Authors’ Response

We thank the author of the Letter-to-Editor¹ for your interest in our article² published in the August 2025 issue of the Indian Journal of Medical Research. We appreciate the thoughtful and constructive comments provided, and we respond to them in detail below.

We would first like to address the concern regarding seasonal variation. Our study was conducted over a complete 12-month period from July 2020 to June 2021, which inherently captures all major climatic seasons in southern Rajasthan. Year-round sampling is an established approach to reduce seasonal bias in the epidemiology of dermatophytosis.^3,4 Although we did not present species-wise seasonal stratification due to the modest sample size, the manuscript does provide overall seasonal distribution, which offers meaningful temporal insight. As our primary objective was to describe the clinico-epidemiological distribution of dermatophytes among dermatology outpatients, detailed seasonal modelling of individual species was beyond the scope of the design. Larger datasets in future research may indeed allow for more granular seasonal interpretation.

Regarding the reliance on morphological identification, we acknowledge—as stated in our manuscript—that molecular techniques such as Internal Transcribed Spacer Sequencing (ITS) sequencing were not available in our laboratory during the study period. Nevertheless, conventional diagnostic methods, including colony morphology, Lacto phenol cotton blue mount (LPCB) microscopy, and urease testing, continue to be widely practiced and accepted standards in routine clinical mycology, especially in resource-constrained settings.^5,6 To ensure diagnostic accuracy, all isolates were independently reviewed by two trained microbiologists, and discordant interpretations were resolved through consensus. Though not explicitly mentioned in the published article due to word limits, this internal cross-verification enhanced reproducibility. We agree that molecular confirmation can further strengthen species-level accuracy, as supported in prior literature,^6,7 which is why this limitation was transparently acknowledged.

Concerning the absence of comorbidity data such as diabetes, immunosuppression, or atopy, our study protocol focused primarily on clinico-mycological trends and socio-behavioral contributors such as fomite sharing, hygiene habits, clothing patterns, occupation, and socioeconomic status. Several Indian OPD-based cross-sectional studies assessing dermatophytosis burden have similarly restricted their scope to demographic and behavioral determinants.^8,9 While comorbidities indeed affect chronic or recurrent infections, their evaluation was outside the predefined objectives of the present study. We agree that inclusion of comorbidity profiling would provide additional clinical depth and represents an important direction for larger future studies.

Finally, we appreciate the suggestion for multi-center, molecularly supported, and seasonally stratified research. Our work was conceived as a baseline study from a region where published data remain limited. Constraints arising from sample size, single-center design, and lack of molecular facilities were transparently acknowledged in our article. Similar limitations have also been discussed in broader national literature addressing dermatophytosis epidemiology.^10,11 We believe our study lays foundational data that can guide and inspire larger multi-center investigations.

We sincerely thank the author for these valuable observations, which strengthen the contextual understanding of our findings and align with the limitations already acknowledged in the manuscript. We believe the comments complement our study and do not undermine the validity or integrity of the methodological approach or results.