A Cross-sectional Study of Clinical Patterns and Etiological Shifts in Dermatophyte Infections from Western India: Is Tide Shifting Again?

Abstract Background: Dermatophytosis remains among the commonest cutaneous fungal infections globally, with considerable geographical and temporal variations in epidemiology. To evaluate the clinical spectrum of dermatophytosis and identify etiological agents in patients attending a tertiary care hospital, and to correlate clinical presentations with specific dermatophyte species. Methods: This prospective, cross-sectional, observational study involved 115 patients with clinical features of dermatophytosis. Data regarding demographics, clinical patterns, and samples for mycological examination were collected. Direct microscopy with 10% KOH and fungal culture on Sabouraud’s dextrose agar with chloramphenicol and cycloheximide were performed for each sample. Results: Young adults aged 16-30 years (42.6%) were most commonly affected, with males predominating (M:F = 2.29:1). Working personnel formed the largest occupational group (40.9%). Tinea cruris was the most frequent clinical type (53%), followed by tinea corporis (23.5%), tinea faciei (9.4%), tinea capitis (6%), onychomycosis (4%), tinea pedis (2.7%), and scrotal tinea (1.3%). Mixed infections occurred in 28.7% cases, mainly tinea cruris with tinea corporis. KOH positivity rate was 53%, culture positivity reached 67.8%. Only T. rubrum (54.5%) and T. mentagrophytes (45.5%) were isolated, with T. mentagrophytes showing higher prevalence than in previous regional studies. T. mentagrophytes predominantly caused tinea pedis, tinea capitis, and tinea faciei, while T. rubrum was more common in tinea corporis, tinea cruris, scrotal tinea, and onychomycosis. Conclusions: Our findings reveal shifting dermatophyte epidemiology with increased prevalence of T. mentagrophytes and unusual presentations like tinea faciei and tinea capitis in adults. These changing patterns warrant continuous surveillance and will have important therapeutic implications.