Siddharth Sethi

Abstract

Introduction: Dermatophytes are fungi that can cause infections of the skin, hair & nails due to their ability to invade keratin. Dermatophytosis is the most common superficial fungal infection worldwide; it is common in tropics and subtropical regions. It may present in epidemic proportions in areas of high humidity. Objective: The present study aimed to identify various species causing dermatophytosis & to determine the invitro susceptibility pattern against commonly used systemic antifungal agents in our tertiary care center.  Material and Methods: A total of 149 samples were collected of infected skin, hair and nails in a period of 1 year from January 2020 to December 2020. Samples were collected under aseptic condition by skin scrapping, nail and hair clipping by using scalpel or forceps. Identification of the causative pathogen was done by performing slide culture, lacto-phenol cotton blue mount, hair perforation tests and urease tests. We adopted a newly developed agar based disk diffusion assay to test susceptibility of clinically isolated dermatophytes for antifungal susceptibility testing. Results: Microbiological investigations revealed the presence of dermatophytic fungi in 71.8% of the samples. Trichophyton rubrum was the predominant pathogen isolated. The study showed Itraconazole to be most effective antifungal drugs against dermatophytes followed by terbinafine and fluconazole.  Conclusions: Further intensive epidemiological and invitro antifungal susceptibility studies of dermatophytes are required which will have more public health significance.   Keywords: Dermatophytes, Antifungals, Susceptibility

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Abstract

Introduction: Vitiligo: An autoimmune disorder of pigmentation characterised by loss of functional melanocytes and melanin in epidermis. The disease has incidence of 0.5%–2% with no ethnic/sex predilection. Aim: Morphological dermoscopic patterns in vitiligo and its correlation with stability. Setting & Desing: An observational study conducted on patients attending C. R. Gardi Hospital, Ujjain during January’19-December’19. Materials and Methods: Dermoscopic examination was done after taking consent in 50 clinically diagnosed cases of vitiligo including stable vitiligo and unstable vitiligo. Statistical Analysis Used : Fisher’s Exact Test Sig. Results: On dermoscopy, patterns like perifollicular pigmentation (44%), perilesional/marginal hyperpigmentation (50%), intra/perilesional erythema with telangiectasia (86%), perifollicular depigmentation (64%), trichrome pattern (50%), leukotrichia (46%), starburst appearance (24%), comet tail appearance (48%), micro-koebner’s phenomenon (42%), tapioca sago appearance (28%) were observed. Perilesional/marginal hyperpigmentation was observed more frequently in stable disease. Perifollicular depigmentation, trichrome pattern, comet tail appearance, micro koebner’s phenomenon and tapioca sago appearance are the findings significant in unstable disease. Perifollicular pigmentation and intra/perilesional erythema with telangiectasia though are findings of stable disease, were observed in both stable and unstable disease in similar numbers. Leukotrichia and starburst appearance were present in both stable and unstable disease despite being the findings of unstable disease. Conclusion: Dermoscopy serves as an auxiliary tool in confirming the diagnosis and assessing stability of the disease. Dermoscopy allows appreciation of subtle features invisible to naked eye. This is the first ever study to find out the statistically significant findings in stable and unstable vitiligo. We conclude that dermoscopic study in cases of vitiligo can be used as an additional aid in confirming the diagnosis of vitiligo apart from other modalities. Keywords: Dermoscopy, Leukotrichia, Trichrome, Tapioca Sago, Starburst.

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