To identify the role of occlusive clothing (undergarments) in the maintenance of fungal infection in treatment resistant, recurrent and persistent tinea cruris: A pilot study at tertiary care hospital

Abstract

Chronic and recurrent dermatophytoses are very common in tropical countries like India. Among many patho-mechanisms implicated, the role of changing lifestyle and clothing patterns is highly suggestive. Our study was done to identify whether the dermatophytes could be cultured from undergarments of the patients and also to find out the persistence of fungi after conventional washing techniques. It was a cross-sectional study carried on patients attending out- patient department of Department of skin and VD of Jhalawar Medical College with samples size of 50.KOH examination of recurrent and chronic tinea cruris patients was done followed by culture of skin scarping from advancing margin of tinea, samples of unwashed and washed undergarment pieces, followed by species identification by using lactophenol cotton blue stain. Males outnumbered females (28 M:22F). Maximum cases belonged to age group of 21 -30 years (27/50); most of the patients opted for tight synthetic undergarments (26/50).Samples of 44 patients were KOH positive. Fungal elements were cultured from 28/50 samples from skin scarping,22/50 from unwashed undergarments,15/30 from washed undergarments. Most common species identified was Trichophyton mentagrophytes. Recurrent and chronic tinea infections are becoming causes of increasing financial burden and impaired quality of life of affected patients. Although culture is not a very sensitive method to confirm dermatophytic infections, yet fungal elements can sustain in undergarments of patients affected by chronic and recurrent tinea cruris which may lead to non-response to standard dose and schedule of antifungal agents. Dermatophytes may sustain in undergarments, even after washing; causing recurrent and chronic tinea cruris.