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Superficial fungal infections in end stage renal disease patients

Background Patients with end stage renal disease commonly present a spectrum of dermatological disorders. Each one has its own unique presentation and treatment approaches. Superficial fungal infections of the skin do not account for much in the end stage renal disease patients; hence most of the reports do not discuss this issue. In the present study we analysed patients with end stage renal disease who had developed superficial fungal infections.

Methods During January 2015 to June 2016, we tried to analyse 150 patients with end stage renal disease, who developed superficial fungal infections and were undergoing haemodialysis at least thrice a week for a minimum of three months at our centre.

Results Out of the 150 suspected cases we identified, 36 cultures tested positive. The macroscopic examination of the scalp, skin and the nails revealed 2.2% Tinea capitis, 13.9% Tinea versicolor, 44.5% Tinea corporis, 8.4% Tinea mannum, 16.8% onychomycosis, 5.7% Tinea cruris and 8.5% Tinea pedis. The culture examination highlighted 44.4% Trichyopyton rubrum, 27.8% Trychophyton mentagrophyte, 2.8% Trychophyton violaceum, 2.8% Trichophyton verrucosum, 2.8% Microsporum canis, 2.8% Epidermophyton flucossum, 2.8% Scopulariopsis brevicaulis and 13.8% Malessesia). The predominant clinical abnormality observed was Tinea corporis and the prevalent fungal isolate was Trichophyton rubrum.

Conclusions The current study illustrates that a significant number of patients with the end stage renal disease had a prevalence of superficial fungal infections; hence, a prompt recognition of skin lesions and the identification of these superficial fungi may alarm us so that early and the judicious management to reduce the associated morbidity and in turn to improve the quality of life in these patients is taken.