Incidence and prevalence of dermatophytosis in and around Chennai, Tamilnadu, India

Background: Dermatophytes are group of fungi that infect keratinized tissues of human and animals. The group consist of three different genera namely, Trichophyton, Microsporum, Epidermophyton and several species within each genera. Among Trichophyton, Trichophyton rubrum is predominant, followed by various strains of Trichophyton mentagrophytes, which include both anthropophiles and zoophiles. Prevalence of dermatophytes varies with location and environmental condition. The infection is common worldwide with higher prevalence in tropical countries like India. Molecular diagnosis renders accurate identification of clinical dermatophyte isolates to species level. The main objective of this study was to determine the prevalence of dermatophytoses, isolate and identify the dermatophyte from samples of clinically suspected cases attending tertiary care centre using conventional and molecular methods.Methods: A total of 210 patients showing lesions typical of dermatophytes infection from outpatient Department of dermatology were sent to mycology unit, Department of Microbiology for the period of April 2011-March 2014 were studied. Diagnosis was confirmed by conventional and polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) technique.Results: Out of 210 samples received, tinea corporis was the predominant clinical site which was followed by tinea cruris. A total of 143 dermatophytes were isolated from the clinical samples. T. rubrum was the predominant etiological agent with 70/143 isolates and T. mentagrophytes was the second most common with 64/143 isolates. Amplification of internal transcribed spacers (ITS) was successful in all the clinical isolates by PCR and produced species specific banding pattern in RFLP using restriction enzyme Mva I.Conclusions: Among dermatophytoses, T. rubrum was the predominant etiological agent present in the whole of Chennai District and T. mentagrophytes takes the second place

Molluscoid pseudovesicles: An unusual presentation of sweet′s syndrome

Sweet′s syndrome is a well-known entity in the field of dermatology. It has presented itself in myriad forms, well-recorded in literature. Our patient presented with a sudden eruption of nontender molluscoid pseudovesicles distributed over the neck and forearms alone. A complete diagnostic work up for the same did not give any clue regarding an underlying systemic ailment, responsible for the dermatosis. This case is being presented because of this extremely rare morphology of Gomm-Button disease

A case of lamellar ichthyosis with rickets and carcinoma of the hypopharynx

Lamellar ichthyosis (LI) is an autosomal recessive disorder rarely associated with systemic organ involvement and development of carcinoma. Rickets has occasionally been described with LI owing to impaired vitamin D synthesis following altered keratinization. There has also been a high association of cutaneous cancers in patients of LI. We as Dermatologists should therefore be very meticulous while doing a full work up of these patients. We report here a case of LI associated with rickets and carcinoma of the hypopharynx

Saw palmetto extract: A dermatologist's perspective

Saw palmetto extract is believed to have antiandrogenic properties and has been used widely for the treatment of androgenic alopecia. It is claimed to have much less side effects as compared to finasteride. Along with its use for androgenic alopecia, it has also been tried for other conditions associated with increased androgen levels in dermatology. This article will review a dermatologist's perspective of this traditional herb

Incidence and prevalence of dermatophytosis in and around Chennai, Tamilnadu, India

Background: Dermatophytes are group of fungi that infect keratinized tissues of human and animals. The group consist of three different genera namely, Trichophyton, Microsporum, Epidermophyton and several species within each genera. Among Trichophyton, Trichophyton rubrum is predominant, followed by various strains of Trichophyton mentagrophytes, which include both anthropophiles and zoophiles. Prevalence of dermatophytes varies with location and environmental condition. The infection is common worldwide with higher prevalence in tropical countries like India. Molecular diagnosis renders accurate identification of clinical dermatophyte isolates to species level. The main objective of this study was to determine the prevalence of dermatophytoses, isolate and identify the dermatophyte from samples of clinically suspected cases attending tertiary care centre using conventional and molecular methods.Methods: A total of 210 patients showing lesions typical of dermatophytes infection from outpatient Department of dermatology were sent to mycology unit, Department of Microbiology for the period of April 2011-March 2014 were studied. Diagnosis was confirmed by conventional and polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) technique.Results: Out of 210 samples received, tinea corporis was the predominant clinical site which was followed by tinea cruris. A total of 143 dermatophytes were isolated from the clinical samples. T. rubrum was the predominant etiological agent with 70/143 isolates and T. mentagrophytes was the second most common with 64/143 isolates. Amplification of internal transcribed spacers (ITS) was successful in all the clinical isolates by PCR and produced species specific banding pattern in RFLP using restriction enzyme Mva I.Conclusions: Among dermatophytoses, T. rubrum was the predominant etiological agent present in the whole of Chennai District and T. mentagrophytes takes the second place

Molecular strain typing of Trichophyton mentagrophytes (T. mentagrophytes var. interdigitale) using non-transcribed spacer region as a molecular marker

Background & objectives: Dermatophytes are keratinophilic fungi that infect keratinized tissues of human and animal origin. Trichophyton mentagrophytes is considered to be a species complex composed of several strains, which include both anthropophiles and zoophiles. Accurate discrimination is critical for comprehensive understanding of the clinical and epidemiological implications of the genetic heterogeneity of this complex. Molecular strain typing renders an effective way to discriminate each strain. The objective of the study was to characterize T. mentagrophytes clinical isolates to sub-species level using molecular techniques and non-transcribed spacer (NTS) region as marker. Methods: Sixty four T. mentagrophytes clinical isolates were identified by phenotypic methods. These were subjected to polymerase chain reaction targeting three sub-repeat elements (SREs), TmiS0, TmiS1 and TmiS2 of the NTS region. Sequence analysis of internal transcribed spacer (ITS) region of different types was also done. Results: Strain-specific polymorphism was observed in all three loci. Totally, 13 different PCR types were obtained on combining all the three SREs loci. No variation was observed in the ITS region. Interpretation & conclusions: The study described the usefulness of molecular strain typing technique for the discrimination of the T. mentagrophytes isolates. This will help for the future explorations into the epidemiology of T. mentagrophytes and its complex

Prevalence of metabolic syndrome in patients with psoriasis: A prospective, observational, descriptive study from a tertiary health-care center in South India

Background: Psoriasis is a chronic inflammatory disorder which of late has been significantly linked with metabolic syndrome (MS). Objective: To assess the association between psoriasis and MS and evaluate specific disease characteristics predisposing for the development of MS. Materials and Methods: We performed a prospective, observational, descriptive study with 207 adult patients with various types of psoriasis. Results: MS was found in 49.8% of psoriatic patients. It was more prevalent after 40 years of age with a female preponderance (P = 0.000). Smoking (P = 0.0320) and alcohol consumption (P = 0.025) were significant contributing factors for the development of MS in our study population. No association for the same was reflected with parameters such as psoriasis type, lifestyle behavior, family history, and other associated systemic disease. Conclusion: A definite association does exist between psoriasis and MS. Patients with psoriasis should be periodically screened for MS and managed appropriately utilizing an interdisciplinary approach

A clinical study of cutaneous lesions in neonates at a tertiary health care center in Chennai

Background: Neonatal dermatoses constitute an important category of cutaneous disorders. They range from physiological transient conditions at one end to serious pathological entities at the other. Any of these could be a source of immense anxiety to the parents, and therefore the significance of their adequate awareness amongst dermatologists. Aim and Objective: To study the clinical pattern of various dermatoses in neonates at a tertiary health care center in Chennai. Materials and Methods: This was a descriptive, cross-sectional, and observational study conducted at our institute which included a detailed dermatologic examination of each neonate followed by recording each finding and their statistical analysis. Results: In the 220 neonates analyzed, 97 were females (44.1%) and 123 males (55.9%), with 126 being term babies (57.3%), 86 preterm (39.1%), and 8 postterm (3.6%). Physiological skin changes (52.7%) were the most common cutaneous change identified, followed by transient non-infective dermatoses (20%), developmental defects (7.3%), birth marks (7.3%), eczema (6.8%) and infections (5.9%). Conclusion: Studying neonatal dermatoses holds significance to all dermatologists so that they are able to differentiate physiological and pathological conditions, thereby relieving unnecessary therapy for neonates in circumstances not requiring any and also facilitating to allay undue anxiety among parents