Name of the candidate and address dr. Afzal hussain p. G student in dermatology venereology and leprology



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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE.
PROFORMA
FOR REGISTRATION OF SUBJECT FOR DISSERTATION.


Sl,No

1

NAME OF THE CANDIDATE AND ADDRESS


DR. AFZAL HUSSAIN

P.G STUDENT IN DERMATOLOGY VENEREOLOGY AND LEPROLOGY.

NAVODAYA MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTRE

MANTRALAYAM ROAD

RAICHUR- 584103


2

NAME OF THE INSTITUTION

NAVODAYA MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTRE

MANTRALAYAM ROAD

RAICHUR-584103




3


DURATION OF COURSE

3 YEARS M.D DERMATOLOGY VENEREOLOGY AND LEPROLOGY


4

DATE OF ADMISSION TO COURSE

1ST JUNE 2009



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TITLE OF THE TOPIC

CLINICAL AND MYCOLOGICAL STUDY OF TINEA CORPORIS.




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6.1

BRIEF RESUME OF INTENDED WORK.

NEED FOR THE STUDY
Tinea corporis is a superficial fungal infection of keratinized tissue caused by dermatophytes.1

The infection is commonly called as ringworm or ‘tinea’.Dermatophytes are moulds belonging to three genera of fungi imperfectii i.e, 1.Microsporum 2.Trichophyton and 3.Epidermophyton.2


According to observation worldwide, dermatophytoses are the most common of the superficial fungal infection. It is common in tropics and may present in epidemic proportions in areas with high rate of humidity ,over population and poor hygienic conditions . 3 Raichur is a tropical area,

hence the present study has been taken to find out the predisposing factors for Tinea corporis,to find out the prevalence of Tinea corporis, and to find out the fungal species affecting Tinea corporis in Raichur.






6.2

REVIEW OF LITERATURE.

During the last 20 years of the 19th century Sabouraud began his monumental studies of dermatophytes or ringworm fungi which culminated with the publication of his classic “Les Teignes” in 1910. Sabouraud is considered the father of modern medical mycology.2

During the 1920’s studies of the dermatophytes by Benham and Hopkins formed the foundation of modern medical mycology.Emmons, Comamt and Geary consolidated these efforts. In 1934, Emmons critically reviewed the taxonomic status of the dermatophytes and he accepted only three genera Microsporum, Trichophyton and Epidermophyton. He also defined each of them according to the systematic rules of the nomenclature and taxonomy.4

Powell, in 1900, reported the prevalence of dermatophytes infection in Assam, there after the incidence of dermatophytosis in different parts of India have been published.5

Dermatophytoses are moulds belonging to 3 genera of fungi imperfectii i.e. Microsporum , Trichophyton and Epidermophyton.2 Dermatophytoses is an infection of the skin, hair or nails caused by dermatophytes.

Dermatophyte differentiation in the clinical setting begins with the source of the organism. Trichophyton can infect hair, skin and nails. Microsporum can infect hair and skin. Epidermophyton can infect skin and nails.14

Tinea corporis is defined as dermatophytoses of the glabrous skin with the exclusion of the palms, soles and groins.3

The site of infection is typically on exposed skin, more so it is due to a zoophilic organism.6 If it is due to an anthropophilic organism then infection may be seen over occluded areas or in areas of trauma, some times infection may represent an extension from a pre-existing infection.2

Transmission is by direct contact.

Most common causes are- Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum canis.

Some variations are seen in the presentation of Tinea corporis , like Bullous Tinea corporis, Tinea imbricate, Majocchi’s granuloma and Tinea incognito.





6.3

OBJECTIVES OF THE STUDY

  • To find out the prevalence of Tinea corporis in Raichur.

  • To find out the fungal species responsible for causing the Tinea corporis in Raichur.



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7.1

MATERIAL AND METHODS

SOURCE OF DATA

The patients attending out patient department of Navodaya Medical College and the patients admitted in Navodaya Medical College hospital from November 2009 to October 2010. One hundred cases would be taken for study






7.2

METHOD OF COLLECTION OF DATA

{INCLUDING SAMPLING PROCEDURES IF ANY}

The patients having lesions of papules with scales over the glabrous skin excluding groin would be selected for study,and scraping from the lesions taken for KOH mount and fungus culture.



INCLUSION CRITERIA:

  • Annular lesions of papules with scales

  • Bullous lesions (KOH positive)

  • Peri follicular , granulomatous lesion over legs (KOH positive)

EXCLUSION CRITERIA:

  • Annular lesions with micaceous scales

  • Annular lesions formed by violaceous flat topped papules

  • Annular lesions (KOH negative)

  • Patients having taken treatment, systemic or topical.

DIRECT MICROSCOPIC EXAMINATION USING 10% KOH:

The scraped material would be placed on a glass slide. A few drops of freshly prepared 10%KOH would be added on the material and a cover slip placed. The slide would be then left at room temperature for 10-15 minutes in the case of skin scrapings.

On microscopic examination, branching hyphae or arthrospores would be looked for.

CULTURE EXAMINATION:

For primary isolations, Sabouraud’s dextrose agar slopes would be used and Dermatophyte test media was used as a selective media.

One set is incubated at 370C and another set at room temperature for one month. Growth is usually seen by 2weeks. Growth is identified based on macroscopic and microscopic features.

Gross morphology of the colony was studied by checking the following characteristics:



  1. Rate of growth

  2. General topography: flat, heaped, regularly or irregularly folded.

  3. Texture:glabrous,powdery,velvety,fluffy etc.

Surface colour and pigment colour on reverse.

If no growth was observed at the end of 4 weeks , the culture was labelled as negative.







7.3

DOSE THE STUDY REQUIRES ANY INVESTIGATION OR INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS.

Yes, skin scraping is taken from patient, for KOH study and fungal culture.






7.4

HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3?

Yes, Ethical clearance has been obtained from ethical committee of Navodaya Medical College Hospital & research Centre Raichur.





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LIST OF REFRENCES


  1. Bindu V, Pavithran K, clinico-mycological study of dermatophytosis in Calicut .Indian J dermatol Venereol Leprol 2002;68:259-261.

  2. Kanwar AJ, Mamta, Chander J, Superficial fungal infections In: Valia RG Editor.IADVL Text book and atlas of dermatology 2nd ed, Mumbai: Bhalani Publishing House; 2001. P215-258.

  3. Nelson MM, Martin AG, Heffernan MP. Superficial fungal infection In: Freedberg IM, Eisen AZ, Wolff K, Austen FK, Gold smith LA, Katz SI Editors. Fitzpatrick’s Dermatology in general medicine 6th ed. New York: Mc Graw-Hill Medical Publishing Division; 2003. P1989-2005.

  4. Emmons CW Dermatophytosis In: Emmons CW, Binford CH, Utz JP editors. Medical mycology 2nd ed. Philadelphia: Lea and Febiger; 1970. P109.

  5. Sanyal M Dermatophytosis in India.Bull Cal Sch Trop Med 1969;17:54.

  6. Hay RJ, Moore MK. Mycology In: Burns T, Breathnach S, Cox N, Griffiths C Editors. Rook’s text book of dermatology 7th ed. Oxford: Blackwell Scientific Publications ; 2004. P31.19-31.60.

  7. Peerapur BV, Inamdar AC, Pushpa PV, Srikant B. Clinico mycological study of Dermatophytosis in Bijapur. Indian J Dermatol Venereol Leprol 2004;22:273-274.

  8. Jolly HW , Carpenter CL: oral glucose tolerence studies in recurrent Trichophyton rubrum infection Arch Dermatol 100:26, 1969.




  1. Many H et al, Trichophyton rubrum: exposure and infection within household groups.Arch Dermatol 82:226, 1960.

  2. Blank F,Mann SJ: Trichophyton rubrum infections according to age, anatomical distribution and sex Br J Dermatol p2:171, 1975.

  3. Allen AM, Taplin D : epidemic Trichophyton mentagrophytes infection in service men: source of infection, role of environment, host factors, and susceptibility.JAMA p226:864, 1973.

  4. George LK: The relationship between the downy and granular forms of Trichophyton mentagrophytes.J invest Dermatol p23:123,1954.

  5. Ratan singh,S.kumari,V.P.Jerath: mycology of Tinea corporis,andT.cruris in Delhi.1980,volume46,issue-4,p218-220,IJDVL.

  6. Donald LG. An Overview of common Dermatophytes. J Am Acad Dermatol 1994; 31: S 112-116.



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Signature of the Candidate






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Remarks of guide






11

11.1

Guide

DR.KALLAPPA HERAKAL

M.D(SKIN)

ASSO. PROF.OF DEPT OF DERMATOLOGY

NAVODAYA MEDICAL COLLEGE, RAICHUR.




11.2

Signature








11.3

Co-Guide {if any}





­­­­




11.4

Signature







11.5

Head of the Department



DR.S.B.ATHANIKAR

M.D(SKIN)

PROF. & H.O.D, DEPT. OF DERMATOLOGY,NAVODAYA MEDICAL COLLEGE ,

RAICHUR.




11.6

Signature




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12.1

Remarks of the Chairman & Principal









12.2

Signature




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