インド・ケララ州の第三次医療センターにおける皮膚糸状菌症のプロフィール

Profile of Dermatophytosis in a Tertiary Care Center in Kerala, India.

• Mary Vineetha
• S Sheeja
• M I Celine
• M S Sadeep
• Seena Palackal
• P E Shanimole
• S Saranya Das

抄録

背景:

皮膚糸状菌症はここ数年増加傾向にあり、再発・慢性化する症例が多い。

Background: The incidence of dermatophytosis is increasing over the last few years and there are many cases which are recurrent and chronic.

目的:

目的は、皮膚糸状菌症の宿主および病原体因子を研究し、原因菌種を同定し、慢性皮膚糸状菌症の病理組織学的特徴を研究することであった。

Aim: The aim was to study the host and pathogen factors in dermatophytosis, to identify the species responsible, and to study the histopathological features of chronic dermatophytosis.

材料と方法:

本研究は皮膚科で1年間実施され、臨床的に皮膚糸状菌症と診断された全患者を対象とした記述的研究である。孤立した毛髪、爪の病変は研究から除外した。疫学的パラメータと治療歴を分析し、スクレーピングと真菌培養を全例に実施した。慢性皮膚糸状菌症でステロイド外用薬を使用した症例では病理組織学的検査を行った。

Materials and Methods: It was a descriptive study conducted in the Department of Dermatology for a period of 1 year and all patients who were clinically diagnosed as dermatophytosis were included. Isolated hair, and nail involvement were excluded from the study. Epidemiological parameters and treatment history were analyzed, scrapings, and fungal culture were done in all patients. Histopathological examination was done in patients with chronic dermatophytosis who had applied topical steroids.

結果:

慢性皮膚糸状菌症は68％に認められ，白癬は最も一般的な症状であり，ステロイド外用薬は63％に認められ，アゾールは最も一般的な抗真菌薬であった．病理組織学的にはステロイド修飾白癬の毛包周囲炎が認められた。また，感受性試験ではitraconazoleの最小阻害濃度が最も低かった。

Results: Chronic dermatophytosis was seen in 68%; tinea corporis was the most common presentation; topical steroid application was seen in 63%; azoles were the most common antifungals used; varied morphologies such as follicular and nonfollicular papules, arciform lesions, pseudoimbricata were seen in steroid modified tinea. and were the most common species isolated in culture, but rare species such as , and were also isolated from chronic cases. Histopathology showed perifolliculitis in steroid modified tinea. Minimal inhibitory concentration was lowest for itraconazole in susceptibility studies.

結論:

皮膚糸状菌症の慢性化はステロイド外用、コンプライアンス違反、優勢種の変化など様々な要因によるものである。

Conclusion: Chronicity in dermatophytosis is due to various factors such as topical steroid application, noncompliance, and change in predominant species.