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Scholars Journal of Applied Medical Sciences | Volume-5 | Issue-06
Epidemic of Dermatophytosis in India, are Topical Steroids Adding Fuel to the Fire? - Hospital Based Longitudinal Prospective Study
Nayankumar H Patel, Jigna Padhiyar, Trusha Gajjar, Mansi Buch, Jayshree Tolani
Published: June 30, 2017 | 152 139
DOI: 10.36347/sjams.2017.v05i06.033
Pages: 2216-2223
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Abstract
Dermatophytic skin infections constitute major bulk of dermatological diseases in India. Use of topical corticosteroid is said to be compounding many aspects of clinical presentations and epidemiology of disease. This study is conducted with aim of bringing forth initial picture of this problem. The objective is to know prevalence of use of topical corticosteroids amongst patients of dermatophytosis and to analyze effects of topical corticosteroids on various clinical parameters of dermtophytosis. Material and Methods: This longitudinal prospective study was conducted by including all new patients who were clinically diagnosed as having dermatophytosis for 30 consecutive days. Epidemiological and clinical parameters were observed and use of corticosteroid was evaluated. Steroid treated patients were compared with de novo group for analysis of obtained parameters. History of Use of steroid was confirmed in 64.5% cases. Significantly longer duration of disease was observed in steroid treated patients compare to de novo cases (t=2.926, CL95%, P=0.00429.) Duration of disease equal to or greater than 1 month was found to be significantly associated with involvement of more than one anatomical site (χ28.94, CL95%, P0.0028,Cramer’s V 0.2099). Atypical clinical presentations were more common (60.1%). Cutaneous signs of adverse effects of topical steroids were found in 36.7% of steroid treated patients. Increase in BMI poses additional risk of longer duration of diseases (χ210.446, CL95%, Cramer’s V0.227).Conclusion: Abuse of topical corticosteroid is a significant problem in patients of dermatophytosis in this part of India and it is further fueling epidemic of dermatophytosis by changing clinical presentation, prolonging duration of disease and helping spread of disease to multiple anatomical sites.