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STUDIES
Year : 1995  |  Volume : 61  |  Issue : 1  |  Page : 16-18

Effect of socio-economic status on the prevalence of dermatophytosis in Madras




Correspondence Address:
S Ranganathan


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Source of Support: None, Conflict of Interest: None


PMID: 20952864

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  Abstract 

A total of 462 patients living in varying socio-economic conditions were screened for tinea infection. 372/462 (70.7%) were found to be culture positive for dermatophytes. Trichophyton rubrum was the most frequently isolated dermatophyte. 35% of the infected cases were from the very low income group (group-I), 34.2% from low income group (group-II), 23.3% from middle income group (group-III) and 1.8% from moderately rich group (group-IV). Recurrent, chronic and extensive dermatophytosis were found to be most common in group-I (20.3%) and group-II (17.8%), whereas localized infections were common in group-IV (66.6%) and group-III (65.7%). Recurrence chronicity were more frequent in tinea cruris and tinea corporis. The present study suggests that group-I and group-II may be the likely reservoirs of human ringworm infections in Madras


Keywords: Socio-economic status; Dermatophytosis


How to cite this article:
Ranganathan S, Menon T, Sentamil G S. Effect of socio-economic status on the prevalence of dermatophytosis in Madras. Indian J Dermatol Venereol Leprol 1995;61:16-8

How to cite this URL:
Ranganathan S, Menon T, Sentamil G S. Effect of socio-economic status on the prevalence of dermatophytosis in Madras. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2019 Nov 14];61:16-8. Available from: http://www.ijdvl.com/text.asp?1995/61/1/16/4117



  Introduction Top


Dermatophytes are the major agents of cutaneous mycoses and remain a general public health problem.[1][2][3] High rate of humidity, over-population and poor hygienic conditions are ideally suited for the growth of dermatophytes. Hence we planned to study the effect of socio-economic status on the prevalence of dermatophytosis in Madras.


  Materials and Methods Top


Out of 462 patients, 442 were patients attending Dermatology, Madras Medical College, Madras and 20 cases were from Taramani village, Madras. Each case was studied clinically and was classified according to age and sex of the patient, and site and extent of the lesion. Detailed case history was taken with reference to occupation, income, hygienic practices adopted by them, other members of the family having same infection, previous treatment, if any and presence of domestic animals etc.

According to income and occupation, the patients were divided into four major groups (group-I to group-IV). The group-I (very low income) patients were mainly daily wage labourers, porters and scavengers. The group-II (low income) patients were mainly peons and sweepers. The group-III (middle income) patients were police officials, clerks and nurses. The group-IV (moderately rich patients were teachers and bank officials. Skin scrapings was taken for culture and identification of species was done using standard procedurs.[1],[2],[4]


  ]Result Top


327/462 patients (70.7%) were culture positive for dermatophytes. Trichophyton rubrum was the most frequently isolated species (52.2%), followed by Trichophyton mentagrophytes granular type (zoophilic) (15.59%), Trichophyton mentagrophytes floccose type (13.76%) and Epidermophyton floccosum (6.11%) [Table - 1].

Majority of the patients with dermatophyte infections belonged to the very low and low income groups (35% and 34.2%) respectively, followed by middle income group (23.2%). Incidence of dermatophytosis was only 1.8% in moderately rich group.

It was found that, chronic tinea was most common in group-I (20.3%) and group-II (17.85%), followed by group-Ill (7.8%). No chronic infections were recorded in group-IV 88.2% of patients with chronic tinea were between 20 to 60 years of age.

Recurrence of tinea infection was also most common in group-I (72.%), group-II (69.6%), followed by group-IV (33.3%) and group-Ill (26.3%).

Recurrence and chronicity were found to be most common in tinea cruris and tinea corporis (waist region in women).

Extensive dermatophytosis was seen only in group-I (5.2%) and group-II (3.5%). These patients were either diabetics, HIV cases or were patients undergoing treatment with immuno-supressive drugs before transplantation [Table - 2].


  Discussion Top


A study of dermatophytosis in a population is important as it may reflect the climatic condition, customs, hygienic and socio-economic status of people.[5] The present study reveals that ringworm infection was most common in very low and low income groups and less common in moderately rich group. Similar findings were reported in Kuwait.[6] One of the reasons why the group-I and group-II were most affected with ringworm may be the prevalence of poor hygienic practices. Only severe or chronic infection compelled the patients to attend the hospital, while early lesions remained neglected and unnoticed. Similar findings was reported by previous workers from India.[7]

Recurrence and chronicity were observed to be more frequent in tinea cruris and tinea corporis (waist region in women). Complete unaeration due to tight clothing, maceration and high rate of sweating in groin and waist regions makes these sites more vulnerable to dermatophytosis.[2] Constant sweating keeps the temperature in these regions at 27C.

It was found that changing and washing the undergarments were practiced only very rarely in group-I and group-II, which accounted for the increase of incidence of dermatophytosis in groin and waist regions. Similar findings was reported by previous workers from India.[7],[8]

Griseofulvin is used for the treatment of tinea infections but most patients in group-I and group-II discontinue the treatment after 2-3 days, which leads to chronicity. Family centred infections and intimate association with various pet animals were also recorded in group-I and group-II.

The present study suggests that, the people of very low and low income group (group-I and group-II) may be the likely reservoirs of human ringworm infections in Madras. There exalted niche in the society further facilitates the dissemination of infection to others. Awareness of general public health and better hygienic practices may be the possible preventive measurs of the disease.


  Acknowledgments Top


The authors are thankful to Lady Tata Memorial Trust, Bombay, for funding the study.

 
  References Top

1.Emmons CW, Binford CH, Utz JP, Kwon-Chung KJ. Medical Mycology, 3rd edn. Philadelphia; Lea & Febiger, 1977;117-67.  Back to cited text no. 1    
2.Rippon JW. The pathogenic fungi and the pathogenic Actinomycetes, Philadelphia; W B Saundes Co, 1982;154-248.  Back to cited text no. 2    
3.Venugopal PV, Venugopal T V. Antimycotic susceptibility testing of dermatophytes, Ind J Med Microbiol. 1993;11:151-4.  Back to cited text no. 3    
4.Larone DH. Medically Important Fungi - A guide to identification, Hagerstown : Harper & Row Publishers, 1976;1-144.  Back to cited text no. 4    
5.Attapattu MC. A Study of tinea capitis in Sri Lanka, Mycol 1982;27:27-32.  Back to cited text no. 5    
6.Karaoui R, Selim M, Mousa. Incidence of Dermatophytosis in Kuwait. Sabouraudia 1979;17:131-7.  Back to cited text no. 6    
7.Padhya AA, Thirumalachar MJ. Dermatophytosis in Poona, India. Observation on incidence, Clinical features, environmental factors and causal agents studied during 1958 to 1963 at Sasson Hospitals. Mycopath Mycol Appl 1970;40:225-36.  Back to cited text no. 7    
8.Das Gupta SN, Shome SK. Studies in Medical Mycology - On the occurrence of mycotic diseases in Lucknow. Mycopath Mycol Appl 1959;10:177-86.  Back to cited text no. 8    


    Tables

[Table - 1], [Table - 2]

This article has been cited by
1 A survey of dermatophytosis in animals in Madras, India
Ranganathan, S., Arun Mozhi Balajee, S., Mahendra Raja, S.
Mycopathologia. 1997; 140(3): 137-140
[Pubmed]



 

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