Recurrent dermatophytosis: A rising problem in Sikkim, a Himalayan state of India.

Changing pattern of dermatophytic infection among people of Sikkim over the past few years and its recurrence rate has brought a need to do a study on clinical pattern and its recurrence from this part of the country. The objectives of this study are to discern the clinical patterns of dermatophytosis, identification of the isolated fungi to its species level and to see the pattern of its recurrence. The study was carried out from January 2015 to May 2016. A total of 192 samples were collected from the patients with clinical findings of dermatophytic infection. Required history of the patients was taken, followed by clinical examination of the lesions and sample collection. The samples were processed for mycological study till species identification and a follow up of patients were done to assess its recurrence pattern. The age distribution of the patients was from 2 to 80 years. The mean and median age was 30.33 and 33 years respectively. The male female ratio was 1.8:1. Dermatophytosis was noted more commonly in students (n = 64, 33.33%) and jawans (n = 44, 22.92%). Maximum occurrence was noted from April to July (n = 106, 55.20%) and was seen mainly in young Hindu males. Tinea corporis (n = 104, 54.16%) was the most common clinical manifestation followed by tinea unguium (n = 30, 15.63%). T. mentagrophyte (40%) was the most common species followed by T. schoenleinii (33.3%), T. tonsurans (16.6%) and T. rubrum (6.6%). The recurrence rate was seen most commonly in clinical cases of tinea faciei 100%, followed by tinea pedis 80% and tinea unguium 46.6%. Overall clinical cure rate was 58.3% and recurrence rate was 34.3%. In the isolated species of dermatophytes, the recurrence rate was 73.68% and that of non-dermatophytes it was 28.07%. Dermatophytosis is an important health problem with high recurrence in Sikkim with difference in the etiological agent from other parts of India.