INTRODUCTION :
The cutaneous infections of man includes a wide variety of diseases
In which the integuments and its appendages the hair and the nail are
Involved. Infection is generally restricted to the non lining cornified layer
But a variety of changes occur in the host because of the presence of the
Infectious agent and its metabolic products. Majority of the infections are
Caused by a homogenous group of keratophilic fungus called the
Dermatophytes. A single species might be involved in several clinical
Types each with its distinct pathology. The fungi are the commonest
Infective agent of man and no group of people or geographical areas are
Without taenia or ringworm infection (taenia-latin for worm). Evolutionary
Development towards an accommodating host parasite relationship can be
Seen among the dermatophytes which is absent among other fungal agent of
Human disease. This group of disease is collectively referred to as
Dermatophytosis. Dermatophytes are a group of closely related group of organisms that
Can use keratin as a nitrogen source. On the basis of clinical,
Morphologic and microscopic charecterteristics three genera are recognized
As Dermatophytes; Trichophyton, Microsporum and Epidermophyton.
Depending on their natural habitat dermatophytes may be Anthropophilic
(people loving), Zoophilic(animal loving) and Geophilic (soil loving).
Dermatophytes includes several distinct clinical varieties, depending
On the anatomical site and the etiological agent involved. The pathology
Induced on the host initially is an eczemiform response followed by allergy
And inflammatory manifestations. The type and severity of these reactions
Are related to the immune status of the host as well as to the strain and
Species of the organism causing the infection.
AIMS AND OBJECTIVES :
1. To isolate the dermatophytes from clinical specimens like skin, nail and hair obtained from patients attending Dermatology OP.
2. To speciate the isolates of dematophytes.
3. To study the correlation of fungal isolates and the clinical manifestations.
4. To determine the commonest prevalent genus and species of dermatophytes in North Chennai.
5. To determine the antifungal susceptibility of the isolates by different methods.
6. To compare the results obtained by different methods.
7. To determine the MIC values of different drugs for the isolates.
CONCLUSION :
1. 170 clincally diagnosed cases of dematophytosis were subjected to
mycological study.
2. Male : Female sex ratio was 54%: 46%.
3. Maximum isolates of dermatophytes were from the age group of
above20 years (70%) The post pubertal changes in harmones may be
attributable to this finding.
4. Maximum number of Tinea capitis cases was found in the age group of
>10 years. As universally reported Tinea capitis is a infection of
children.
5. Culture positivity was 35.2%. Tinea unguium cases showed more
positivity than other lesions(28%)
6. Trichophyton spp were the predominant isolates (93.9%) followed by
Microsporum spp (5%) and Epidermophyton (3.3%).
7. Trichophyton rubrum was the most predominant isolate from
skin(35.7%) and nail (28.5%).Adults males were found to be more
susceptible to T.rubrum infection than children.
8. In Tinea corporis, Trichophyton rubrum was the most commonest
isolate (46.6%).
9. In cases of Tinea cruris, Trichophton verrucosum and Epidermophyton
floccosm were isolated in maximum numbers (33.3% each).
10. In Tinea capitis, Trichophyton violeceum was isolated maximally
(44.4%).
11. In Tinea mannum , Trichophyon mentagrophytes was the main isolate
(50%).
12. In Tinea pedis , Trichophyton tonsurans was the maximum isolated
species(66.6%).
13. In Tinea barbae , 50% of isolates were Trichophyton mentagrophytes
and 50% were Trichophyton verrucosum.
14. In tinea unguium , Trichophyton rubrum was the main isolate (28.5%)
followed by Trichophyton mentagrophytes (23.8%) and Trichophyton
verrucosum (19%).
15. Fluconazole showed a higher MIC value when compared to other drugs
by both methods.
16. Terbinifine was found to be the most effective antifungal drug as
evaluated by the agar dilution method and microbroth dilution method.
17. A marked reduction in the MIC range was noted when antifungal
susceptibility testing was done by microbroth dilution method.
18. Terbinifine was the most effective of all the drugs tested.
In recent years several studies on In vitro susceptibility of
dermatophytes to anti fungal drugs have been done and the results have shown
considerable variation. This variability is probably due to important
methodological differences among the laboratories.
Our study demonstrated that several antifungal agents are very active
against dermatophytes, although these results are species dependent. This can
allow clinician to adopt different therapeutic options with high probability to
successful results
