Epidemiology of dermatomycoses in Kerman province, southeast of Iran: A 10-years retrospective study (2004e2014) Samira Salari a, b , Seyyed Amin Ayatollahi Mousavi a, b, * , Sanaz Hadizadeh b , Alireza Izadi c a Research Center for Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran b Department of Medical Mycology and Parasitology, School of Medicine, Medical University of Kerman, Kerman, Iran c School of Medicine, Bam University of Medical Sciences, Bam, Iran article info Article history: Received 21 November 2016 Received in revised form 25 July 2017 Accepted 25 July 2017 Available online 27 July 2017 Keywords: Epidemiology Skin diseases Dermatomycoses Onychomycosis Iran abstract Objectives: Superficial and cutaneous fungal infections (SCFIs) are an important public health problem and are common in tropical and subtropical countries. Pityriasis versicolor, dermatophytosis, erythrasma, onychomycosis, and otomycosis are the major diseases associated with SCFIs. The aim of this study was to evaluate the prevalence and causative agents of dermatomycoses over a period of 10 years in Kerman province, southeast of Iran. Methods: A number of 1782 subjects, including 1096 females and 686 males, with cutaneous disorders in their skin, nail, and hair suspected to have SCFIs participated in this study. The collected specimens were examined using direct microscopy examination, staining, culture on specific media and PCR-RFLP technique. Results: In total, 617 (34.62%) subjects had SCFIs, of whom 290 (47%) were female and 327 (53%) were male. Identified SCFIs included yeast infections, dermatophytosis, saprophyte onychomycosis, eryth- rasma, and otomycosis due to non-dermatophytic molds (NDMs). The highest prevalence of dermato- mycoses was found among the 41e50-year and 31e40-year age groups. Tinea unguium was the most common clinical pattern of dermatomycoses, and T. mentagrophytes was the predominant agent. Also, Aspergillus spp. were the most common NDMs agents of onychomycosis and otomycosis. Conclusions: This study summarized the epidemiological trends and etiologic agents of SCFIs in a 10-year period in Kerman, southeast of Iran. Consideration of the current epidemiologic trends in the prevalence and knowledge of the exact causative agents of SCFIs may play an important key role towards further investigations, diagnosis, and modification of current treatments. © 2017 Elsevier Ltd. All rights reserved. 1. Introduction Cutaneous mycoses are common fungal diseases and are known as one of the important causes of morbidity in tropical and sub- tropical countries [1,2]. Pityriasis versicolor (PV), dermatophytosis, erythrasma, onychomycosis, and otomycosis are the major diseases associated with SCFIs. PV is a prevalent and mild disease that is characterized by a skin eruption on the trunk and proximal ex- tremities, and is caused by lipophilic yeasts of the genus Malassezia [3,4]. Malassezia spp. are the etiological agents of hyper or hypo- pigmentation disorders, catheter-associated fungemia, folliculitis, seborrheic dermatitis, dacrylitis, blepharitis, onychomycosis, as well as nosocomial bloodstream infections in pediatric care units [5]. Yeast infections result from an overgrowth of yeast species in any part of the body. Candidiasis is a fungal infection due to different Candida species and is the major common type of yeast infections [6e9]. The non- Candida yeasts include Cryptococcus, Trichosporon, Rhodotorula, Malassezia, and Sporobolomyces species. These yeasts are considered as causative agents of mucosa- associated, superficial infections and disseminated infections in immunocompromised patients [10e12]. In cutaneous mycoses, dermatophyte spp. attach to the integu- ment and its associated structures, including nails, hair and rarely, the deeper layers of the epidermis [13]. Dermatophytes are comprised of three genera of Epidermophyton, Microsporum, and Trichophyton [14,15]. Dermatophytosis has a worldwide * Corresponding author. Department of Medical Mycology & Parasitology, Faculty of Medicine, Kerman Medical University, Kerman, Iran. E-mail address: aminayatollahi@kmu.ac.ir (S.A. Ayatollahi Mousavi). Contents lists available at ScienceDirect Microbial Pathogenesis journal homepage: www.elsevier.com/locate/micpath http://dx.doi.org/10.1016/j.micpath.2017.07.043 0882-4010/© 2017 Elsevier Ltd. All rights reserved. Microbial Pathogenesis 110 (2017) 561e567