Clinico-mycological study of dermatophytosis in a tertiary care centre in North Eastern India

Background: The dermatophytosis constitutes a group of superficial fungal infections of keratinized tissues, namely, the epidermis, hair, and nails. The present study was undertaken to find out the clinical profile of dermatophytosis and to identify the causative fungal species in the various clinical presentations. Materials & Methods: This was a hospital‐based observational study. One hundred clinically suspected patients attending OPD of M. G. M. Medical College and Lion Seva Kendra Hospital were included in the study. History was taken, general physical and cutaneous examination was done and details of skin lesions noted. Direct microscopy in 10% KOH (40% KOH for nail) and fungal culture on SDA with 0.05% chloramphenicol and 0.5% cycloheximide was done in every case. Chi‐square test and contingency coefficient test were used as significant tests for analysis. Results: In the present study, tinea accounted for 22.68 % of the total Dermatology OPD cases of which male constituted 59 % and 41 % females. The mean age was 38.4 ± 16.98 years. Majority were of age group 21-30 years followed by age group 31-40 years.Out of all the samples 68 cases were KOH positive as compared to 61 cases which were culture positive. Two KOH negative cases were culture positive and 9 culture negative cases came out to be KOH positive. Out of 81 skin scrapping samples 54 were KOH positive and 47 were culture positive, 11 nail clipping samples 8 were KOH as well as culture positive and out of 8 hair pluck samples 6 were KOH as well as culture positive.In 61 culture positive cases there were 7 non-dermatophytic growth which included 4 aspergillus spp. and 3 candida spp. Conclusion: Dermatophytosis is one of the most common if not the commonest dermatological condition we come across the Dermatology OPD. It most commonly affects the young age group rather than extremes of age

Porokeratotic eccrine ostial and dermal duct nevus - revisited

We hereby report a rare case of a 14-year-old girl presenting with asymptomatic pitted papules over the flexor aspect of her right 4th and 5th digits. This was histopathologically proven to be porokeratotic eccrine ostial and dermal duct nevus (PEODDN)

Porokeratotic eccrine ostial and dermal duct nevus - revisited

We hereby report a rare case of a 14-year-old girl presenting with asymptomatic pitted papules over the flexor aspect of her right 4th and 5th digits. This was histopathologically proven to be porokeratotic eccrine ostial and dermal duct nevus (PEODDN)

A study of onychomycosis at a tertiary care hospital in Eastern Bihar

Background: Onychomycosis (OM) is a major public health problem which is increasing worldwide. It is associated with high morbidity and causes physical, psychological, and occupational problems in patients. Aims: This study aims to study the pattern of etiological agents, clinical features, and severity assessment of OM in this part of India. Materials and Methods: Sixty eight clinically suspected patients with positive potassium hydroxide and fungal culture were studied. Results: Males were infected more often than females (1.61:1). The most common age group affected was 21–40 years. Finger nails were affected more frequently than toe nails. Distal and lateral subungual OM was the most common (48 cases, 70.59%) clinical pattern. For most of the patients (66.18%), nail involvement was severe. Discoloration was the most common (67 cases, 98.53%) change, followed by subungual hyperkeratosis (51 cases, 75%). Principal causative agents were dermatophytes (55 cases, 80.88%) with Trichophyton rubrum being the most common one (35 cases, 51.47%). In 9 (13.23%) cases, Candida albicans, in 6 (8.82%) Aspergillus niger and in 1 (1.47%) case Acremonium sp. (AC) have been isolated as the sole causative agent. In 2 (2.94%) cases, mixed infection with dermatophyte and Aspergillus and in 1 (1.47%) case dermatophyte and Candida were noted. Conclusion: Although dermatophytes were the most common causative agent of OM, nondermatophytic molds, and yeasts were also encountered. The genus and species identification helps in the proper diagnosis and management. Morphological changes in nail may help in presumptive diagnosis of OM

Subcutaneous panniculitis-like T-cell lymphoma with unusual eschar-like crusting

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of non-Hodgkin's lymphoma of the skin. Clinically, SPTCL presents as subcutaneous tumors located on the extremities or trunk, often associated with systemic symptoms like fever or fatigue. The therapeutic regimen for SPTCL is at present not standardized. We describe herein a case of a young woman who presented with intermittent fever and skin rash and was diagnosed later with SPTCL. The case is reported here for its rarity and rapidly changing unusual clinical manifestations. This case also highlights that monotherapy with systemic steroid can be a valuable treatment option for the management of SPTCL, especially in those without hemophagocytic syndrome