Clinicomycological and Dermoscopic Study of 300 Cases of Dermatophytosis in a Tertiary Care Hospital in Dehradun, India

Abstract Context: Dermatophytosis has recently emerged as a major health problem because of its chronic, recalcitrant, widespread nature causing a considerable psychosocial and financial impact among the patients. Aims: The purpose of the study was to assess the clinicomycological and dermoscopic profile of dermatophyte infection. Settings and Design: This cross-sectional study included 300 clinically diagnosed cases of dermatophyte infection. Materials and Methods: Dermlite 3G dermoscope was used for bedside evaluation of the lesions. Potassium hydroxide mount and fungal culture were done in each case to confirm the diagnosis. Statistical Analysis: P value less than or equal to 0.05 was considered significant. Results: There were 167 females and 133 males with an age range of 3 months to 80 years. Homemakers constituted most patients (37.33%) followed by students (25%). The total number of clinical patterns seen in 300 patients was 404. Tinea corporis was the most common clinical pattern. On dermoscopic examination in tinea corporis, erythematous background, red dots, and reddish-brown globules were overrepresented ( P < 0.05) in lesions of shorter duration, whereas grey background, interfollicular scales, brown-black globules, broken hair, and hypopigmented terminal hair were appreciated more ( P < 0.05) in lesions of long duration. Dermoscopy identified features like a reddish background, white scales in skin furrows, and scales in adjoining dermatoglyphics in tinea pedis and tinea manuum. Onychoscopy revealed two new patterns like lamellar microsplitting and white fluffy shadows. The characteristic trichoscopic features were perifollicular scales, black dots with corkscrew, comma shaped, easily deformable, short vellus, and morse code hairs. Trichophyton mentagrophyte was the most common dermatophyte species isolated. Conclusions: Dermoscopy serves as a simple noninvasive and rapid diagnostic tool to complement clinical diagnosis, thus helping to initiate early treatment. Fungus culture helps mainly to identify the dermatophyte species.