Epidemiology of dermatophytosis in Northeastern Iran; A subtropical region


1 Department of Biology, Damghan Branch, Islamic Azad University of Damghan, Damghan, Iran

2 Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Cutaneous Leishmaniasis Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Biology, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia


Background and Purpose: Dermatophytes as the causative agents of dermatophytosis (ringworm) are widely spread around the world. Accurate identification of dermatophytes in one area can be particularly important for epidemiological studies. Regarding this, the aim of the present study was to describe the species spectrum of dermatophytes, isolated from patients in Mashhad city, Iran, using the molecular-based method.

Materials and Methods: This study was conducted on 79 dermatophyte isolates obtained from the human skin, hair, and nail specimens. Species identification was performed by the polymerase chain reaction-restriction fragment length polymorphism analysis of ribosomal DNA internal transcribed spacer regions using MvaI restriction enzyme.

Results: The identified species included Trichophyton mentagrophytes/T. interdigitale species complex (n=37, 46.8%), Epidermophyton floccosum (n=12, 15.2%), T. rubrum (n=8, 10.1%), Microsporum canis (n=8, 10.1%), T. violaceum (n=5, 6.3%), T. tonsurans (n=4, 5.1%), Nannizzia gypsea (n=3, 3.8%), T. benhamiae (n=1, 1.3%), and T. verrucosum (n=1, 1.3%). The clinical forms of infection were tinea corporis (n=26, 32.8%), tinea cruris (n=22, 27.8%), tinea capitis (n=10, 12.6%), tinea unguium (n=7, 9%), tinea manuum (n=6, 8%), tinea pedis (n=5, 6.3%), and tinea faciei (n=3, 3.5%).

Conclusion: As the findings indicated, T. mentagrophytes/T. interdigitale species complex had the highest prevalence, and T. benhamiae appeared to be a new emerging agent of dermatophytosis in Mashhad, northeastern Iran.


1. Weitzman I, Summerbell RC. The dermatophytes. Clin Microbiol Rev. 1995; 8(2):240-59.
2. de Hoog GS, Dukik K, Monod M, Packeu A, Stubbe D, Hendrickx M, et al. Toward a novel multilocus phylogenetic taxonomy for the dermatophytes. Mycopathologia. 2017; 182(1-2):5-31.
3. Seebacher C, Bouchara JP, Mignon B. Updates on the epidemiology of dermatophyte infections. Mycopathologia. 2008; 166(5-6):335-52.
4. Svejgaard EL. Epidemiology of dermatophytes in Europe. Int J Dermatol. 1995; 34(8):525-8.
5. Rezaei-Matehkolaei A, Rafiei A, Makimura K, Gräser Y, Gharghani M, Sadeghi-Nejad B. Epidemiological aspects of dermatophytosis in Khuzestan, southwestern Iran, an update. Mycopathologia. 2016; 181(7):547-53.
6. Lanternier F, Pathan S, Vincent QB, Liu L, Cypowyj S, Prando C, et al. Deep dermatophytosis and inherited CARD9 deficiency. N Engl J Med. 2013; 369(18):1704-14.
7. Adimi P, Hashemi SJ, Mahmoudi M, Mirhendi H, Shidfar MR, Emmami M, et al. In-vitro activity of 10 antifungal agents against 320 dermatophyte strains using micro dilution method in Tehran. Iran J Pharm Res. 2013; 12(3):537-45.
8. Rezaei-Matehkolaei A, Makimura K, de Hoog S, Shidfar MR, Zaini F, Eshraghian M, et al. Molecular epidemiology of dermatophytosis in Tehran, Iran, a clinical and microbial survey. Med Mycol. 2013; 51(2):203-7.
9. Ahmadi B, Mirhendi H, Shidfar MR, Nouripour-Sisakht S, Jalalizand N, Geramishoar M, et al. A comparative study on morphological versus molecular identification of dermatophyte isolates. J Mycol Med. 2015; 25(1):29-35.
10. Heidemann S, Monod M, Gräser Y. Signature polymorphisms in the internal transcribed spacer region relevant for the differentiation of zoophilic and anthropophilic strains of Trichophyton interdigitale and other species of T. mentagrophytes sensu lato. Br J Dermatol. 2010; 162(2):282-95.
11. Rezaei-Matehkolaei A, Makimura K, Shidfar M, Zaini F, Eshraghian M, Jalalizand N, et al. Use of Single-enzyme PCR-restriction digestion barcode targeting the internal transcribed spacers (ITS rDNA) to identify dermatophyte species. Iran J Public Health. 2012; 41(3):82-94.
12. White TJ, Bruns T, Lee S, Taylor JL. Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics. PCR Protocols. 1990; 18(1):315-22.
13. Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008; 51(Suppl 4):2-15.
14. Naseri A, Fata A, Najafzadeh MJ, Shokri H. Surveillance of dermatophytosis in northeast of Iran (Mashhad) and review of published studies. Mycopathologia. 2013; 176(3-4):247-53.
15. Hainer BL. Dermatophyte infections. Am Fam Physician. 2003; 67(1):101-8.
16. Theel ES, Hall L, Mandrekar J, Wengenack NL. Dermatophyte identification using matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2011; 49(12):4067-71.
17. Nweze E, Eke I. Dermatophytes and dermatophytosis in the eastern and southern parts of Africa. Med Mycol. 2017; 56(1):13-28.
18. Heidrich D, Garcia MR, Stopiglia CD, Magagnin CM, Daboit TC, Vetoratto G, et al. Dermatophytosis: a 16-year retrospective study in a metropolitan area in southern Brazil. J Infect Dev
Ctries. 2015; 9(8):865-71.
19. Neji S, Makni F, Cheikhrouhou F, Sellami A, Sellami H, Marreckchi S, et al. Epidemiology of dermatophytoses in Sfax, Tunisia. Mycoses. 2009; 52(6):534-8.
20. Bhagra S, Ganju SA, Kanga A, Sharma NL, Guleria RC. Mycological pattern of dermatophytosis in and around shimla hills. Indian J Dermatol. 2014; 59(3):268-70.
21. Alemayehu A, Minwuyelet G, Andualem G. Prevalence and etiologic agents of dermatophytosis among primary school children in Harari Regional State, Ethiopia. J Mycol. 2016; 2016:1489387.
22. Abastabar M, Rezaei-Matehkolaei A, Shidfar MR, Kordbacheh P, Mohammadi R, Shokoohi T, et al. A molecular epidemiological survey of clinically important dermatophytes in Iran based on specific RFLP profiles of beta-tubulin gene. Iran J Public Health. 2013; 42(9):1049-57.
23. Achterman RR, White TC. Dermatophyte virulence factors: identifying and analyzing genes that may contribute to chronic or acute skin infections. Int J Microbiol. 2011; 2012:358305.
24. Mahmoudabadi AZ. A study of dermatophytosis in South West of Iran (Ahwaz). Mycopathologia. 2005; 160(1):21-4.
25. Mathur M, Shrestha S. Intravenous iron sucrose therapy in iron deficiency anemia in antenatal and postnatal patients. JNMA J Nepal Med Assoc. 2015; 53(198):108-12.
26. Nenoff P, Krüger C, Ginter‐Hanselmayer G, Tietz HJ. Mycology-an update. Part 1: dermatomycoses: causative agents, epidemiology and pathogenesis. J Dtsch Dermatol Ges. 2014; 12(3):188-209.
27. Heidrich D, Garcia MR, Stopiglia CD, Magagnin CM, Daboit TC, Vetoratto G, et al. Dermatophytosis: a 16-year retrospective study in a metropolitan area in southern Brazil. J Infect Dev Ctries. 2015; 9(8):865-71.
28. Shimamura T, Kubota N, Shibuya K. Animal model of dermatophytosis. J Biomed Biotechnol. 2012; 2012:125384.
29. Didehdar M, Shokohi T, Khansarinejad B, Ali Asghar Sefidgar S, Abastabar M, Haghani I, et al. Characterization of clinically important dermatophytes in North of Iran using PCR-RFLP on ITS region. J Mycol Med. 2016; 26(4):345-50.
30. Mohammadi R, Abastabar M, Mirhendi H, Badali H, Shadzi S, Chadeganipour M, et al. Use of restriction fragment length polymorphism to rapidly identify dermatophyte species related to dermatophytosis. Jundishapur J Microbiol. 2015; 8(6):e17296.
31. Ghojoghi A, Falahati M, Pagheh As, Abastabar M, Ghasemi Z, Ansari S, et al. Molecular identification and epidemiological aspects of dermatophytosis in Tehran, Iran. Res Mol Med. 2015; 3(3):11-6.
32. Ameen M. Epidemiology of superficial fungal infections. Clin Dermatol. 2010; 28(2):197-201.
33. Omidynia E, Farshchian M, Sadjjadi M, Zamanian A, Rashidpouraei R. A study of dermatophytoses in Hamadan, the governmentship of West Iran. Mycopathologia. 1996; 133(1):9-13.
34. Zamani S, Sadeghi G, Yazdinia F, Moosa H, Pazooki A, Ghafarinia Z, et al. Epidemiological trends of dermatophytosis in Tehran, Iran: a five-year retrospective study. J Mycol Med. 2016; 26(4):351-8.
35. Weinstein A, Berman B. Topical treatment of common superficial tinea infections. Am Fam Physician. 2002; 65(10):2095-102.
36. El-Gohary M, van Zuuren EJ, Fedorowicz Z, Burgess H, Doney L, Stuart B, et al. Topical antifungal treatments for tinea cruris and tinea corporis. Cochrane Database Syst Rev. 2014; 8:CD009992.
37. Bassiri-Jahromi S, Khaksari AA. Epidemiological survey of dermatophytosis in Tehran, Iran, from 2000 to 2005. Indian J Dermatol Venereol Leprol. 2009; 75(2):142-7.
38. Toukabri N, Dhieb C, El Euch D, Rouissi M, Mokni M, Sadfi-Zouaoui N. Prevalence, etiology, and risk factors of tinea pedis and tinea unguium in Tunisia. Can J Infect Dis Med Microbiol. 2017; 2017:6835725.
39. Vena GA, Chieco P, Posa F, Garofalo A, Bosco A, Cassano N. Epidemiology of dermatophytoses: retrospective analysis from 2005 to 2010 and comparison with previous data from 1975. New Microbiol. 2012; 35(2):207-13.
40. Farnoodian M, Yazdanparast SA, Sadri MF. Effects of environmental factors and selected antifungal agents on arthroconidia production in common species of Trichophyton genus and Epidermophyton floccosum. J Biol Sci. 2009; 9(6):561-6.
41. Hayette MP, Sacheli R. Dermatophytosis, trends in epidemiology and diagnostic approach. Curr Fungal Infect Rep. 2015;
42. López-Martínez R, Manzano-Gayosso P, Hernández-Hernández F, Bazán-Mora E, Méndez-Tovar L. Dynamics of dermatophytosis frequency in Mexico: an analysis of 2084 cases. Med Mycol. 2010; 48(3):476-9.
Volume 5, Issue 2
June 2019
Pages 16-21
  • Receive Date: 09 July 2019
  • Revise Date: 07 September 2020
  • Accept Date: 09 July 2019
  • First Publish Date: 09 July 2019