Prevalence of dermatophytosis among Suse federal prison inmates using conventional identification methods and PCR-RFLP typing


  • Saman M. Mohammed Department of Biology, College of Education, University of Sulaimani, Kurdistan Region, Iraq. Author
  • Bahrouz M. A. Al-Jaff Department of Biology, College of Education, University of Sulaimani, Kurdistan Region, Iraq. Author



Dermatophytes, Tinea, Prison, PCR-RFLP


Dermatophytosis is a common skin infection especially in closed area with high temperature and humidity. Prisons are considered as closed areas especially for long times existed inmates in addition to some risk factors that may increase dermatophytosis. To investigate the prevalence and the risk factors of dermatophytosis in Suse federal prison for men at Sulaimani, northern Iraq, a total of 1620 inmates were clinically screened. Clinically suspected dermatophytosis by specialists were 139 (8.5%), they distributed on 102 (73%) Tinea pedis, 18 (12%) Tinea cruris, 14 (10%) Tinea corporis, 4 (3%) Onychomycosis, and 1 (0.7%) tinea mannum. By microscopical, cultural and PCR-RFLP typing procedures 50 cases were confirmed that distributed on 25 (50%) tinea pedis, 15 (30%) tinea cruris, 9 (18%) tinea corporis and 1 (2%) onychomycosis. The causative agents were Trichophyton rubrum 16 (32%), Trichophyton mentagrophytes and Trichophyton interdigitale 14 (28%) for each, Epidermophyton floccosum 4 (8%) and Trichophyton schoenleinii 2 (4%). Trichophyton interdigitale was the most frequently isolated from tinea pedis (40%), Trichophyton rubrum and Trichophyton mentagrophytes from tinea corporis (33% for each) and Trichophyton rubrum from onychomycosis and tinea cruris (%100 and 40% respectively).  Antifungal administration and frequency of bathing were with significant effect on identification of the causative agent by direct KOH test (P= 0.000 and P= 0.026 respectively) and on its recovery by culture method (P= 0.000 and P= 0.016 respectively). The non-significant risk factors were age (P= 0.07), education level (P= 0.82), smoking (P= 0.61), and duration of imprison (P= 0.557). KOH exam was fast and cheap but it is less specific and sensitive. Culture method of identification is essential to identify species of dermatophytes, but it was time consuming and with problems related with confusion in dissemination between species morphologically that could be avoided by PCR-RFLP method which we consider it as a golden method for identification in spite of its high cost but it is with less time, correct identification, and highest sensitivity.


Baldo, A. et al., "Mechanisms of skin adherence and invasion by dermatophytes". Mycoses. Vol. 55, No. 3, pp. 218–223. (2012). DOI:

Grumbt, M. M. Monod, T. Yamada, C. Hertweck, J. Kunert, and P. Staib, "Keratin Degradation by Dermatophytes Relies on Cysteine Dioxygenase and a Sulfite Efflux Pump". J. Invest. Dermatol.. Vol. 133, No. 6, pp. 1550–1555. (2013). DOI:

Brooks, G. F. K. C. Carroll, J. S. Butel, S. A. Morse, and T. A. Mietzner, "Jawetz, Melnick, & Adelberg’s Medical Microbiology", Twenty-Six. New York: McGraw-Hill. (2013)

Reiss, E. H., J. Shadomy, and G. M. Lyon, "Fundamental Medical Mycology", First Edit. New Jersey: Wiley-Blackwell & Sons Inc. (2012). DOI:

Weitzman, I. and R. C. Summerbell, "The dermatophytes". Clin. Microbiol. Rev.. Vol. 8, No. 2, pp. 240–259. (1995). DOI:

Forbes, B. A., D. F. Sahm, and A. S. Weissfeld, BAILEY & SCOTT’S Diagnostic Microbiology, Twelfth Edi. Mosby Elsivier, (2007).

Porter, J. M., "Problems and Priorities for Dermatology in Developing Countries". Int. J. Dermatol.. Vol. 17, pp. 233–236. (1978). DOI:

Oninla, O. A., O. Onayemi, O. A. Olasode, and S. O. Oninla, "Pattern of dermatoses among inmates of Ilesha Prison, Nigeria.". Niger. Postgrad. Med. J.. Vol. 20, No. 3, pp. 174–180. (2013). DOI:

Kanish, B. and A. Bhatia, "Pattern of Cutaneous Disease S in Inmates of Central Jail, Ludhiana , Punjab". J. EVol. Med. Dent. Sci.. Vol. 3, No. 14, pp. 3679–3681. (2014). DOI:

Oninla, O. and O. Onayemi, "Skin infections and infestations in prison inmates". Int. J. Dermatol.. Vol. 51, No. 2, pp. 178–181. (2012). DOI:

Hayette, M. P. and R. Sacheli, "Dermatophytosis, Trends in Epidemiology and Diagnostic Approach". Curr. Fungal Infect. Rep.. Vol. 9, No. 3, pp. 164–179. (2015).

Field, L. A. and B. B. Adams, "Tinea pedis in athletes". Int. J. Dermatol.. Vol. 47, No. 5, pp. 485–492. (2008). DOI:

Nenoff, P., C. Krüger, G. Ginter-Hanselmayer, and H. J. Tietz, "Mycology – an update. Part 1: Dermatomycoses: Causative agents, epidemiology and pathogenesis". J. Ger. Soc. Dermatology. Vol. 12, No. 3, pp. 188–212. (2014). DOI:

Seebacher, C., J. Bouchara, and B. Mignon, "Updates on the epidemiology of dermatophyte infections". Mycopathologia. Vol. 166, No. 5–6, pp. 335–352. (2008). DOI:

Weitzman, I., N.-X. Chin, N. Kunjukunju, and P. Della-Latta, "A survey of dermatophytes isolated from human patients in the United States from 1993 to 1995". Am. Acad. Dermatology. Vol. 39, No. 2. (1998). DOI:

Najem, M. H., "Diagnostic and biological study for some dermatophytes isolated from patients in Thi-Qar province". University of Thi-Qar, Iraq. (2015).

Al-hmadani, A. H., M. A. Al-Dhalimi, and M. M. Alrufae, "Epidemiologic study of Dermatophytosis in Al-Najaf government". Mag. Al-Kufa Univ. Biol.. Vol. 6, No. 1, pp. 1–14. (2014).

Jasim, S. M., A. A. Noaimi, and S. E. Khalifa, "A Survey Of Dermatophytes Isolated From Iraqi Patients In Baghdad City". AL-Qadisiya Med. J.. Vol. 11, No. 19, pp. 10–15. (2015).

Maikhan, H. K., S. K. Rachid, and K. A. Habeb, "Isolation and molecular identification of Trichophyton mentagrophytes from patients with dermatophytosis". in 2nd International Conference on Mycology & Mushrooms, Chicago, USA. September 25-26. (2017).

Ismael H. M., "Isolation and identification of dermatophytes and other fungal agents from clinical specimens in Erbil city". in 2nd Scientific Conference for Biological Science, Mousil Univ., Mousil November 16-17. (2011).

Campbell, C. K., E. M. Johnson, and D. W. Warnockk, Identification of Pathogenic Fungi, Second edi. Chichester, U.K: Wiley-Blackwell. (2013). DOI:

McGinnis, M. R., laboratory handbook of medical mycology, First edit. New York: Academic Press. (1980). DOI:

Shin, J. H. et al., "Species identification and strain differentiation of dermatophyte fungi using polymerase chain reaction amplification and restriction enzyme analysis". J. Am. Acad. Dermatol.. Vol. 48, No. 6, pp. 857–865. (2003). DOI:

Didehdar, M. et al., "Characterization of clinically important dermatophytes in North of Iran using PCR-RFLP on ITS region". J. Mycol. Med.. Vol. 26, No. 4, pp. 345–350. (2016). DOI:

Rezaei-Matehkolaei, A. 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. Vol. 41, No. 3, pp. 82–94. (2012).

Altman, D. and J. Bland, "Diagnostic tests 1 - sensitivity and specificity". BMJ. Vol. 308, No. 6943, p. 1552. (1994). DOI:

Liu, D., S. Coloe, R. Baird, and J. Pedersen, "Application of PCR to the identification of dermatophyte fungi". J. Med. Microbiol.. Vol. 49, No. 2000, pp. 493–497. (2000). DOI:

Kimyai-Asadi, A. and A. Usman, "The role of psychological stress in skin disease.". J. Cutan. Med. Surg.. Vol. 5, No. 2, pp. 140–5. (2001). DOI:

Gulcan, A., E. Gulcan, S. Oksuz, I. Sahin, and D. Kaya, "Prevalence of toenail onychomycosis in patients with type 2 diabetes mellitus and evaluation of risk factors.". J. Am. Podiatr. Med. Assoc.. Vol. 101, No. 1, pp. 49–54. (2011). DOI:

Kocatürk, E., A. Kocatürk, and M. Kavala, "Prevalence of skin diseases in female prisoners in Turkey: Analysis of impact of prison conditions and psychological stress". Acta Dermatovenerologica Croat.. Vol. 22, No. 1, pp. 26–31. (2014).

Faergemann, L. and R. Baran, "Epidemiology, clinical presentation and diagnosis of onychomycosis". Br. J. Dermatol.. Vol. 149, pp. 1–4. (2003). DOI:

Arcavi, L. and N. L. Benowitz, "Cigarette smoking and infection". Arch. Intern. Med.. Vol. 164, No. 20, pp. 2206–2216. (2004). DOI:

Merlin, K., M. Kilkenny, A. Plunkett, and R. Marks, "The prevalence of common skin conditions in Australian school students : 4 Tinea pedis". Br. J. Dermatol.. Vol. 12, No. 140, pp. 897–901. (1999). DOI:

Coury, C. and B. Kelly, "Prison Dermatology: Experience in the Texas Department of Criminal Justice Dermatology Clinic". J. Correct. Heal. Care. Vol. 18, No. 4, pp. 302–308. (2012). DOI:

Rippon, J. W., Medical mycology; the pathogenic fungi and the pathogenic actinomycetes, Second edi. Eastbourne, UK; WB Saunders Company. (1982).

Ajello, L. and M. E. Getz, "Recovery of dermatophytes from shoes and shower stalls.". J. Invest. Dermatol.. Vol. 22, No. 1, pp. 17–24. (1954). DOI:

Nwadiaro, P. O., "Inciddence of dermatophyte infections amongst some occupational and select groups in JOS". African J. Clin. Exp. Microbiol.. Vol. 4, No. 2. (2003). DOI:

Daniel, C. R. and J. J. Nathaniel, "The Pedal Fungus Reservoir". Arch dermatol. Vol. 142, pp. 1344–1346. (2006). DOI:

Aly, R., "Ecology and epidemiology of dermatophyte infections". J. Am. Acad. Dermatol.. Vol. 31, No. 3, pp. S21–S25. (1994). DOI:

Gupta, A. K. and L. Q. Tu, "Dermatophytes: Diagnosis and treatment". J. Am. Acad. Dermatol.. Vol. 54, No. 6, pp. 1050–1055. (2006). DOI:

Borman A. M., C. K. Campbell, M. Fraser, and E. M. Johnson, "Analysis of the dermatophyte species isolated in the British Isles between 1980 and 2005 and review of worldwide dermatophyte trends over the last three decades". Med. Mycol.. Vol. 45, No. 2, pp. 131–141. (2007).

Hayette, M. P. and R. Sacheli, "Dermatophytosis, Trends in Epidemiology and Diagnostic Approach". Curr. Fungal Infect. Rep.. Vol. 9, No. 3, pp. 164–179. (2015). DOI:

Borman, A. M., C. K. Campbell, M. Fraser, and E. M. Johnson, "Analysis of the dermatophyte species isolated in the British Isles between 1980 and 2005 and review of worldwide dermatophyte trends over the last three decades". Med. Mycol., No. 45, pp. 131–141. (2007). DOI:

Muhsin, T. M., K. K. Al-Rubaiy, and A.-H. A. Al-Duboon, "Characteristics of dermatophytoses in Basrah , Iraq". Mycoses. Vol. 42, pp. 335–338. (1999). DOI:

Smith, B. M. and R. M. McGinnis, "Dermatophytosis". in Tropical infectious diseases: principles, pathogens and practice, Thrid Edit., Saunders Elsevier Inc., pp. 558–569. (2011). DOI:

Shabani, F., L. Kumar, and S. Taylor, "Climate change impacts on the future distribution of date palms: a modeling exercise using CLIMEX.". PLoS One. Vol. 7, No. 10, p. e48021. (2012). DOI:

Khaled, J. M., H. A. Golah, A. S. Khalel, N. S. Alharbi, and R. A. Mothana, "Dermatophyte and non dermatophyte fungi in Riyadh City, Saudi Arabia". Saudi J. Biol. Sci.. Vol. 22, No. 5, pp. 604–609. (2015). DOI:

Simpanya, M. F., "Dermatophytes Their taxonomy, ecology and pathogenicity". Iberoam. Micol.. Vol. 699. (2000).

Abd Elmegeed, A. S. M., S. A. Ouf, T. A. A. Moussa, and S. M. R. Eltahlawi, "Dermatophytes and other associated fungi in patients attending to some hospitals in Egypt". Brazilian J. Microbiol.. Vol. 46, No. 3, pp. 799–805. (2015). DOI:

Jackson, C. J., R. C. Barton, and E. G. V. Evans, "Species identification and strain differentiation of dermatophyte fungi by analysis of ribosomal-DNA intergenic spacer regions". J. Clin. Microbiol.. Vol. 37, No. 4, pp. 931–936. (1999). DOI:

Mirzahoseini, H., E. Omidinia, M. Shams-Ghahfarokhi, G. Sadeghi, and M. Razzaghi-Abyaneh, "Application of PCR-RFLP to Rapid Identification of the Main Pathogenic Dermatophytes from Clinical Specimens". Iran. J. Public Health. Vol. 38, No. 1, pp. 18–24. (2009).

Oyeka, C. A. and I. I. Eze, "Fungal skin infections among prison inmates in Abakaliki, Nigeria". Mycoses. Vol. 51, No. 1, pp. 50–54. (2008). DOI:

Zida, A., F. Barro-Traoré, M. Dera, Z. Bazié, P. Niamba, and T. R. Guiguemdé, "Aspects épidémiologiques et étiologiques des mycoses cutanéo-phanériennes chez les détenus de la maison d’arrêt et de correction de Ouagadougou (Burkina Faso)". J. Mycol. Med.. Vol. 25, No. 2, pp. e73–e79. (2015). DOI:

Brauner, G. J., P. Herbert, and M. D. Goodheart, "Dermatologic care behind bars". J. Am. Acad. Dermatol.. Vol. 18, No. 5, pp. 1066–73. (1988). DOI:

Bayle, P. et al., "Prisoners and skin diseases in Toulouse, France: Epidemiological analysis and evaluation of life impact". J. Eur. Acad. Dermatology Venereol.. Vol. 23, No. 1, pp. 52–57. (2009). DOI:



How to Cite

Prevalence of dermatophytosis among Suse federal prison inmates using conventional identification methods and PCR-RFLP typing. (2020). Journal of Zankoy Sulaimani - Part A, 22(1), 273-286.