Changing Spectrum of Dermatophytes and their Association with Clinical Patterns in a Tertiary Care Centre

Abstract

Background: Dermatophytosis is a common superficial fungal infection with considerable variation in its clinical presentation and etiological profile. Recent studies from India have reported changes in the distribution of dermatophyte species, particularly an increasing contribution of the Trichophyton mentagrophytes complex and emergence of Trichophyton indotineae. The present study evaluated the contemporary dermatophyte spectrum and its relationship with clinical patterns in a tertiary care setting. Methods: A prospective observational study was conducted among 280 patients with clinically suspected dermatophytosis attending a tertiary care center. Demographic and clinical characteristics, including age, sex, duration of disease, recurrence, previous antifungal treatment, anatomical site and clinical pattern, were recorded. Skin scrapings, nail clippings or hair samples were collected as appropriate. Direct microscopy using 10% potassium hydroxide preparation and fungal culture were performed, followed by identification of dermatophyte species using standard mycological methods. The distribution of species across clinical patterns and anatomical sites was analyzed. Associations were assessed using the Chi-square test, with P < 0.05 considered statistically significant. Results: The majority of patients were aged 21–30 years (32.5%), and males constituted 58.6% of the study population. Tinea corporis was the commonest clinical pattern (29.3%), followed by tinea cruris (19.6%) and combined tinea corporis with cruris (16.8%). The T. mentagrophytes complex was the predominant dermatophyte (37.1%), followed by Trichophyton rubrum (25.4%) and T. indotineae (15.0%). Dermatophyte distribution differed significantly across clinical patterns (χ2 = 25.84, P = 0.016). Conclusion: The study demonstrates a changing dermatophyte spectrum characterized by predominance of the T. mentagrophytes complex, continued representation of T. rubrum and notable occurrence of T. indotineae. The significant variation of species across clinical patterns supports the importance of clinicomycological correlation and continued local surveillance of dermatophytosis.