The unprecedented epidemic-like scenario of dermatophytosis in India: II. Diagnostic methods and taxonomical aspects.

Trichophyton (T.) mentagrophytes now accounts for an overwhelming majority of clinical cases in India, a new "Indian genotype" (T. mentagrophytes ITS genotype VIII) having been isolated from skin samples obtained from cases across a wide geographical distribution in this country. The conventional diagnostic methods, like fungal culture, are, however, inadequate for diagnosing this agent. Thus, molecular methods of diagnosis are necessary for proper characterization of the causative agent. The shift in the predominant agent of dermatophytosis from T. rubrum to T. mentagrophytes, within a relatively short span of time, is without historic parallel. The apparent ease of transmission of a zoophilic fungus among human hosts can also be explained by means of mycological phenomena, like anthropization.

Distribution of Species of Dermatophyte Among Patients at a Dermatology Centre of Nghean Province, Vietnam, 2015-2016.

INTRODUCTION: Vietnam is a tropical country so fungal diseases including dermatophytosis may be prevalent, but epidemiological profiles of agents responsible for the infection have rarely been reported. OBJECTIVE: To find out the distribution of dermatophytes among patients living in a central province of Vietnam. METHODS: We examined dermatophyte infections in patients with lesions suspected of dermatophytosis referred to the Nghean provincial leprosy and dermatology centre from August 2015 to August 2016. The speciation of dermatophyte was performed by conventional and molecular approaches. RESULTS: One hundred and thirty-six patients (90 males and 46 females) were included. Those aged from 11 to 30 contribute 59.1%. The most common agent found was Trichophyton rubrum (66.9%), followed by T. interdigitale (12.5%), T. tonsurans (9.6%), Microsporum incurvatum (8.1%), and the less frequent species were M. canis (2.2%) and T. violaceum (0.7%). Epidermophyton floccosum was not reported. T. rubrum were more common in men (74.4%) than in women (52.2%), while T. interdigitale and M. incurvatum were more common in women (21.7 and 15.2%) than in men (7.8 and 4.4%). Patients infected with Microsporum spp. had small-sized lesions for only 3 months, while those affected by Trichophyton spp. had large-sized lesions with longer duration. CONCLUSION: Trichophyton species are the predominant agents of infection in Nghean province, while Epidermophyton species is absent. Additional investigations are required to clarify the epidemiological profile of dermatophytes in Vietnam.

Tinea capitis in the pediatric population: a study from North India.

BACKGROUND: Tinea capitis (TC) is a common superficial fungal infection seen predominantly in children. The etiological factors vary from one region to the other. The clinical and microbiological characteristics of the same were studied in patients up to the age of 12 years seen at a pediatric super specialty hospital in New Delhi, India. AIMS: To delineate the various patterns of TC observed in North India and to assess for any correlation between the clinical, microscopic and microbiologic findings in the patients seen. Also, to identify the common fungal species responsible for producing TC in North India. METHODS: Clinical morphology and KOH findings were studied in 214 patients with the suspected diagnosis of TC. Fungal culture were also performed for all the cases. An attempt was made to evaluate any correlation among the clinical, microscopic and etiological findings. The epidemiological factors associated with the disease were also assessed. RESULTS: TC was found to be most common in the 8-10-year age group, with noninflmmatory TC being the more common type (56.5%). A mixed morphological pattern was recorded in 10% of the cases. Microscopic examination revealed an endothrix pattern of hair invasion to be more common (41.5% cases). Again, 8.8% of the cases showed foci of both endothrix and ectothrix pattern of invasion simultaneously. Trichophyton violaceum was the most common fungal species isolated. CONCLUSIONS: In the present study, clinical morphology or KOH findings were not found to be clearly or exclusively predictive of the species involved. There was a fair degree of overlap in the clinical or microscopic patterns produced by the fungal species. Mixed patterns were observed both on clinical examination as well as on KOH examination. However, none of the specimens grew more than one fungal species.