Prevalence of Dermatophytes in Egypt & Mycological assessment before and after Itraconazole therapy in patient with Recalcitrant Dermatophytosis

Abstract

Background: A common superficial illness called dermatophytosis is brought on by dermatophytes, a genus of keratinophilic, pathogenic fungi. In addition to invading the epidermal barrier, host immunological reactions to dermatophytes may partially cause tissue injury and pathologic inflammation. Understanding the pathophysiology of dermatophytosis, including fungal virulence factors and immune responses against pathogens, is therefore very beneficial. Dermatophytes are classified into nine genera based on the characteristics of their asexual spores, or macroconidae. This study aimed to detect the prevalence of dermatophytes in Egypt with mycological assessment before and after oral itraconazole therapy for chronic, recurrent, and recalcitrant dermatophytosis. Patients and methods: This study included 75 patients with different clinical types of chronic, recurrent, and/or recalcitrant dermatophytosis. All patients were subjected to adequate dermatological examination as regarding site and size of the lesions, the presence of associated papules, vesicles and/or pustules, lesion distribution, morphological variants, duration, and the presence of inflammation and scaling at each follow-up visit. All patients received oral itraconazole at a dose of 200mg/day for 6 weeks. Results: T.mentagrophytes was the most common isolated dermatophyte in patient with recalcitrant dermatophytosis (28%), followed by T.rubrum which represents (20%) of the recalcitrant tinea cases. as regarding Therapeutic response after end of itraconazole therapy, complete mycological cure was observed in (66.7%) of cases and complete clinical cure (69.3%) of cases. Recurrence after end of itraconazole therapy was detected in 13 cases (17%). Conclusion: T. mentagrophytes is the most common fungal isolates in patients with recalcitrant dermatophytosis.