Emerging atypical and unusual presentations of dermatophytosis in India

In the recent past, there has been an alarming rise in patients presenting with atypical clinical types of dermatophytosis. These patients require prolonged treatment with systemic and topical antifungal agents. In majority of patients, close household contacts are affected. Frequent relapses and extensive disease affect the quality of life of the patient significantly. The emergence of such a challenging scenario is attributed to complex interplay of host, environment, and agent factors. The change in prevalence of dermatophytes causing the disease; host factors such as comorbidity and immunosuppression; and hot and humid climate, lifestyle changes, and poor hygiene are responsible for atypical dermatophytosis. Several atypical clinical types such as psoriasis-like, eczematous dermatitis-like, seborrheic dermatitis-like, and rosacea-like have been reported. Hence, dermatophytosis has been suggested to be included in the list of great imitators. The collaborative effort involving dermatologists, microbiologists, and public health professionals is required to address this emerging public health problem