Abstract
BACKGROUND: Dermatophytes, primarily Epidermophyton spp., Trichophyton spp., and Microsporum spp., are responsible for superficial cutaneous mycoses, estimated to affect 20-25% of the people worldwide. The rise of antifungal resistance, especially to terbinafine, has made treating dermatophytosis increasingly difficult. This study aims to assess the clinical and mycological characteristics of dermatophytosis cases and evaluate the in vitro susceptibility of dermatophyte isolates to terbinafine and griseofulvin.
MATERIALS AND METHODS: A total of 118 samples were studied from patients with clinical suspicion of dermatophytosis. The samples were processed for KOH mount and fungal culture for further speciation. Susceptibility to terbinafine and griseofulvin was assessed using the microbroth dilution technique, following the guidelines established by the Clinical and Laboratory Standards Institute (CLSI).
RESULTS: Tinea corporis (57.6%) appeared as the leading symptomatology in our study, followed by tinea cruris (10.2%). KOH positivity was higher (70.3%) compared to positivity by culture (16.9%). Trichophyton mentagrophytes was the predominant species (85%) isolated, followed by Trichophyton violaceum (10%) and Microsporum gypseum (5%). Terbinafine resistance was observed in over 60% of T. mentagrophytes isolates, with moderate resistance detected in T. violaceum. Griseofulvin showed moderate resistance in T. mentagrophytes and higher resistance in T. violaceum.
CONCLUSION: This study highlights the increased resistance of T. mentagrophytes to terbinafine and T. violaceum to griseofulvin, stressing the critical role of routine susceptibility profiling. The findings highlight the growing challenge of antifungal resistance in dermatophytes and the importance of optimizing diagnostic and treatment strategies to improve patient outcomes.