Clinicomycological Profile and Antifungal Sensitivity Pattern of Commonly Used Azoles in Dermatophytosis

Introduction: Dermatophytosis is a common superficial fungal infection of the skin, hair and nails caused by Trichophyton, Microsporum and Epidermophyton dermatophytic species. Identification of causative dermatophytic species tend to vary with time and place and antifungal sensitivity is of epidemiological concern as well as significant for the treatment with precision at the current scenario of increasing antifungal resistance. To study clinicomycological profile and antifungal sensitivity pattern of commonly used azoles in dermatophytosis. 
 Methods: The prospective analysis of 145 clinically suspected cases of dermatophytosis was conducted from January 2014 to January 2015 at Department of Dermatology of COMS, Bharatpur, Chitwan, Nepal. Cases were evaluated and data recorded as per proforma. Samples were collected for microscopy and culture from skin, hair and nail. Antifungal sensitivity pattern was evaluated by standard disk diffusion technique. 
 Results: Maximum numbers of cases with dermatophytosis were observed between June to September with male to female ratio of 1.4:1. The youngest patient was 3 years and the oldest was 76 years. Tinea corporis (25.5%) was the dominant clnical type observed. Overall direct microscopy (KOH) positivity and culture positivity was 64.8% and 57.2% respectively. Predominant species of dermatophyte isolated was T. mentagrophyte (23.4%). Out of five antifungals used in our study, fluconazole and ketoconazole were found 100% resistant. 
 Conclusions: This study highlighted the increasing resistance of the antifungals, which is responsible for the treatment failure in dermatophye infections. 
 Keywords: antifungal resistance; dermatophyte; epidemiology