Clinico-Mycological Pattern of Hair and Skin Infection in New Delhi

Abstract

Introduction: Fungus parasitizing structures rich in keratin, like hair, skin and nails, lead to a dermal inflammatory response with intense itching and cosmetic disfigurement. Hence, diagnosis, treatment and regional epidemiological characteristics of the fungus by in vitro culture are required. Aim and objective: To see the Clinico-mycological pattern of skin and hair infections in dermatology outpatient’s in New Delhi. Materials and methods: This study was conducted (April 2013-December2013) in Mycology laboratory of a tertiary care hospital, New Delhi on 100 consecutive outpatients with clinical suspicion of superficial fungal infection of hair and skin. Plucked hair and scrapings, biopsy, and scales of skin were collected. Potassium Hydroxide (KOH) mounts and culture on Sabourauds Dextrose Agar (SDA) was done and incubated at 25°C and 37°C for 4-6 weeks. Identification was done by colony morphology, microscopic of Lactophenol cotton blue (LPCB) mounts and slide culture as per standard mycological procedures. Results: The infection was more common in males (66%) with a male: female ratio of 1.9:1 and predominantly seen in <10 years of age (30%). Tinea corporis (32%) was the commonest presentation, followed by T. capitis (26%), T. mannum (20%), T. pedis (20%) and T. faciei (2%). Direct microscopy by KOH mount was positive in 37%, 46% by culture and 27% by both microscopy and culture. Dermatophytes were grown in 27(24.5%), while 17 (16.5%) had growth of non dermatophyte moulds (NDM) with only 6 (5.8%) of yeasts. Trichophyton rubrum (7.8%) was the commonest dermatophyte. T. verrucossum (5.8%), T. schoenleinii (5.8%), T. mentagrophyte (3.9%) and T. violaceum (1.9%) were also isolated. Aspergillus flavus (2.9%) was the most common NDM. Other NDMs isolated were, A. terreus, A. fumigatus, A. niger, Penicillium spp., Syncephalastrum spp., Paecillomyces spp., Mucor spp. Rhizopus spp. and Epicoccum spp. Conclusion: There is a rising trend of Non dermatophytic Moulds causing infection replacing the most common Dermatophytes.