and central clearing and in males it is
often seen on the inner thighs confined to
the anatomical limits of the scrotum.
Majority of the dermatophytes are
cosmopolitan in distribution. However,
some species are endemic. Dermatophytes
are host specific. They can be categorized
as; zoophilic (which parasitize animals of
lower order), anthropophilic (which
parasitize human beings), and geophilic
(which are inhabitants of soil). The latter
rarely cause diseases in human beings4-7.
Many geophilic species which never cause
skin diseases in human beings and belong to
Trichophyta, Epidermophyton and
Microsporum should not be included in
dermphytes. Dermatophytes infections of
the skin produce reactions that vary from
mild to erythema and scalling to severe
vesicular, heavily crusted, suppurative or
rarely granulomatous lesions. The infections
may be itchy and painful. Ring-worm
infected nails are deformed, discoloured, and
thinckened. Infections in the bearded areas
are frequently suppurive and painful. The
scalp infections are characterized by circular
lesions with less hair, erythema, scalling,
vesiculations and suppuration. The
prevalent species of dermatophytes vary
considerably in different geographical
regions of the world. So far, there is no
comprehensive report of dermatophyte
infections, except, some investigators8-11,
from Madhya Pradesh. It is therefore, the
present research work was undertake.
MATERIALS AND METHODS

Pages 221 - 226


During July, 1986 to June, 1987 various
periodical surveys were made in different
hostels, schools, and hospitals, etc., to
collect the scrapings of tinea infections. The
details regarding sex, age, date of collection,
habits duration and periodically of the
disease, suspected fungus, and earlier
treatment given if any, were recorded in a
note book. The diagnosis of the tinea
infections was based on the site of infection.
For collection of the scrapings, the margins
of the infected parts were swabbed with
70% alcohol to remove surface
contaminants, and topical medication that
might be present. A flame sterilized scalpel
was used to scrape the active edges of the
lesion. These scales were kept in white
paper envelops or blotting paper envelops
for transfer of the scales were kept in white
paper envelops or blotting paper envelops
for transfer of the scales to the laboratory.
Some infected scales were observed directly
in the laboratory and others were kept for
isolation of the dermatophytes associated
with the scales. For direct microscopic
examination, a portion of the scrapings was
placed on the slide containing 10% KOH
solution and the gently heated. Thereafter,
the fungal hyphae were observed. In
addition to lactophenol, cotton blue was
used for mounting and staining. Isolation
was done by inoculation of the clinical
material on Sabouraud’s dextrose agar
medium (Dextrose – 40g, peptone – 10g,
agar-20g, distilled water-1,000ml, pH-5.6
supplemented with cycloheximide and
chloramphenicol under aseptic conditions).
Three replicates were maintained for each
case. The isolates were incubated at 28±20C
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for 2-weeks. The slides were prepared in
lactophenol cotton-blue for cultural studies.
Identification of the dermatophytes was
based on morphological and cultural studies.
RESULTS
During the survey of dermatophytes 307-
cases were examined. The highest
percentage of dermatophytes was observed
in August, while in March it was lowest.
Tinea corporis was most prevalent followed
by tinea cruris, tinea pedis, tinea capitis,
tinea unguinum and tinea barbae (Table 1).
In the present studies, it was found that
frequency of dermatophytes was
comparatively higher in males. But in case
of tinea pedis the condition was just reverse.
Tinea infections were abundant in the age
group 21 – 30 years, whereas their
percentage was lower in case of children
below 10 – years followed by people of 41 –
years onward (Table 2.)
Direct microscopic examination of infected
specimens showed that 48.85%v cases were
KOH positive, 51.14% KOH negative,
30.29% culture positive and 69.70% culture
negative (Table 3). All the isolates were
categorized under three genera viz.,
Trichophyton, Epidermophyton, and
Microsporum. Trichophyton includes – T.
rubru,. T mentagrophytes and T. violaceum,
T. rubrum (64.5%) was found to be a
common dermatophyte followed by
Epidermophyton floccosum (16.12%),
Microsporum gypseum (7.52%),
Microsporum nanum (5.37%),
t.mentagrophytes (5.37%) and T.violaceum
(1.07%) (Table 4).
 TABLE – 1

Periodicity of tinea infections in Chhindwara during 1986 – 1987.

Month Year No. T. corporis T. crurius T. pedis T.capitis T.unguinum T.barbae

of M F M F M F M F M F M F
July 1986 35 10 4 14 1 1 2 1 0 1 0 1 0

August 1986 43 13 5 13 1 3 4 1 2 0 0 0 0

September 1986 34 11 3 14 1 1 2 2 0 0 0 0 0

October 1986 28 7 3 11 1 1 2 1 1 1 0 0 0

November 1986 26 6 4 10 0 2 2 1 1 0 0 0 0

December 1986 24 6 3 9 1 1 2 1 1 0 0 0 0

January 1987 23 6 4 5 1 1 2 1 2 1 0 0 0

February 1987 19 5 4 6 0 1 2 0 1 0 0 0 0

March 1987 17 4 1 7 0 2 1 0 1 0 0 1 0

April 1987 19 7 2 6 0 2 1 1 0 0 0 0 0

May 1987 20 5 2 7 2 1 2 1 0 0 0 0 0

June 1987 18 5 2 7 1 1 1 0 0 0 0 1 0

Total 307 85 37 109 10 17 23 10 9 3 0 4 0

Grand Total 307 122 119 40 19 3 4
Total% 39.73% 38.76% 13.02% 6.18% 0.97% 1.30%

TABLE – 2

Relation between tinea infections and age

Tinea types Age range of patients (years)

0 – 10 11 – 20 21 – 30 31 – 40 41 – 50 51 – 60
Tinea corporis 10 23 43 26 11 9

Tinea cruris 5 22 48 28 9 7

Tinea pedis 1 4 10 19 4 2

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Tinea capitis 12 4 2 1 0 0

Tinea unguinum 0 0 1 2 0 0

Tinea barbae 0 0 2 1 1 0

Grand Total 28 53 106 77 25 18

Percentage 9.12% 17.26% 34.52% 25.08% 8.14% 5.86%

TABLE – 3

KOH positive and culture positive cases with reference to clinical types.

Tinea infection Total No. of No. of KOH No. of KOH No. of Culture No. of Culture
samples ‘-’ cases ‘+’ cases ‘-’ cases ‘+’ cases

Tinea corporis 122 63 59 85 37

Tinea cruris 119 54 65 83 36

Tinea pedis 40 22 18 28 12

Tinea capitis 19 13 6 13 6

Tinea unguinum 3 2 1 2 1

Tinea barbae 4 3 1 3 1
Grand Total 307 157 150 214 93
Percentage 51.14% 48.85% 69.70% 30.29%

TABLE – 4

Corelation between clinical and mycological studies

Clinical types Dermatophytes

TR TM TV EF MG MN Total
Tinea corporis 25 2 1 5 2 2 37

Tinea cruris 24 2 0 9 1 0 36

Tinea pedis 6 1 0 1 2 2 12

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 Tinea capitis 3 0 0 0 2 1 6

Tinea unguinum 1 0 0 0 0 0 1

Tinea barbae 1 0 0 0 0 0 1

Total 60 5 1 15 7 5 93
Total percentage 64.5% 5.37% 1.07% 16.12% 7.52% 5.37%

Tr = Trichophyton rubrum, TM = Trichophyton mentagrophytes, TV = Trichophyton

violaceum, EF = Epidermophyton flccosum, MG = Microsporum gypseum, MN = Microsporum
naum

DISCUSSION

In the present investigation, it was found
that tinea infections were observed in 307
cases during one year duration in
Chhindwara, which agrees with the previous
reports from other places of the country
(9.12). Among all the clinical types, Tinea
corporis followed by tinea cruris were most
common. The high incidence of these
clinical entity was reported from Jabalpur
(11). In youths, tinea cruris was a common
clinical type. Besides, this clinical type was
also observed in children below 10 year.
The dermatophytes spread among the family
members from olders to youngers by direct
contract of towels, napkins, shoes and under
garments (14). The incidence of tinea
capitis was 6.18%. In comparison to other
clinical types, tinea capitis was found to be
less common in India especially in north
(10, 11, 15, 16, and 17). In contrast, in
South India, tinea capitis was endemic
during November, 1973 to October, 1976
(13). Use of different types of vegetable oil
in north and south India may be a factor
responsible for variation in the incidence of
tinea capitia as it is evidenced by its low
incidence in north where most of the people
use mustard oil. Hajini et al (15) suggested
that mustard oil checks the growth of
dermatophytes, and also inhibits the
penetration of hair by dermatophytes. In
children, the percentage of tinea capitis was
higher in comparison to tinea cruris (11).
According to George (18) and Perlman (19)
the adult immunity to tinea capitis is due to
long chain odd numbered fatty acids in the
post pubertal sebum which has got
fungistatic nature. The high incidence of the
dermatophytes was observed in males in
comparison to females which concur with
the findings of Shukla et al. (11). It was
suggested by Philpot (20) that Men are more
vulnerable to infection than females.
Further, it is considered that the higher
frequency of dermatophytes is due to greater
exposure of males to the environment.
Tinea pedis was found to be common among
females. It is assumed that women are
comparatively greater in touch with water in
contrast, English (21) reported that she
could not observe any difference between
male and female in the distribution of tinea
pedis.
The survey of dermatophytes showed that
T.ubrum was abundant (64.5%). Srivastava
and Gupta (17), and Shukla et al. (11)
reported the higher incidence of T.rubrum in
Lucknow and Jabalpur, respectively.
However, the infections of Microsporum
were comparatively low.

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It is clear from the present studies that for a
rational approach to chemotherapy it is a
must to isolate and identify the
dermatophytes. Further, it is concluded that
for real and authentic diagnosis it is
important that a medical practitioner should
always have a intimate association with a
medical mycologist.
ACKNOWLEDGEMENTS
We are grateful to Dr. R. C. Rajak, and to
Dr. S.M. Singh, Department of P.G. Studies
and Research in Bio Sciences, Rani
Durgawati Vishwa Vidyalay, Jabalpur for
encouragement, to Professor L. M. Lall for
laboratory facilities, and to Department of
Science and Technology for providing
financial support for the present research
work.

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