Dermatophytosis: A Review on Epidemiology, Pathogenesis, Clinical Features, Diagnosis and Treatment Strategies in Nepal

Abstract

Fungal infections of the skin, hair, and nails are the most common clinical conditions caused by dermatophytes. The most common causes of dermatophytic infections are Trichophyton, Epidermophyton, and Microsporum spp. If left untreated, these infections can lead to increased morbidity and secondary bacterial infections. This review highlights the knowledge on dermatophytes, including their epidemiology, prevalence, pathogenesis, diagnosis, and treatment among Nepalese, based on electronic databases (Google Scholar, NCBI, Pubmed, and Scopus). Terai region has a higher prevalence of dermatophytosis cases compared to the mountainous areas, primarily due to the hot and humid climate. Trichophyton rubrum and Trichophyton mentagrophytes are the two most common causative agents. In Nepal's tertiary medical facilities, only microscopy and culture techniques are used for diagnosis. However, in community settings, the only diagnostic technique available is clinical observation.  In Nepal, topical therapy with azoles or terbinafine is the first-line treatment for cutaneous tinea, while systemic medication with terbinafine is the first line treatment for onychomycosis and tinea capitis. There is a need for further research to develop better prevention and treatment strategies to reduce the burden of these infections.