Dermatophytosis Among Outpatients in Gaza, Particularly Tinea Capitis

Superficial fungal infections caused by dermatophytes, are a public health problem in many parts of the world especially in developing countries. The aim of this study is to determine the prevalence and etiological agents of dermatophytosis, and their distribution according to age and gender in the region of Gaza, Palestine. Skin, hair and nail samples were collected from 111 subjects suspected to have cutaneous mycoses, who attended the dermatology clinic at Gaza over 7-month study period, from March to September 2009. Samples were examined by direct microscopy  with 10-20% KOH preparation and culture on Sabouraud's dextrose agar.

In light of clinical diagnosis, the most common dermatophytic infection was tinea capitis (50.5%), followed by tinea corporis and tinea unguium (12.6% for each), and tinea versicolor (4.5%). Diagnosis was confirmed by microscopic examination in 37 cases (33.3%), and the causative agent was isolated and cultured in 34 cases (30.6%). However, 40 cases (36%) were confirmed by microscopic examination or culture and 31 cases (27.9%) confirmed by both methods.

Dermatophytes were significantly the most common isolated pathogens (28/34, 82.4%), followed by Candida spp. (5/34, 14.7%) and Malassezia furfur (1/34, 2.9%). Among dermatophytes, Trichophyton spp. was the most frequent isolate (14/34, 41.2%), followed by Microsporum spp. (13/34, 38.2%). The least isolated dermatophyte was Epidermophyton floccosum  (1/34, 2.9%).

There was no significant difference between the percentage of infection in males (52.5%) and females (47.5%). However, highest prevalence of dermatophytic infection was detected among age group 1-15 years, in particular tinea capitis, where mostly caused by the genera Trichophyton and Microsporum.

In conclusion, our study showed that the most common dermatophytic infection was tinea capitis, tinea corporis and tinea unguium respectively and the most common isolated agents were Trichophyton and Microsporum spp.

Keywords: Dermatophytosis, Outpatients, Tinea capitis, Gaza.