|Year : 1980 | Volume
| Issue : 2 | Page : 61-62
Dermatophytosis and mycotic keratitis
D Samraj1, A Kamalam1, AS Thambiah2
1 Department of Ophthalmology, Madras Medical College, Madras, India
2 Department of Dermatology, Madras Medical College, Madras, India
Department of Ophthalmology, Madras Medical College, Madras
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Samraj D, Kamalam A, Thambiah A S. Dermatophytosis and mycotic keratitis. Indian J Ophthalmol 1980;28:61-2
The superficial mycoses contribute to a large extent in the incidence of dermatoses in any skin clinic in India due to the tropical climatic conditions. Among this large group, dermatophytoses are the commonest and involves the body surface from scalp to feet including the hair and nails. Even though tinea capitis. tinea barbae and tinea facie are common, involvement of eyelids and cilia is uncommon. However, one should bear in mind the possibility of these being infected by dermatophytes. But the conjunctivae and cornea are not affected by the latter. However, other fungi like Aspergillus, Candida etc. can produce infection, in these sites. The present report describes one such case.
| Case report|| |
A 45 year old male farmer presented with complaints of diminution of vision in both eyes of 12, years duration. There was preceding injury to his left eye while working in the fields and hay was blamed as the cause. On examination his skin showed itchy scaly marginated lesions of tinea corporis on the trunk and arms, tinea facie involving the face and skin around the eyes, including the eyelids and eye brows. [Figure - 1] Patient confessed that these lesions had been present since 4 years. The eyelids on both sides showed scaling, mild inflammation and sparse hairs.
His left eye showed circumcorneal congestion with corneal ulcer [Figure - 2] and stained with fluorescein. Mature cataract was present in both eyes and vision was reduced to PL in both eyes and there was no view of fundi. A routine general examination did not reveal any abnormality.
Scales from the eyelids, cilia and scales from the trunk in wet preparation (10% KOH) showed filaments and arthrospores of dermatophyte [Figure - 3] and grew Trichophyton rubrum.
Scrapings from the corneal ulcer showed broad septate hyphae and grew Aspergillus species. A routine haematological and urine examination were normal. His tinea lesions were treated with oral griseofulvin (Grisovin F. P.) 250mg twice daily after meals and topical application of 3 % sulphur salicylic ointment daily for 6 weeks. His left corneal ulcer was treated with 1% atropine ointment and 2% miconazole cream. The affected eye was kept under pad and bandage.
With the above treatment his skin and eye conditions resolved in 6 weeks and he was referred for surgery of cataract.
| Discussion|| |
Dermatophytoses of scalp, face and the rest of the body surface are common, amounting to about 14% of dermatoses in skin clinic. Among these tinea facie may sometimes lead to involvement of eyelids and cilia but the conjunctiva and cornea are never affected by dermatophytes as seen in this patient who had been harbouring T. rubrum for over 4 years However, fungi like Aspergillus species, Candida and several other nondermatophyte group can produce lesions in these sites. Aspergillus sp. was the agent in this case and it was carried through hay, to the cornea. This mode of infection in farmers is quite common and occurs as an occupational disease. Treatment in both the diseases is distinct.
| Summary|| |
Mycotic keratitis due to Aspergillus species associated with tinea corporis and tinea facie caused by Trichophyton rubrum is described in a 45 year old male farmer.
| Acknowledgement|| |
We thank the Superintendent, Government Ophthalmic Hospital, Madras for permission to publish this case.
| References|| |
Kamalam, A. and Thambiah, A.S., 1976. Sabouraudia, 14,129.
Vanbreuseghem, R., De. Vroey, CH. and Takashio, M.. 1976, Aspergillus and Veterinary Mycology. 2nd Edition pp, 30-33. Masson Publishing USA, New York.
[Figure - 1], [Figure - 2], [Figure - 3]