Can dermoscopy serve as a diagnostic tool in dermatophytosis? A pilot study

Trichophyton (T.)mentagrophytes now accounts for an overwhelming majority of clinical cases in India, a new “Indian genotype” (T. mentagrophytes ITS genotype VIII) having been isolated from skin samples obtained from cases across a wide geographical distribution in this country. The conventional diagnostic methods, like fungal culture, are, however, inadequate for diagnosing this agent. Thus, molecular methods of diagnosis are necessary for proper characterization of the causative agent. The shift in the predominant agent of dermatophytosis from T. rubrum to T. mentagrophytes, within a relatively short span of time, is without historic parallel. The apparent ease of transmission of a zoophilic fungus among human hosts can also be explained by means of mycological phenomena, like anthropization.

Section: Nonmycological Tests For Dermatophytosescontrasting

confidence: 63%

The unprecedented epidemic-like scenario of dermatophytosis in India: II. Diagnostic methods and taxonomical aspects

Verma¹,

Panda²,

Nenoff³

et al. 2021

“…Follicular micropustules, diffuse intense erythema (not as regular dots), and brown spots with white-yellowish halo have been described in superficial fungal infections. 17 Dotted vessels, yellow scales, and serocrusts are evident in contact dermatitis and inverse strawberry pattern with salmon-colored follicular dots surrounded by white halos in malar rash of lupus. 18,19 Older term of "steroid dermatitis resembling rosacea" suggests that TSDF can mimic rosacea with or without demodecidosis, especially in the absence of a supportive history of TCS application.…”

Section: Discussionmentioning

confidence: 99%

Dermoscopy of topical steroid-dependent or damaged face: A cross-sectional study

Sethi¹,

Chauhan²,

Jindal³

et al. 2021

Background: Topical corticosteroid (TCS) abuse is rampant and results in steroid addiction labeled as topical steroid-dependent or damaged face (TSDF). Indian market is replete with triple combination creams containing TCS sold as over-the-counter products at low cost, luring people to use them without prescription. The resultant damage if detected late is irreversible and difficult to treat. Dermoscopy can help in the early identification of features of TSDF at a preclinical stage resulting in better prognosis. However, the literature on the same is limited. Aims: This study is undertaken to characterize dermoscopic features of TSDF and to correlate them with potency and duration of application of the TCS. Methods: One hundred and thirty-two patients aged 18 years or above, with clinical symptoms and signs suggestive of TSDF and with history of application of TCS on the face for a period of more than one month, were enrolled in the study. Their demographic details, clinical features, and dermoscopy findings were recorded using a predesigned structured format. Comparison of dermoscopic findings with clinical examination, gender, potency of TCS, and duration of TCS use was done using Chi-square test, Fisher’s exact test, and one-tailed Z-test. Results: Mean age of the patients was 31.7 ± 8.1 years. Male to female ratio was 2:9. Sixty-nine (52.3%) patients abused TCS for more than one year. Clinical findings noted in the patients were erythema (81.1%), hyperpigmentation (80.3%), and hypertrichosis (68.2%). The most common dermoscopy findings seen were brown globules (96.2%), red diffuse areas (92.4%), vessels (87.1%), white structureless areas (86.4%), and hypertrichosis (80.3%). Red diffuse areas, vessels, brown globules, white structureless areas, and white hair were observed in a statistically higher proportion of cases dermoscopically. Y-shaped vessels and brown globules were seen in significantly higher number of patients, using TCS for more than three months and in those continuing it beyond six months, polygonal vessels were predominant. Limitations: Lack of histopathological correlation is the limitation of our study. Furthermore, brown globules seen in 96.2% patients of TSDF on dermoscopy may have been over-estimated and not always signify TSDF; instead, it could represent melasma for which patient applied TCS. Conclusion: Dermoscopy in TSDF can help dermatologists in a multitude of ways from confirming the diagnosis to differentiating from other causes of red face and predicting the approximate duration of TCS abuse.

“…61 This needs to be validated with large scale studies. While tinea of vellus hair can be documented using a dermatoscope 56,62 and a potassium hydroxide mount, subclinical infection of the nail can be documented by periodic acid-Schiff stain of nail clippings.…”

Section: Tinea Of Vellus Hair and Subclinical Infection Of The Nailsmentioning

confidence: 99%

The unprecedented epidemic-like scenario of dermatophytosis in India: I. Epidemiology, risk factors and clinical features

Verma¹,

Panda²,

Nenoff³

et al. 2021

104

Dermatophytosis has attained unprecedented dimensions in recent years in India. Its clinical presentation is now multifarious, often with atypical morphology, severe forms and unusually extensive disease in all age groups. We hesitate to call it an epidemic owing to the lack of population-based prevalence surveys. In this part of the review, we discuss the epidemiology and clinical features of this contemporary problem. While the epidemiology is marked by a stark increase in the number of chronic, relapsing and recurrent cases, the clinical distribution is marked by a disproportionate rise in the number of cases with tinea corporis and cruris, cases presenting with the involvement of extensive areas, and tinea faciei.