{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:24:08Z","timestamp":1787772248223,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,3]]},"abstract":"\n Background:<\/jats:title>\n Dermatophytosis have assumed epidemic proportions in India. Antifungal drug resistance solely cannot explain disease magnitude and changing epidemiology.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n Aim of this study was to analyse clinical-mycological aspects of dermatophytosis, and estimate contribution of drug resistance in clinical recalcitrance.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This single-centre observational, cross-sectional, descriptive study was done in tertiary centre of western India after ethical approval, enrolling dermatophytosis patients of all ages and sex. After history and examination, KOH mount and culture in modified SDA medium was done. Culture positive isolates were subjected to E-strip antifungal susceptibility method to test MIC for Terbinafine, Itraconazole, Fluconazole and Griseofulvin.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Total 300 patients were included, with mean age of 33.83\u00b127.5 years and male-to-female ratio of 1.22:1; tinea corporis et cruris being commonest, 39.33% (\n n<\/jats:italic>\n =118). Only 11.67% (\n n<\/jats:italic>\n =35) were treatment na\u00efve, having classical annular morphology. History of topical steroid abuse was found in 81.67% (\n n<\/jats:italic>\n =245), with pseudoimbricate lesions in 70.61% (\n n<\/jats:italic>\n =173). 86.67% (\n n<\/jats:italic>\n =260) had KOH positivity while 83.33% (\n n<\/jats:italic>\n =250) had culture positivity: Trichophyton mentagrophytes 45.6% (\n n<\/jats:italic>\n =114), followed by Trichophyton rubrum in 34.4% (\n n<\/jats:italic>\n =86). A total of 265 patients fit into definition of recalcitrance, from which 12.45%, i.e., 33 isolates showed in-vitro fluconazole resistance. 14.33% (\n n<\/jats:italic>\n =43) cases were chronic, 37% (\n n<\/jats:italic>\n =111) persistent, 46% (\n n<\/jats:italic>\n =138) recurrent while 17% (\n n<\/jats:italic>\n =51) had relapse in their disease course. Steroid abuse was the commonest denominator.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Role of antifungal resistance in recalcitrant dermatophytosis remains debatable. Stopping steroid abuse, which is often the commonest culprit, with adherence to standard antifungal therapy remains the paradigm in management.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijd.ijd_999_22","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T01:47:09Z","timestamp":1715737629000},"page":"234","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["A Clinical-Mycological Study of Dermatophytosis in Western India with Focus on Antifungal Drug Resistance as a Factor in Recalcitrance"],"prefix":"10.4103","volume":"68","author":[{"given":"Shikha R.","family":"Shah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshita R.","family":"Vyas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bela J.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha C.","family":"Jangid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankita","family":"Choudhary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarun","family":"Gehlawat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deval","family":"Mistry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rutu","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-34-20240829","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12895-018-0073-1","article-title":"Expert consensus on the management of dermatophytosis in India (ECTODERM India)","volume":"18","author":"Rajagopalan","year":"2018","journal-title":"BMC Dermatol"},{"key":"R2-34-20240829","doi-asserted-by":"crossref","first-page":"227","DOI":"10.4103\/ijd.IJD_206_17","article-title":"The great Indian epidemic of superficial dermatophytosis: An appraisal","volume":"62","author":"Verma","year":"2017","journal-title":"Indian J Dermatol"},{"key":"R3-34-20240829","doi-asserted-by":"crossref","first-page":"281","DOI":"10.4103\/ijdvl.IJDVL_224_17","article-title":"The menace of dermatophytosis in India: The evidence that we need","volume":"83","author":"Panda","year":"2017","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R4-34-20240829","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s11046-008-9103-6","article-title":"Immunology of dermatophytosis","volume":"166","author":"Almeida","year":"2008","journal-title":"Mycopathologia"},{"key":"R5-34-20240829","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1111\/myc.12878","article-title":"The current Indian epidemic of superficial dermatophytosis due to Trichophyton mentagrophytes-A molecular study","volume":"62","author":"Nenoff","year":"2019","journal-title":"Mycoses"},{"key":"R6-34-20240829","doi-asserted-by":"crossref","first-page":"277","DOI":"10.4103\/ijd.IJD_456_18","article-title":"A study of In vitro antifungal susceptibility patterns of dermatophytic fungi at a tertiary care center in Western India","volume":"64","author":"Poojary","year":"2019","journal-title":"Indian J Dermatol"},{"key":"R7-34-20240829","doi-asserted-by":"crossref","first-page":"598","DOI":"10.18203\/issn.2455-4529.IntJResDermatol20193236","article-title":"Clinicomycological study of tinea infections in and around Pune","volume":"5","author":"Dhayagude","year":"2019","journal-title":"Int J Res Dermatol"},{"key":"R8-34-20240829","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.4103\/jfmpc.jfmpc_159_19","article-title":"Dermatophytoses and spectrum of dermatophytes in patients attending a teaching hospital in Western Rajasthan, India","volume":"8","author":"Kalita","year":"2019","journal-title":"J Family Med Prim Care"},{"key":"R9-34-20240829","doi-asserted-by":"crossref","first-page":"214","DOI":"10.4103\/idoj.IDOJ_497_18","article-title":"South Asian epidemic of antifungal therapeutic failures: Congress proceedings and take-home messages. First international congress of SAARCUM: South Asian alliance against recalcitrant CUtaneous Mycosis. 17 November 2018, Medanta - The Medicity, Gurugram, India","volume":"10","author":"Aggarwal","year":"2019","journal-title":"Indian Dermatol Online J"},{"key":"R10-34-20240829","doi-asserted-by":"crossref","first-page":"90","DOI":"10.4103\/idoj.IDOJ_137_17","article-title":"Is Antifungal Resistance a Cause for Treatment Failure in Dermatophytosis: A Study Focused on Tinea Corporis and Cruris from a Tertiary Centre?","volume":"9","author":"Sardana","year":"2018","journal-title":"Indian Dermatol Online J"},{"key":"R11-34-20240829","doi-asserted-by":"crossref","first-page":"713687","DOI":"10.1155\/2012\/713687","article-title":"Antifungal resistance and new strategies to control fungal infections","volume":"2012","author":"Vandeputte","year":"2012","journal-title":"Int J Microbiol"},{"key":"R12-34-20240829","doi-asserted-by":"crossref","first-page":"225","DOI":"10.4103\/idoj.IDOJ_146_19","article-title":"Antifungal drug susceptibility testing of dermatophytes: Laboratory findings to clinical implications","volume":"10","author":"Dogra","year":"2019","journal-title":"Indian Dermatol Online J"},{"key":"R13-34-20240829","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1128\/JCM.02416-16","article-title":"Establishment and use of epidemiological cutoff values for molds and yeasts by use of the clinical and laboratory standards institute M57 standard","volume":"55","author":"Lockhart","year":"2017","journal-title":"J Clin Microbiol"},{"key":"R14-34-20240829","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s11046-019-00360-9","article-title":"In Vitro activity of antifungal drugs against Trichophyton rubrum and Trichophyton mentagrophytes spp.by E-Test Method and non-supplemented Mueller-Hinton Agar Plates","volume":"184","author":"Intra","year":"2019","journal-title":"Mycopathologia"},{"key":"R15-34-20240829","first-page":"595","article-title":"Prevalence of dermatophytosis and its spectrum in a tertiary care hospital, Kolhapur","volume":"5","author":"Putta","year":"2016","journal-title":"Indian J Basic Appl Med Res"},{"key":"R16-34-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4172\/2327-5073.1000145","article-title":"In vitro antifungal susceptibility testing of 5 antifungal agents against dermatophytic species by CLSI (M38-A) micro dilution method","volume":"3","author":"Indira","year":"2014","journal-title":"Clin Microbial"},{"key":"R17-34-20240829","first-page":"64","article-title":"Antifungal susceptibility testing for dermatophytes isolated from clinical samples by broth dilution method in a tertiary care hospital","volume":"1","author":"Sowmya","year":"2015","journal-title":"JMR"},{"key":"R18-34-20240829","doi-asserted-by":"crossref","first-page":"533","DOI":"10.4103\/0255-0857.167341","article-title":"Determination of minimum inhibitory concentrations of itraconazole, terbinafine and ketoconazole against dermatophyte species by broth microdilution method","volume":"33","author":"Bhatia","year":"2015","journal-title":"Indian J Med Microbiol"},{"key":"R19-34-20240829","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3390\/jof3020017","article-title":"Molecular identification and antifungal susceptibility patterns of clinical dermatophytes following CLSI and EUCAST guidelines","volume":"3","author":"Dabas","year":"2017","journal-title":"J Fungi (Basel"},{"key":"R20-34-20240829","doi-asserted-by":"crossref","first-page":"678","DOI":"10.4103\/ijdvl.IJDVL_645_17","article-title":"A prospective study of the epidemiological and clinical patterns of recurrent dermatophytosis at a tertiary care hospital in India","volume":"84","author":"Pathania","year":"2018","journal-title":"Indian J Dermatol Venereol Leprol"}],"container-title":["Indian Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijd.ijd_999_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:35:05Z","timestamp":1787769305000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijd.ijd_999_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijd.ijd_999_22","relation":{},"ISSN":["0019-5154"],"issn-type":[{"value":"0019-5154","type":"print"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}