CLINICAL PROFILE AND PREDISPOSING FACTORS OF SUPERFICIAL FUNGAL INFECTIONS (DERMATOPHYTOSIS) AMONG PATIENTS ATTENDING A TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL STUDY

Abstract

Background: Dermatophytosis, the commonest superficial fungal infection of keratinised tissue, has emerged as a major public-health concern across India, where the hot and humid climate, changing lifestyles, over-the-counter topical corticosteroid misuse and irrational antifungal use have driven a surge in chronic and recurrent disease. Contemporary regional data describing the clinical profile and predisposing factors in South India remain limited. Objectives: To characterise the demographic and clinical profile, identify predisposing factors, describe the mycological spectrum, and evaluate the diagnostic yield of potassium hydroxide (KOH) microscopy and fungal culture among patients with clinically suspected dermatophytosis attending a tertiary-care dermatology service in South India. Methods: This analytical cross-sectional study analysed 300 consecutive patients with clinically suspected superficial fungal infection. Demographic details, predisposing factors, clinical type, anatomical site and severity were recorded on a structured proforma. KOH microscopy and Sabouraud dextrose agar culture with species identification were performed where feasible. Descriptive statistics were computed and associations tested using the chi-square test, with p < 0.05 considered significant. Results: The mean age was 42.8 years (SD 21.6; range 5–80), with a male predominance (176; 58.7%; M:F 1.42:1). Tinea cruris (26.0%) and tinea corporis (22.3%) were the commonest clinical types, together accounting for nearly half of cases. The mean symptom duration was 91.7 days, and severe disease was recorded in 149 (49.7%). KOH microscopy was positive in 166 patients (55.3% of all patients; 79.4% of those tested) and culture in 91 (30.3%). Trichophyton rubrum was the predominant isolate (36; 39.6%). Frequent predisposing factors were previous tinea (32.7%), wet-work exposure (28.7%) and shared clothing or towels (25.3%); topical corticosteroid use (10.3%) and prior antifungal use (19.0%) were notable. Neither topical corticosteroid use versus multi-site involvement (p = 0.59) nor diabetes versus severity (p = 0.31) reached significance. Conclusion: Dermatophytosis affected all age groups with a male predominance, was dominated by glabrous-skin tinea and T. rubrum, and was frequently chronic and extensive. The pattern underscores the need for preventive counselling, restriction of topical-steroid misuse and antifungal stewardship in South India.