Title : Total serum IgE levels in dermatomycoses: Association with inflammatory morphotypes and rural exposure
Abstract:
Introduction: Superficial dermatophytosis may be encountered in a broad spectrum of clinical manifestations, varying from mild epidermal scaling to deeper suppurative inflammatory plaques as seen in Tinea Barbae. This study aimed to evaluate the disease severity as well as the fungal pathogen patterns within a symptomatic patient group using Total Serum Immunoglobulin E (IgE) as an immunological biomarker
Methods: To achieve the aim of this study a cross-sectional analysis was conducted on n = 64 symptomatic patients with mycologically confirmed active dermatomycoses. Through the usage of chemiluminescent immunoassay the quantification of baseline total serum IgE(IU/ml) was achieved. For the identification of the fungus, Sabouraud Dextrose Agar culture analysis was taken into account together with KOH microscopy. Furthermore, IgE levels were correlated against the clinical morphotypes i.e severe inflammatory as opposed to superficial non-inflammatory, and the geographic background i.e urban vs rural.
Results: The entire sample presented with marked elevations in total serum IgE, with a baseline mean of 172.4 ± 36.8 IU/mL. Individuals within the cohort who presented with deep inflammatory morphotypes such as Tinea Barbae, and highly inflammatory Tinea Corporis, displayed a statistically elevated IgE levels compared to the individuals with non- inflammatory superficial phenotypes with the following results 298.6± 49.2 IU/mL versus 112.4 ± 18.5 IU/mL, p < 0.001. These high IgE expressions demonstrate a strong association with zoophilic strains, specifically Microsporum canis and Trichophyton mentagrophytes. The afore mentioned were considerably more prevalent among the patients from rural areas as opposed to urban residents, as presented in the following; 71.4% versus 16.7%; χ² = 19.53, p < 0.001.
Conclusion: Total serum IgE serves as a useful immunological biomarker when evaluating the dermatomicoses severity. The statistical analysis suggests a distinctive immunopathogenic pattern as a result of the marked association involving the elevated IgE concentrations, the rural exposure as well as the zoophilic dermatophyte strains. This clinical profile may be used as a prognostic indicator and objective diagnostic, aiding clinicians in initiating aggressive and timely systemic medical therapies prior to the irreversible tissue damage or the permanent scarring.
