Analysis of pathogen spectrum changes and epidemiological characteristics of superficial mycosis in the Shantou region of China from 2022 to 2024.

OBJECTIVE

The etiological spectrum of superficial mycoses varies regionally. This retrospective study investigated the clinical type composition and pathogen distribution shifts in Shantou from 2022-2024 to inform localized diagnosis and treatment.

METHODS

A total of 2,635 patients with positive fungal cultures from the Shantou Institute of Dermatology and Venereology were enrolled. Categorical data were compared using Chi-square or Fisher's exact tests; non-normally distributed continuous data were expressed as median (IQR). Advanced visualizations (Sankey diagrams, heatmaps) were generated using Python. P < 0.05 was considered significant.

RESULTS

The cohort comprised 1,488 males (56.47%) and 1,147 females (43.53%), with a median age of 31.0 years (IQR: 18.0-48.0). The five most common diagnoses were pityrosporum folliculitis (463, 17.57%), tinea pedis (286, 10.85%), tinea cruris (284, 10.78%), onychomycosis (273, 10.36%), and tinea corporis (243, 9.22%). Predominant pathogens were Malassezia (1,112, 42.20%), yeast-like fungi (784, 29.75%), Trichophyton rubrum (273, 10.36%), and T. mentagrophytes (252, 9.56%). Significant gender differences were observed for tinea cruris, tinea corporis, onychomycosis, and seborrheic dermatitis (all P < 0.05), but not for pityrosporum folliculitis (P = 0.754). Gender-based variations were also significant for Malassezia (P = 0.002) and T. rubrum (P < 0.001). Pathogen distribution differed significantly across age groups (all P < 0.001).

CONCLUSIONS

The etiological spectrum in Shantou has shifted, with Malassezia now the leading pathogen. Distinct gender- and age-specific patterns warrant increased clinical vigilance and targeted prevention strategies.