Clinicomycological Profile of Dermatophytosis in a Tertiary Care Hospital in Tamil Nadu, India.

Background Dermatophytosis, a prevalent superficial fungal infection, has emerged as a significant public health concern in India, warranting comprehensive investigations to understand its clinicomycological profile. This study aimed to analyze the demographic, clinical, and mycological patterns of dermatophytosis in patients attending a tertiary care center in Tamil Nadu, with a particular focus on species identification given the changing epidemiology and emerging antifungal resistance in the region. Methodology This cross-sectional study included 194 clinically diagnosed dermatophytosis cases visiting the Dermatology Outpatient Department from March 2022 to February 2023. Socio-demographic data, clinical presentations, and laboratory findings were recorded. Samples, including skin scrapings, nail clippings, and epilated hair, were collected by dermatologists and processed by trained laboratory technicians. Fungal isolates were identified based on colony morphology and microscopic characteristics. Results The study population comprised 112 (57.7%) males and 82 (42.3%) females. The predominant age group was 21-30 years old, observed in 59 (30.4%) cases. Acute presentations (<1 month) were most frequent with 92 (47.4%) cases, followed by chronic cases (>3 months) with 63 (32.5%) cases. Family members were the primary source of infection in 56 (28.9%) cases. Laboratory analysis revealed potassium hydroxide (KOH) positivity in 148 (76.3%) cases and culture positivity in 169 (87.1%) cases. Tinea corporis was the predominant clinical presentation, with 114 (58.7%) cases, followed by tinea cruris, with 39 (20.1%) cases. Risk factor analysis identified male gender (OR: 1.86, 95% CI: 1.24-2.78), family contact (OR: 2.34, 95% CI: 1.52-3.60), age >20 years (OR: 1.67, 95% CI: 1.12-2.49), and duration >3 months (OR: 1.93, 95% CI: 1.28-2.91) as significant risk factors. Mycological analysis revealed Trichophyton mentagrophytes as the predominant species with 149 (76.8%) isolates, followed by T. rubrum with 35 (18.0%) isolates. Conclusion This study elucidates the clinicomycological profile of dermatophytosis in a tertiary care setting in Tamil Nadu, India, highlighting the predominance of Trichophyton mentagrophytes as the primary etiological agent. The ascendancy of T. mentagrophytes warrants clinical vigilance, given its established association with terbinafine resistance and chronic dermatophytosis across the Indian subcontinent. These findings underscore the imperative of accurate species identification to facilitate evidence-based antifungal selection, potentially mitigating therapeutic failures and recalcitrant infections.