Changing face of epidemiology of dermatophytoses in Chinese Mainland: A 30 years nationwide retrospective study from 1991 to 2020

Dermatophytoses are the most common infectious skin disease. Its epidemiology varies in different countries and regions, and its prevalence in China is still unknown.We aimed to reveal the epidemiological features of dermatophytoses in Chinese mainland in the past thirty years.From 1991 to 2020, a 30-year retrospective epidemiological study was carried out. All published literatures containing dermatophytoses and dermatophytes were collected and analysed.A total of more than 180,000 cases in 124 articles from more than 100 hospitals were included and analysed. Among dermatophytoses, tinea cruris (24.92%) was the predominant clinical type, followed by tinea pedis (22.97%) and tinea corporis (18.12%). In recent 10 years, tinea pedis (25.40%) was more common than tinea cruris (22.39%) and became the most common infection. Among dermatophytes, T rubrum (69.48%) has always been the most common isolates, followed by T mentagrophytes (16.45%) and M canis (8.09%). Other species were found below 3%. In superficial mycoses, dermatophytes accounted for 75.52%, higher than that of yeasts/yeast-like (21.83%) and moulds (2.65%). The prevalence of tinea capitis was lower in economically developed eastern region than that in central and western regions. Tinea cruris was more common in warm zones than cold zones.The top three dermatophytoses are tinea cruris, tinea pedis and tinea corporis, while the top three dermatophytes are T rubrum, T mentagrophytes and M canis. The distribution of dermatophytoses may be influenced by socioeconomic status and geographical-meteorological conditions.