Burden of Chronic Dermatophytosis in a Tertiary Care Hospital: Interaction of Fungal Virulence and Host Immunity
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Dermatophytosis is caused by keratinophilic dermatophytes and affects the superficial skin and its appendages. The nature of infection and response to treatment is influenced by host–pathogen factors like duration and severity of disease, prior drug history and type of causative organism. In our study, the burden of dermatophytosis affecting glabrous skin saw a rise in recalcitrant and reinfection cases with only 1.6% achieving complete cure. Chronicity of dermatophytic infection was reflected in the high serum IgE levels and immediate hypersensitivity reactions. Hence, it becomes pertinent for clinicians to identify the non-responders and modify therapy to achieve clinical cure with fungal clearance confirmed by mycological tools.
KeywordsChronic dermatophytosis Reinfection/recalcitrant dermatophytosis Trichophyton mentagrophytes complex Antifungal therapy
This work was supported by the Intramural Grant from the University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India.
Compliance with Ethical Standards
Conflict of interest
The authors state no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
- 4.Chinnapun D, Thammarat NS. Virulence factors involved in pathogenicity of dermatophytes. Walailak J Sci Technol. 2015;12(7):573–80.Google Scholar
- 6.Rudramurthy S, Shankarnarayan S, Dogra S, Shaw D, Mushtaq K, Paul R, et al. Mutation in the squalene epoxidase gene of Trichophyton interdigitale and Trichophyton rubrum associated with allylamine resistance. Antimicrob Agents Chemother. 2018. https://doi.org/10.1128/AAC.02522-17.CrossRefPubMedPubMedCentralGoogle Scholar
- 10.White TJ, Bruns T, Lee S, Taylor JW. Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics. In: Innis MA, Gelfand DH, Sninsky JJ, White TJ, editors. PCR protocols: a guide to methods and applications. San Diego: Academic Press Inc; 1990. p. 315–22.Google Scholar
- 16.Singh A, Masih A, Khurana A, Singh P, Gupta M, Hagen F, et al. High terbinafine resistance in Trichophyton interdigitale isolates in Delhi, India harbouring mutations in the squalene epoxidase gene. Mycoses. 2018. https://doi.org/10.1111/myc.12772.
- 20.Nenoff P, Verma SB, Uhrlaß S, Burmester A, Gräser Y. A clarion call for preventing taxonomical errors of dermatophytes using the example of the novel Trichophyton mentagrophytes genotype VIII uniformly isolated in the Indian epidemic of superficial dermatophytosis. Mycoses. 2018. https://doi.org/10.1111/myc.12848.