Skip to main content

Advertisement

Log in

Burden of Chronic Dermatophytosis in a Tertiary Care Hospital: Interaction of Fungal Virulence and Host Immunity

  • Original Paper
  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Marques S, Robles A, Tortorano A, Tuculet M, Negroni R, Mendes R. Mycoses associated with AIDS in the third world. Med Mycol. 2000;38(1):269–79.

    Article  Google Scholar 

  2. Lakshmanan A, Ganesh Kumar P, Mohan SR, HemaMalini M, Madhavan R. Epidemiological and clinical pattern of dermatomycoses in rural India. Indian J Med Microbiol. 2015;33(5):134–6.

    Article  Google Scholar 

  3. Zhan P, Liu W. The changing face of dermatophytic infections worldwide. Mycopathologia. 2017;182(1–2):77–86.

    Article  Google Scholar 

  4. Chinnapun D, Thammarat NS. Virulence factors involved in pathogenicity of dermatophytes. Walailak J Sci Technol. 2015;12(7):573–80.

    Google Scholar 

  5. Monod M, Lechenne B, Jousson O, Grand D, Zaugg C, Stocklin R, et al. Aminopetidases and dipeptidyl-peptidases secreted by the dermatophyte Trichophyton rubrum. Microbiology. 2005;151(1):145–55.

    Article  CAS  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.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Dabas Y, Xess I, Singh G, Pandey M, Meena S. Molecular identification and antifungal susceptibility patterns of clinical dermatophytes following CLSI and EUCAST guidelines. J Fungi. 2017;3(2):17.

    Article  Google Scholar 

  8. Dogra S, Uprety S. The menace of chronic and recurrent dermatophytosis in India: Is the problem deeper than we perceive? Indian Dermatol Online J. 2016;7(2):73–6.

    Article  Google Scholar 

  9. Gupta C, Das S, Ramachandran VG, Saha R, Bhattacharya SN, Dar SA, et al. Possible role of trichophytin antigen in inducing impaired immunological clearance of fungus in onychomycosis. Mycopathologia. 2016;181(3–4):247–51.

    Article  CAS  Google 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 

  11. Verma S, Madhu R. The great Indian epidemic of superficial dermatophytosis: an appraisal. Indian J Dermatol. 2017;62(3):227–36.

    PubMed  PubMed Central  Google Scholar 

  12. Peerapur BBV, Inamdar AC, Pushpa PV, Microbiol M, Srikant B, Microbiol M. Clinicomycological study of dermatophytosis in Bijapur. Indian J Med Microbiol. 2004;22(4):273–5.

    CAS  PubMed  Google Scholar 

  13. Surendran K, Bhat RR, Boloor R, Nandakishore B, Sukumar D. A clinical and mycological study of dermatophytic infections. Indian J Dermatol. 2014;59(3):262–7.

    Article  Google Scholar 

  14. Sahai S, Mishra D. Change in spectrum of dermatophytes isolated from superficial mycoses cases: first report from Central India. Indian J Dermatol Venereol Leprol. 2011;77(3):335–6.

    Article  Google Scholar 

  15. Shukla P, Yaqoob S, Haider F, Shukla V. Dermatophytoses; epidemiology and distribution among urban and sub urban population. Indian J Microbiol Res. 2016;3(3):292–8.

    Article  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.

  17. Woodfolk JA. Allergy and dermatophytes. Clin Microbiol Rev. 2005;18(1):30–43.

    Article  CAS  Google Scholar 

  18. Gupta AK, Chaudhry M, Elewski B. Tinea corporis, tinea cruris, tinea nigra, and piedra. Dermatol Clin. 2003;21(3):395–400.

    Article  Google Scholar 

  19. de Hoog GS, Dukik K, Monod M, Packeu A, Stubbe D, Hendrickx M, et al. Toward a novel multilocus phylogenetic taxonomy for the dermatophytes. Mycopathologia. 2017;182(1–2):5–31.

    Article  Google Scholar 

  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.

Download references

Acknowledgements

This work was supported by the Intramural Grant from the University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shukla Das.

Ethics declarations

Conflict of interest

The authors state no conflict of interest.

Ethical Approval

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.

Additional information

Handling editor: Stephane Ranque.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 35 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tigga, R.A., Das, S., Bhattacharya, S.N. et al. Burden of Chronic Dermatophytosis in a Tertiary Care Hospital: Interaction of Fungal Virulence and Host Immunity. Mycopathologia 183, 951–959 (2018). https://doi.org/10.1007/s11046-018-0303-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11046-018-0303-4

Keywords

Navigation