Changing Clinical Spectrum of Dermatophytosis: Impact of Topical Steroid Abuse in Patients with Tinea Incognito
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Objective: To evaluate the changing clinical spectrum of dermatophytosis with special emphasis on the impact of topical steroid abuse in patients presenting with tinea incognito. Methods: This hospital-based observational study was conducted in the dermatology department of a tertiary care hospital over one year. A total of 220 patients with clinically and mycologically confirmed dermatophytosis were included. Detailed history regarding topical steroid use, clinical examination, and laboratory investigations including KOH mount and fungal culture were performed. Patients were categorized into classical dermatophytosis and tinea incognito groups for comparative analysis. Results: Out of 220 patients, 134 (60.9%) presented with tinea incognito and 86 (39.1%) had classical dermatophytosis. Atypical clinical features such as loss of central clearing, diffuse erythema, and eczematous changes were significantly more common in the steroid-exposed group (p < 0.001). Self-medication was the most common source of topical steroid use (61.9%). Tinea incognito cases showed longer disease duration and more extensive involvement compared to classical cases. Trichophyton rubrum was the most frequently isolated organism. Conclusion: The study demonstrates a strong association between topical corticosteroid misuse and the changing clinical spectrum of dermatophytosis, leading to a high burden of tinea incognito. Rational use of topical agents, strict regulation of steroid-containing formulations, and increased public awareness are essential to prevent disease modification and improve treatment outcomes.Abstract
Objective: To evaluate the changing clinical spectrum of dermatophytosis with special emphasis on the impact of topical steroid abuse in patients presenting with tinea incognito. Methods: This hospital-based observational study was conducted in the dermatology department of a tertiary care hospital over one year. A total of 220 patients with clinically and mycologically confirmed dermatophytosis were included. Detailed history regarding topical steroid use, clinical examination, and laboratory investigations including KOH mount and fungal culture were performed. Patients were categorized into classical dermatophytosis and tinea incognito groups for comparative analysis. Results: Out of 220 patients, 134 (60.9%) presented with tinea incognito and 86 (39.1%) had classical dermatophytosis. Atypical clinical features such as loss of central clearing, diffuse erythema, and eczematous changes were significantly more common in the steroid-exposed group (p < 0.001). Self-medication was the most common source of topical steroid use (61.9%). Tinea incognito cases showed longer disease duration and more extensive involvement compared to classical cases. Trichophyton rubrum was the most frequently isolated organism. Conclusion: The study demonstrates a strong association between topical corticosteroid misuse and the changing clinical spectrum of dermatophytosis, leading to a high burden of tinea incognito. Rational use of topical agents, strict regulation of steroid-containing formulations, and increased public awareness are essential to prevent disease modification and improve treatment outcomes.
