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Study of Clinical Profile and Immunological Dysfunction in One Hundred Patients of Recurrent Dermatophytosis

60 Pages Posted: 8 Jan 2019

See all articles by Krishna Jha

Krishna Jha

Post Graduate Institute of Medical Education & Research (PGIMER) - Department of Dermatology, Venereology and Leprology

Tarun Narang

Post Graduate Institute of Medical Education & Research (PGIMER) - Department of Dermatology, Venereology and Leprology

Biman Saikia

Post Graduate Institute of Medical Education & Research (PGIMER)

Shivaprakash Rudramurthy

Post Graduate Institute of Medical Education & Research (PGIMER)

Uma Saikia

Post Graduate Institute of Medical Education & Research (PGIMER)

Adil Karim

Post Graduate Institute of Medical Education & Research (PGIMER)

Dipika Shaw

Post Graduate Institute of Medical Education & Research (PGIMER)

Sunil Dogra

Post Graduate Institute of Medical Education & Research (PGIMER) - Department of Dermatology, Venereology and Leprology

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Abstract

Background: An alarming increase in number of patients with chronic and recurrent dermatophytosis has invoked the need to study immunological parameters of the host in addition to traditional pathogens studies. This study was done to evaluate delayed type of hypersensitivity (DTH) response by estimating TH1 cells  along with TH17 cells and immediate hypersensitivity (IH) response by estimating TH2 cells population in peripheral blood along with intradermal trichophytin skin test  in patients with recurrent dermatophytosis.  

Methods: In this case-control study, 100 patients with recurrent dermatophytosis and 50 controls were included. Flow-cytometric evaluation of TH1, TH17 and TH2 cells in peripheral blood along with intradermal trichophytin extract test was done. Dermatophytes pathogens were isolated on culture and antifungal drug susceptibility test was done. Relevant risk factors for recurrent disease were analysed and serum IgE levels were estimated.  

Findings: TH1 cells were reduced in 72.6 % cases vs 52 % controls (p=0.01) and TH17 cells were reduced in 49.4% cases vs 26 % controls (p=0.006). Intradermal trichophytin test demonstrated negative DTH response in 100 % of cases (p=0.0001). Positive IH response was observed in 91% cases vs 68% controls (p=0.0001). T.mentagrophytes complex (95.8%) was the most common species isolated followed by T.rubrum (4.16%). The risk factors associated were family history of tinea, sharing of towels and clothes and corticosteroids use in recent past (p= 0.007, p=0.009, p=0.0001). Serum IgE was elevated in 83.15 % cases (p=0.01).

 Interpretations:Our study demonstrated impaired DTH response and reduced TH1 and TH17 cell population in patients with recurrent dermatophytosis.  

Funding Statement: The authors declare: "None ."

Declaration of Interests: The authors declare: "None."

Ethics Approval Statement: The study protocol was approved by the Institutional Ethics Committee (Intramural) of the Postgraduate Institute of Medical Education and Research, Chandigarh.

Keywords: Recurrent dermatophytosis; TH1 cells; TH2 cells; TH17 cells; Delayed type hypersensitivity(DTH); Immediate hypersensitivity (IH); intradermal skin test; antifungal susceptibility

Suggested Citation

Jha, Krishna and Narang, Tarun and Saikia, Biman and Rudramurthy, Shivaprakash and Saikia, Uma and Karim, Adil and Shaw, Dipika and Dogra, Sunil, Study of Clinical Profile and Immunological Dysfunction in One Hundred Patients of Recurrent Dermatophytosis (February 1, 2019). Available at SSRN: https://ssrn.com/abstract=3309417

Krishna Jha

Post Graduate Institute of Medical Education & Research (PGIMER) - Department of Dermatology, Venereology and Leprology

Sector 12
PGIMER, Sec. 12
Chandigarh, 160012
India

Tarun Narang

Post Graduate Institute of Medical Education & Research (PGIMER) - Department of Dermatology, Venereology and Leprology

Sector 12
PGIMER, Sec. 12
Chandigarh, 160012
India

Biman Saikia

Post Graduate Institute of Medical Education & Research (PGIMER)

Sector 12
PGIMER, Sec. 12
Chandigarh, 160012
India

Shivaprakash Rudramurthy

Post Graduate Institute of Medical Education & Research (PGIMER)

Sector 12
PGIMER, Sec. 12
Chandigarh, 160012
India

Uma Saikia

Post Graduate Institute of Medical Education & Research (PGIMER)

Sector 12
PGIMER, Sec. 12
Chandigarh, 160012
India

Adil Karim

Post Graduate Institute of Medical Education & Research (PGIMER)

Sector 12
PGIMER, Sec. 12
Chandigarh, 160012
India

Dipika Shaw

Post Graduate Institute of Medical Education & Research (PGIMER)

Sector 12
PGIMER, Sec. 12
Chandigarh, 160012
India

Sunil Dogra (Contact Author)

Post Graduate Institute of Medical Education & Research (PGIMER) - Department of Dermatology, Venereology and Leprology ( email )

Sector 12
PGIMER, Sec. 12
Chandigarh, 160012
India

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