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  In this article
   Abstract
   Introduction
   Material and Methods
   Results
   Discussion
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STUDIES
Year : 1995  |  Volume : 61  |  Issue : 5  |  Page : 280-283

Dermatophytoses in a desert district of Western Rajasthan




Correspondence Address:
Sanchita Karmakar


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Source of Support: None, Conflict of Interest: None


PMID: 20952989

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  Abstract 

Clinico-mycological study of 250 cases of dermatophytoses was undertaken in a desert district of Western Rajasthan. Incidence of dermatophytoses in this area was 8.60% with tinea cruris (34.4%) as the major clinical type followed by tinea corporis (24.0%) Incidence of tinea capitis was 16.8% and 90% of those affected were in the age group of 0-10 years. Male preponderance was observed (M:F=2:1). There were 15 cases of tinea faciei (6%), majority belonging to 0-10 years age group. Trichophyton violaceumwas isolated In majority (55.76%) from all clinical types followed by Trichophyton rubrum(42.3%)


Keywords: Dermatophytoses, Tinea, T violacoum, T rubrum


How to cite this article:
Karmakar S, Kalla G, Joshi K R, Karmakar S. Dermatophytoses in a desert district of Western Rajasthan. Indian J Dermatol Venereol Leprol 1995;61:280-3

How to cite this URL:
Karmakar S, Kalla G, Joshi K R, Karmakar S. Dermatophytoses in a desert district of Western Rajasthan. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2019 Sep 17];61:280-3. Available from: http://www.ijdvl.com/text.asp?1995/61/5/280/4240



  Introduction Top


Dermatophytoses is still one of the major skin diseases prevalent all over the world and its prevalence varies in India. Most Indian studies indicate that it is more prevalent in Southern and Eastern regions[1][2][3] than Northern regions[4][5][6] of the country. However, no study on dermatophytoses is available from Western Rajasthan. Therefore, present study was undertaken in the city of Jodhpur which is situated in the Thar desert of Rajasthan, to study the incidence, clinical presentation and causative agents of dermatophytoses in this district.


  Material and Methods Top


The study was conducted on 250 clinically diagnosed cases of dermatophytoses attending Skin, STD and Leprosy OPD of Mathuradas Mathur Hospital attached to Dr S N Medical College, Jodhpur during the period of July to September, when a total of 9955 patients attended the OPD for various skin ailments. Mycological study conducted on each case included:



  1. 1. Direct KOH preparation of specimen obtained by scraping, epilated hair and nail clippings where needed, for demonstration of fungal elements.


  2. 2. Culture of specimen on Sabouraud's agar with chloramphenicol and actidione. The isolated fungi were identified by their Colony characters and microscopic morphology of elements in the lesion macroconidia, microconidia and hyphae.[7] When needed sub-culturs were done on cornmeal agar and the colony characters were studied as described above.





  Results Top


Cases of dermatophytoses constituted 8.06% of the total dermatological cases. The distribution of cases according to age and sex are shwon in the [Table - 1].

Fungal elements (hyphae and/or arthrospores) could be demonstrated in scrapings from 215 out of 250 cases. Dermatophytes, however, were isolated from 104 cases only. Taking the two tests together fungus was demonstrated/isolated from 221 cases (88.4). The species of dermatophytes isolated from various clinical sites are shown in the [Table - 2].

From cases of t. capitis the fungus was isolated from 59.5% of cases and in all of them the isolated fungus was T. violaceum.

More than 70% of the cases were in the age group 0-30 years. Highest numbers of cases (28.4%) were encountered in age group 0-10 years. The ratio of male cases to female cases was 2:1. The distribution of cases according to site of lesion i.e., clinical types is shown in the [Table - 3]. Tinea cruris (34.8%) was the major clinical type found; followed by tinea corporis (24.0%); tinea capitis (16.8%); tinea faciei (6.0%); tinea manuum (3.2%) tinea unguium (2.8%) and tinea pedis (2.0%). Tinea cruris associated with tinea corporis was found in 10.4% cases.


  Discussion Top


In the present study dermatophytoses was found in 8.06% of skin patients. This low incidence could be due to several factors like: the inability of the patients to reach to this hospital from far flung areas; poor patients may prefer home made remedies; and the patients seek advice only for inflammatory type of dermatophyte lesions. The incidence of superficial fungal infections is lower as compared to other studies,[8],[9],[11],[12]. The dry arid climate of the region may also be responsible for this low incidence.

Most of the dermatophyte infections (64%) were found in the adult age group of 11-50 years, similar to another report.[12] Other studies have found 21-30 years age group as the commonest group affected.[13][14][15] However, We found a substantially large number of children (28.4%) in our study. Male preponderance (2:1) was observed in our study like others.[4],[14]

Tinea cruris as the main clinical variety in our study is in agreement with several other Indian studies.[14],[16],[17] However, many other Indian studies have reported tinea corporis as the commonest clinical variety.[5],[11],[12]

One of the unique findings of this study is that children below 10 years constituted the maximum proportion of cases whereas reports of majority of other studies revealed that maximum cases occur in age group 21-30 years.[13],[14],[15]

In the present study it was observed that 18% of the cases of dermatophytoses were of t. capitis. Tinea capitis has been reported to be rare entity from Northern India. [4, 6, 8] Similar high incidence has been reported from Udaipur region.[11],[18] In the present study we also found 90% of the patients affected with tinea capitis were children of 0-10 years age group with males more commonly affected. The high frequency in males could be due to the custom of regular application of vegetable oils over the scalp of female which has fungistatic properties.[19] Out of 15 cases (6%) of tinea faciei reported in this study, 10 cases (66.6%) belonged to 0-10 years age group. The youngest child was aged 1˝ months. 70% cases with tinea faciei had tinea capitis also.

Fungus identification by KOH Mount was positive in 86% cases [Table - 2]; however culture positivity was observed only in 41.6%, Trichophyton violaceumwas the prime isolate in present study followed by Trichophyton rubrum. Most studies from India however reported Trichophyton rubrum as the commonest isolates[14],[20],[21] including those from Rajasthan. [11, 12, 18] Higher isolation rate (43.3%) of Trichophyton violaceum has been reported by Kamlanm and Thambiah 1981[22] from Tinea capitis cases in Madras and this species is supposed to be endemic in Southern India.[1],[2]

An interesting feature of this study was that Trichophyton violaceumwas isolated from all the cases of tinea capitis, this is in agreement with other Indian studies, who have either found 100% isolation [23,24] of Trichophyton violaceum or it as predominant isolate.[22],[25] Sharma et al 1983[12] from Jaipur found Microsporum gypseum; Dalai et at 1984[11] from Udaipur found Trichophyton mentagrophyte and Murdia, 1987[18] from Udaipur found Trichophyton rubrum as the main causative fungus of tinea capitis.

This difference in isolation pattern of fungus from tinea capitis cases could be explained to some extent on the basis of climatic difference i.e. Jaipur and Udaipur regions are relatively more humid because of better monsoon, where as Western Rajasthan has a hot and dry climate. However, the studies conducted in Middle East with similar climatic conditions yielded Trichophyton schoenleinei as the commonest cause of tinea capitis.[26]

 
  References Top

1.Klokee AH, Durairaj P. The casual agents of superficial mycoses isolatated in rural areas of South India. Sabouraudia 1967;5:153-8.  Back to cited text no. 1    
2.Kamlam A, Thambiah AS. Tinea capitis in Madras. Sabouraudia 1973;11:106-8.  Back to cited text no. 2    
3.Dasgupta LR, Sharma KB, Fernandez D. Superficial mycoses Pondicherry. Ind J Pathol Bacteriol 1973;16:41-6.  Back to cited text no. 3  [PUBMED]  
4.Kandhari K C, Sethi K K. Dermatopriytosis in Delhi area. J Ind Med Assoc 1964;42:324-6.  Back to cited text no. 4    
5.Kalra SL, Mohapatra LN, Gugnani HC. Etiology of dermalomycosis in Delhi. Ind J Med Res 1964;52:553-8.  Back to cited text no. 5  [PUBMED]  
6.Hajini GH. Kandhari KC, Mohapatra L N, Bhutani L K. Tinea capitis in North India. Sabouraudia 1970;8:170-3.  Back to cited text no. 6    
7.Conant NF, Smith DT, Baker RD, Coloway J L Manual of clinical Mycology, 3rd edn, W.B. Saunders Co, 1971;527-631.  Back to cited text no. 7    
8.Desai SC. Bhatt MLA. Dermatomycosis in Bombay, A study on the incidence clinical dermetophytes and their epidemicity Ind J Med Res 1961;49:662-71.  Back to cited text no. 8    
9.Sobhandri C, Tirumala Rao D, Sharatbabu K. Clinical and mycological study of superficial fungal infections of Govt. Gen. Hos., Guntur and their response to treatment with Hamycin, Dermostatin and Dermamycin. Ind J Dermatol Venereol 1970;36:209-14.  Back to cited text no. 9    
10.Phadke SN, Gupta DK, Agarwal S. Dermatophytoses in Jabalpur (MP). Ind J Pathol Bacteriol 1973;16:42-8.  Back to cited text no. 10    
11.Dalal AS, Dhruva A, Mogra N, Mehra SK. Dermatomycoses in South-east Rajasthan. J Ind Med Asso 1984;83:197-9.  Back to cited text no. 11    
12.Sharma M, Bhargava RK, Williamson D. Dermatophytic Profile of Jaipur-1. Bio Bull Ind 1983;5:57-63.  Back to cited text no. 12    
13.Talwar P, Hunjan BS, Kaur S. Kumar B, Chitkara NL. Study of human dermatomycoses. Ind J Med Res 1979;70:187-94.  Back to cited text no. 13    
14.Singh R, Kumari, Jerath VP. Mycology of tinea corposis and tinea crusis in Delhi, Ind J Dermatol Venereol Leprol 1980;46:218-20.  Back to cited text no. 14    
15.Maheswari Amma S, Paniker CKJ, Gopinathan T. Studies of dermatomycoses in Calicut (Kerala) (Clinical and Mycological investigations). Ind J Pathol Microbiol 1982;25:11-7.  Back to cited text no. 15    
16.Mehrotra HK, Bajaj AK, Gupta SC. Mehrotra TN, Atal PR, Agarwal AK. A study of dermatophytes at Allahabad. Ind J Pathol Microbiol 1978;21:131-9.  Back to cited text no. 16    
17.Singh UK, Nath P. Fungal flora in the superficial infections of the skin in males at Lucknow. Ind J Pathol Microbiol 1981;24:189-93.  Back to cited text no. 17  [PUBMED]  
18.Murdia P. Dermatomycoses in Udaipur region (Rajasthan). Ind J Dermatol 1987;32:5-10.  Back to cited text no. 18  [PUBMED]  
19.Hajini GH, Kandhari KC, Mahapatra LN, Bhutani LK. Effect of hair oil and fatty acids on the growth of dermatophytes and their in vitro prevention of human scalp hair. Sabouraudia 1970;8:174-6.  Back to cited text no. 19    
20.Shah AK, Dixit CV, Shah BH. A study of dermatophytoses. Ind J Dermatol venerol Leprol 1976;42:225-30.  Back to cited text no. 20    
21.Shukla NP, Agarwal GP, Gupta DK. Prevalence of dermatophytoses in Jabalpur. Ind J Pathol Microbiol 1983;26:31-9.  Back to cited text no. 21    
22.Kamlam A, Thambiah AS. Prevalence of dermatomycoses in Madras City. Ind J Med Res 1981;73:513-8.  Back to cited text no. 22    
23.Vasu DRBH. Incidence of Dermatophytoses in Wernangal (AP). Ind J Med Res 1966;54:468-74.  Back to cited text no. 23    
24.Sudershan V, Agarwal S. Dermatophytoses in Raipur (MP). Ind J Pathol Microbiol 1975;19:57-62.  Back to cited text no. 24    
25.Rajgopal A, Gingle HS, Pandey SS. Clinical, mycological and immunological study of tinea capitis. Ind J Dermatol Venereol Leprol 1981;47:146-50.  Back to cited text no. 25    
26.Malhotra Y K, Garg M P, Kanwar A J. A School Survey of tinea capitis in Benghazi, Libya. J Trop Med Hyg 1979;82:59-61.  Back to cited text no. 26    


    Tables

[Table - 1], [Table - 2], [Table - 3]

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