Serum Dectin-2 levels in immunocompetent patients with recalcitrant dermatophytosis: a case-control study

Background Recalcitrant dermatophytosis has become a major clinical problem and a global source of concern. Objectives To measure serum Dectin-2 levels in immunocompetent patients with recalcitrant dermatophytosis. Patients and methods This study comprised 160 participants in total: 80 patients with recalcitrant dermatophytosis and 80 healthy controls who were matched for age and sex. Patients with immunodeficiency diseases, diabetes mellitus, immunosuppressive medications, or systemic steroids were excluded. All patients were subjected to history taking and dermatological examination regarding the site and size of the lesions, the presence of inflammation, and scaling. Serum Dectin-2 levels were measured using enzyme-linked immunosorbent assay (ELISA). Results Serum Dectin-2 levels were significantly lower in patients (122.28±37.97 ng/l) compared with controls (387.03±168.94 ng/l), ( P <0.001). A negative correlation was detected between Dectin-2 levels and disease severity ( r =-0.31, P =0.005). The cutoff point of serum Dectin-2 level as a diagnostic marker of recalcitrant dermatophytosis was 145.49 ng/l, with a sensitivity of 92.4% and a specificity of 85% at an area under the curve of 0.94. The predominantly isolated dermatophytes have been demonstrated to be Trichophyton mentagrophytes (58.75%) more than Trichophyton rubrum (41.25%). Conclusion In immunocompetent patients with intractable dermatophytosis, decreased Dectin-2 levels may be a factor in fungal persistence and the failure of antifungal therapy. Dectin-2 may be a therapeutic target for enhancing antifungal immunity as well as a possible biomarker for disease severity.