EVALUATION OF TINEA MANNUM IN THE STUDENTS OF DIYALA MEDICAL COLLEGE

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1 International Journal of Bio-Technology and Research (IJBTR) ISSN(P): ; ISSN(E): X Vol. 4, Issue 2, Apr 2014, 1-6 TJPRC Pvt. Ltd. EVALUATION OF TINEA MANNUM IN THE STUDENTS OF DIYALA MEDICAL COLLEGE LUMA TAHA AHMED Microbiology Branch, College of Medicine, University of Diyala, Baqubah, Iraq ABSTRACT Dermatophytes remain a major challenge to the people in hot country and result in significant mortality rate the objective of this study was to determine the fungal contamination rate of the students hands with symptomatic and asymptomatic tinea manum. Results: A total of 50 subjects were selected in this (male and female).the contamination of symptomatic hands were observed in %most of isolate are known to cause tinea infections which included (3.5% Microsporum canis, 5% Trichophyton mentagrophytes, 3%Epedermophyton species., 2% Aspergillous niger, 1.5% Aspergillous terrus, 2% Penicillium species). While the percentage of fungal species in asymptomatic tinea mannum hands were (2.5% Microsporum canis, 2.5% Trichophyton mentagrophytes, 1% Epedermophyton sp., 1.5% Aspergillous niger, 0% Aspergillous terrus, 0.5% Penicillium species). Conclusions: According to these results tinea were contaminated with various types of dermatophytes and non-dermatophytes students must follow carefull hand washing process to minimize transmission of disease and should remove rings, watches and brancelets before washing their hands. KEYWORDS: Dermatophytes, Tinea Manum, Hand Contaminants INTRODUCTION Dermatophytosis is a common contagious disease caused by fungi known as dermatophytes. Dermatophytes belong to a group of organisms that are able to break down the keratin in tissues such as the epidermis, hair, nails, feathers, horns and hooves. Most of these fungi reside in the soil and are involved in decomposition; however, the dermatophytes can infect living hosts. Some dermatophytes (anthropophilic species) are adapted to humans, and are usually transmitted from person to person. Others (zoophilic species) are adapted to animals. A few (geophilic) species normally live in the environment, but occasionally act as parasites. The zoophilic and geophilic species are sometimes transmitted from animals to people. It is also possible for humans to transmit anthropophilic dermatophytes to animals, although this seems to be uncommon [1]. In humans the dermatophytoses are referred to as tinea infections and are named according to the area of the body involved. Infections can however, spread from one area to another, e.g. tinea faciei (facial dermatophytosis) in children may result from a tinea capitis. Dermatophytes consisting of organisms in the Trichophyton, Epidermatophyten and Microsporum genera,are the primary etiologic pathogens of various dermatophytoses, such as tinea capitis, tinea corporis, tinea inguinalis, tinea unguium and tinea pedis. These infections are widespread and increasing in prevalence on a global scale. Indeed, in some geographic regions, dermatophytes infection is now considered a major public health concern [2]. The dermatophytes fungi specialized in keratin degradation are frequently involved in chronic infections editor@tjprc.org

2 2 Luma Taha Ahmed that affect humans on a global scale. The most prevalent dermatophyte is Trichophyton rubrum, which has been isolated from tinea corporis, tinea unguium and tinea pedis infections [3]. Tinea manuum is a dermatophyte infection that tends to affect one hand, although involvement of both hands is possible. In this form, the palms become diffusely dry, scaly and erythematous. Inflammatory (vesicular or pustular) lesions can be seen occasionally. Tinea manuum is most often caused by anthropophilic dermatophytes, particularly T. rubrum (cases are frequently an extension of athlete s foot) but occasional cases may be caused by zoophilic organisms such as M. canis, T. mentagrophytes, T. verrucosum and T. erinacei, or the geophilic organism M. gypseum. Dermatophytes grow best in warm and humid environments and are, therefore, more common in tropical and subtropical regions. Their distribution varies with the organism. M. canis, M. nanum, M. gypseum, T. mentagrophytes, T. verrucosum and T. equinum, occur worldwide, although their prevalence varies with the region [4]. Like zoophilic species, anthropophilic dermatophytes may be either cosmopolitan or more limited in their distribution. The latter group may be imported into other countries on infected individuals. From above its important to screen hands contamination with dermatophytes and non dermatophytes fungi, the aim of this study is to screen fungal contamination among medical school students 2nd and third stage in winter. MATERIALS AND METHODS Examination and Isolation of Dermatophytes Skin scales of hands were examined after KOH preparation is made by emulsifying the specimen in a drop of 10% KOH on a microscope slide. Lactophenol is added to stain the specimen after that the specimen is examined under light microscope at (10,40) X powers respectively after that isolation of dermatophytes were done by culturing Skin scales, nail scrapings, and hairs directly on the media and incubated at 30C for 7 days [5]. RESULTS AND DISCUSSIONS The results revealed that there are different fungal species were observed in culture media, the higher percentage of fungal species were the dermatophytes, Trichophyton mentagrophytes, Microsporum canis and Epidermophyton species as shown in table 1. While the less percentage were the following fungal isolate (Aspergillus niger %, Penecillium species %, Aspergillus terrus %). The percentage of fungal species for symptomatic students with tinea mannum were higher than asymptomatic students as shown in table 2, however the asymptomatic students were infected with non-dermatophytes species such as (A. niger, A.terrus, P.) and about 1% were non infected with any fungal species (dermatophytes and non-dermatophytes). The distribution of fungal species between symptomatic and asymptomatic the dermatophytic fungal species were higher in percentage in symptomatic group than in asymptomatic group as shown in table 2, in addition the correlation coefficient between symptomatic and asymptomatic demonstrate that the fungal species were 97 (P<0.01) level of significance correlated with symptomatic tinea mannum whereas the fungal species were 95 correlated with asymptomatic tinea mannum The correlation coefficient between symptomatic and asymptomatic tinea mannum was 84 at (P<0.01) level of significance as demonstrated in table 3. 85% of college students carried a ring worm fungus, fungi probably transmitted Impact Factor (JCC): Index Copernicus Value (ICV): 3.0

3 Evaluation of Tinea Mannum in the Students of Diyala Medical College 3 host to host through infected squamous, flat keratinized dead cells shed from the outer most layer of stratified squamous epithelium. Local socio-economic conditions and cultural practices can also influence the prevalence of a particular infection in a given area [6]. In tropical and subtropical countries, infectious diseases of the skin are not just more prevalent than in central Europe; they are more frequent and more distinctive. This is particularly true for certain areas in Asia (especially India) and for the whole continent of Africa. Socio-economic conditions tend to be poorer than in Europe and the Americas and there are more problems with diagnosis and therapy, but most of all, the humid and warm climatic conditions encourage the extensive skin mycoses. In Africa, a large number of HIV infections favour certain fungal infections by reducing the cellular immunity needed in the defense against fungi [6]. In Asia, T. rubrum and T. mentagrophytes are the most commonly isolated pathogens, causing tinea pedis and unguium, the prevalence of tinea pedis in Asia is similar to that in Europe (approx. 20%); it is also common in Australia. Tinea corporis and capitis are frequently found in children and adolescents. A study performed in a Turkish University Hospital during found the prevalence of dermatophytoses to be 7.34% (68 out of 926).39 Trichophyton rubrum was the most frequently isolated dermatophyte (56%), followed by T. mentagrophytes (38%), T. violaceum, T. verrucosum, M. canis and E. floccosum. Tinea unguium (29%), tinea inguinalis (15%). The characteristics of dermatophytoses among children in an area south of Tehran were reported by Lari et al [7]. 382 children aged 16 years with suspected dermatophytic lesions were examined between 1999 and the incidence rate of dermatophytoses was 6.6 per person-years. M. canis (15.1%), E. floccosum (15.1%), T. rubrum (13.2%), T. mentagrophytes (11.3%), M. gypseum (7.5%). tinea manuum (7.5%). In Jordan, The Zarqa district of Jordan has an industrialized area surrounded by farms and villages; the climate is relatively hot and semi-arid. The most common dermatophytes isolated were T. mentagrophytes, E. floccosum, T. rubrum and M. canis. Tinea unguium (22%) are more frequent during the spring and winter.61 there is evidence that the increasing prevalence of T. rubrum is because of immigration from Mediterranean countries. Table 1: Number and Percentage of Fungal Species Isolated from Symptomatic and Asymptomatic Tinea Manum Students Fungal Species No. of Fungal Species Percentage of Fungal Species (%) Trichophyton Mentagrophytes Microsporum Canis Epidermophyton Genera 8 16 Aspergillus Niger 7 14 Aspergillus Terrus 3 6 Penicillum Species 5 10 Total Table 2: Distribution of Fungal Species According to Symptomatic and Asymptomatic Tinea Mannum Students Fungal Species Symptomatic Tinea Mannum Asymptomatic Tinea Mannum No. Percentage% No. Percentage% Trichophyton mentagrophytes Microsporum canis Epidermophyton genera editor@tjprc.org

4 4 Luma Taha Ahmed Table 2: Contd., Aspergillus niger Aspergillus terrus / / Penicillum species Total Table 3: Correlation Coefficient among Symptomatic and Asymptomatic Tinea Mannum Variables Associated with The Correlation Coefficient (r) Level of Significance Percentage of Fungal species(%) & Symptomatic Tinea mannum 0.97 ** Percentage of Fungal species(%) & Asymptomatic Tinea mannum 0.95 ** Symptomatic Tinea mannum & Asymptomatic Tinea mannum 0.84 ** ** (P<0.01). There are several factors enhance the fungal skin infection they are: Have Recently Taken a Course of Antibiotics are Pregnant Have Poorly Controlled Diabetes Have a Weakened Immune System, For Example, HIV/AIDS are Overweight Come Into Direct Contact with Another Person or an Animal that has a Fungal Skin Infection have Indirect Contact with Items Contaminated with a Fungus, for Example, Clothes, Towels and Bedclothes Walk Barefoot in Shower and Pool Areas Don t Dry Yourself After Sweating or Bathing Wear Tight Clothing That Doesn t Allow Sweat To Evaporate Cut or graze the surface of your skin [8]. Symptoms of Tinea Itching, rash and nail discolouration are the most common symptoms of tinea infection. Complications such as secondary infection (cellulitis and impetigo) can lead to symptoms. It is common in people who play contact sports. It occurs in immune compromised patients[9]. Prevention of Tinea Mannum are Good skin hygiene. Good nail hygiene. Avoiding prolonged wetting or dampness of skin and feet. Avoid trainers, which can retain sweat and promote a warm, moist environment. Treatment of tinea pedis helps prevent onychomycosis. Impact Factor (JCC): Index Copernicus Value (ICV): 3.0

5 Evaluation of Tinea Mannum in the Students of Diyala Medical College 5 Wear clean, loose-fitting underwear [10]. REFERENCES 1. Centre for food safety and public health, 2006, Iowa state university, college of vet. medicine. 2. Lingling wang, LiMa, W enchuan. leg, Tao Liu, LuYu, Jian Yang etal. Analysis of the dermatophyte Trichophyton rubrum expressed sequence tags, Bio Med central genomics : Weitzman I. and Summer bell, R.C. The dermatophytes.clin.microbiol.rev : Ismael Hero Mohammed, Prevalence of dermatophytic and non-dermatophytic fungi in a rural village of Iraqi Kurdistan with special references to their inhibition by some natural plant extract PhD. thesis. Uni. of Salahaddin Erbil, College of science. 5. Washington W. Jr, Allen, S., Janda W., Koneman, E., Procop, G., Schreckenberger, P. and Woods, G. (2006). Color Atlas and text book of diagnostic microbiology, Lippincott Williams and wilkins(ed.), 6th Ed. Baltimore. U.S.A. 6. Blancko Havlickova, Viktor A. Czaika and Markus Friedrich. Epidemiological trends in skin mycoses world wide. Mycoses, 2008, 51.: Rastegar Lari A., Akhlaghi L., Falahati M., Alaghbandan R..Characteristics of dermatophytoses among children in an area south of Tehran, Iran, Mycoses2005, 48.: Amir Jalil, Philip Ian G. Barlaan, Boris Kwok Keung Fung, Josephine Wing-Yuk Ip. Hand infection in diabetic patients, Hand surg : Ellis D, Dermatophytosis, Mycology Online, Dermatophytosis (Tinea Infections) Fungal nail infection (onychomycosis); NICE CKS, May editor@tjprc.org

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