Clinical efficacy of mucopolysaccharide polysulfate cream in combination with sertaconazole nitrate cream in the treatment of scaly hyperkeratotic tinea pedis / 中华皮肤科杂志

Objective:To investigate clinical efficacy of mucopolysaccharide polysulfate cream combined with sertaconazole nitrate cream in the treatment of scaly hyperkeratotic tinea pedis.Methods:From March 2019 to January 2020, 100 patients with scaly hyperkeratotic tinea pedis were enrolled into this study, and randomly and equally divided into 2 groups by using a random number table: control group treated with topical sertaconazole nitrate cream alone at a dose of 0.5-1 g twice a day; combined group treated with topical mucopolysaccharide polysulfate cream at a dose of 0.5-1 g followed by topical sertaconazole nitrate cream at a dose of 0.5-1 g 30 minutes later, which were performed twice a day. The treatment lasted 4 weeks. The time to clinical symptom relief, efficacy and incidence of adverse reactions were compared between the two groups. Dermatology life quality index (DLQI) was assessed at 0, 2 and 4 weeks after the start of treatment. Two-independent-sample t test, repeated measures analysis of variance and chi-square test were used for statistical analysis. Results:After treatment, the time to pruritus relief and that to desquamation improvement were 6.05 ± 1.98 and 12.03 ± 3.92 days respectively in the combined group, which were significantly shorter than those in the control group (8.39 ± 2.11, 15.11 ± 4.05 days, t = 5.72, 3.86, respectively, both P < 0.001) . During the 4 weeks of treatment, DLQI scores gradually decreased in both the 2 groups (all P < 0.001) , which were significantly lower in the combined group than in the control group at weeks 2 and 4 (both P < 0.001) . After 4-week treatment, the total response rate was 98% (49/50) in the combined group, significantly higher than that in the control group (82%, 41/50; χ2= 7.11, P= 0.007) . There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05) . Conclusion:Mucopolysaccharide polysulfate cream can improve the efficacy of sertaconazole nitrate cream in the treatment of scaly hyperkeratotic tinea pedis.

Micosis superficiales en pacientes embarazadas en un hospital general de segundo nivel de atención / Superficial mycosis in pregnant patients in a general hospital

Resumen: ANTECEDENTES: Las micosis superficiales se generan por contacto directo con el hongo o con una persona o animal infectado, y afectan la piel, los anexos y las mucosas; las pacientes embarazadas son susceptibles a cambios cutáneos fisiológicos y patológicos. OBJETIVO: Describir las micosis superficiales en pacientes embarazadas del Servicio de Obstetricia del Hospital General Dr. Manuel Gea González. MATERIAL Y MÉTODO: Estudio descriptivo, observacional, prospectivo y transversal realizado en pacientes embarazadas de la consulta externa del Servicio de Gineco-obstetricia del Hospital General Dr. Manuel Gea González de julio de 2016 a julio de 2017. RESULTADOS: Se incluyeron 23 pacientes que acudieron al Servicio de Micología; el grupo de edad más afectado fue de 21 a 40 años de edad (86.9%); 17 tuvieron tiña plantar (73.9%) y 4 (17.9%) tuvieron onicomicosis distrófica total. Dos cultivos fueron positivos para Trichophyton rubrum. CONCLUSIONES: Las micosis superficiales fueron poco frecuentes en el grupo estudiado: 17 pacientes con tiña de los pies y 4 con onicomicosis. El agente aislado fue Trichophyton rubrum.

Abstract: BACKGROUND: Superficial mycoses are generated by direct contact with the fungus or with an infected person or animal, and affect the skin, the attachments and mucous membranes; pregnant patients are susceptible to skin changes, both physiological and pathological. OBJECTIVE: To know the frequency of superficial mycoses in pregnant patients from the obstetrics service of the Hospital General Dr. Manuel Gea González. MATERIAL AND METHOD: A descriptive, observational, prospective and crosssectional study carried out in pregnant patients of the Gineco-Obstetrics Service of the Hospital General Dr. Manuel Gea González, Mexico City, from July 2016 to July 2017. RESULTS: Twenty-three patients were included in the mycology department for their physical examination; the most affected group was between 21 and 40 age years (86.9%); 17 patients presented tinea pedis (73.9%) and 4 (17.9%) onychomycosis. CONCLUSIONS: Superficial mycosis were not frequent in the group of study: 17 patients had tinea pedis and 4 onychomycosis. The causal agent isolated was Trichophyton rubrum.

Micosis en los pies: descripción clínico-epidemiológica en un centro de referencia de Bogotá, Colombia / Foot mycosis: clinical and epidemiological characterization in one referal center in Bogota, Colombia

Objetivo: Describir las características clínico-epidemiológicas de una población con diagnóstico de infección cutánea micótica en los pies confirmada por examen directo con KOH y cultivo en un centro de referencia de Bogotá, Colombia. Material y método: Estudio observacional descriptivo en el que se incluyeron todos los pacientes con lesiones en los pies que fueron atendidos en el servicio de micología entre el año 2011 y el 2016. Se analizaron las características sociodemográficas, clínicas, etiologías y el perfil de tratamiento por medio de un análisis bivariado. Resultados: Se incluyeron 305 pacientes, de los cuales el 82% residía en zona urbana de la ciudad de Bogotá. El hábito más frecuente fue bañarse descalzo, la forma clínica que predominó fue la interdigital y el 35% de los casos presentó de forma simultánea tiña del pie y onicomicosis. Los agentes etiológicos más comunes fueron los dermatofitos con el 95,2% de los casos. Discusión: La presentación clínica sugestiva de micosis, además del resultado positivo del examen directo y del cultivo, permiten hacer el diagnóstico de estas in fecciones. Las características sociodemográficas de quienes sufren este tipo de micosis en Colombia se relacionan con su contagiosidad y tendencia a la cronicidad. La intervención de tales aspectos debe hacer parte de las estrategias para su prevención.

Objective: To describe the clinical and epidemiological characteristics of the population with cutaneous mycosis in the feet confirmed by positive mycological studies diagnosed in a reference center in Bogota, Colombia. Methods: Descriptive observational study in which all patients with lesions in the feet that were treated in the mycology service between 2011 and 2016 were included. In all cases KOH examination and fungal culture were performed. The sociodemographic and clinical characteristics, etiologies and the treatment profile were assessed using a bivariate analysis. Results: A total of 305 patients were included, of which 61% were men and 82% lived in an urban area of the city of Bogota. The most common behavior was to take a barefoot bath, the most important comorbidities were venous insufficiency and psoriasis, the main clinical form was interdigital and 35% of the cases presented simultaneously tinea pedis and onychomycosis. The group of dermatophytes was the most frequently isolated (95.2%). Discussion: Clinical examination corresponding with mycosis in the feet, direct examination, and positive culture, allow the physician accurate diagnosis and guide the most appropriate treatment of these infections according to their etiology. The sociodemographic characteristics of those who suffer from this mycosis in Co lombia are related to their contagiousness and tendency to chronicity, therefore, the intervention of such aspects must be part of the strategies for their prevention.

Efficacy of combination of ozonated water with oil for treatment of tinea pedis / 中南大学学报(医学版)

Objective:To evaluate efficacy of combined therapy with ozonated water and oil on patients with tinea pedis.Methods:A total of 60 patients with tinea pedis were divided into 2 groups in a randomized and blinded test.Patients in a control group were treated with naftinfine hydrochloride and ketoconazole cream once a day.Patients in an ozone group were treated with ozonated water bath and then ozonated oil topical application once a day.Patients in the 2 groups were treated for 4 weeks.Clinical and laboratory data were collected for both groups at the end of the 1st week,the 2nd week,and the 4th week.The Pearson chi-square was performed to compare scores of the clinical signs and symptoms (CSS) and the mycological result between the 2 groups.Independent samples T-test was performed to compare the curative effect between the 2 groups.Results:After 4 weeks' treatment,6 patients were positive in the control group determined by mycological examination while 1 patient was positive in the ozone group,with no significant difference between the 2 groups (P＞0.05).Changes in CSS at the end of the 1st week,2nd week,and 4th week were obtained and showed no significant difference between the 2 groups at the 3 different time points (P＞0.05).No side effects were observed.Conclusion:Combination of ozonated water with oil is effective on treatment oftinea pedis and it shows no side effects.

A Case of Bilateral Tinea Manus and the Frequency of the Superficial Fungal Hand Infection (1997-2016) / 대한의진균학회지

Dermatophytosis of the palm of the hands (tinea manus) tends to involve one hand. We encountered a case of bilateral tinea manus in a patient with type 1 diabetes mellitus and bilateral tinea pedis. A 57-year-old man presented for evaluation of hyperkeratotic lesions on both his palms and soles. Skin examination revealed hyperkeratotic scaly lesions on the palmar surfaces of his hands and plantar surfaces of his feet. Yellow discoloration and thickening were observed on both his nails. Fasting venous plasma glucose concentration and hemoglobin A1c levels were 332 mg/dL and 7.5%, respectively. Fungus cultures revealed white colonies with brown color on the reverse side in a 14-day incubation period. Trichophyton rubrum infection was identified using polymerase chain reaction with amplified internal transcribed spacer regions. He was treated with oral fluconazole (150 mg/week) and topical flutrimazole spray. In addition, we examined the frequency of 77 superficial fungal hand infections (age, sex, seasonal distributions and coexisting fungal infections) among patients who visited the dermatologic clinic of Chonbuk University Hospital between January 1997 and December 2016.

Índice de severidad y afectación en la tiña pedis / Severity index involvement in tinea pedis

INTRODUCCIÓN: la tiña pedis es una infección por dermatofitos que afecta a los pies e invade frecuentemente los espacios interdigitales, bordes laterales y plantas, la cual tiene una alta incidencia, tendencia a las recidivas y rebeldía a los tratamientos. OBJETIVO: evaluar la severidad de la tiña pedis escamosa a través del índice de severidad y afectación de la tiña pedis (ISATP), MÉTODOS: estudio de evaluación en 347 pacientes a los que se les diagnosticó tiña pedis escamosa, que se atendieron por la especialidad de Dermatología del Hospital Militar Central "Dr. Carlos J Finlay", entre septiembre de 2010 y septiembre de 2012. Se aplicó el algoritmo ISATP, desarrollado a partir del índice de severidad y área de psoriasis (PASI). RESULTADOS: predominó el ISATP moderado con 46,6 %. La mayor frecuencia se encontró en el grupo de 46 a 55 años (55,9 %) y en el sexo masculino (73,1 %). Según el color de la piel, los pacientes de piel blanca (40,0 %) tuvieron el primer lugar. El ISATP severo prevaleció en el grupo etario de 56 a 65 años (50,0 %), en el sexo masculino (93,5 %) y en los pacientes de color de la piel negra (65,7 %). CONCLUSIONES: se comprobó que el algoritmo empleado, ISATP, es útil para definir los grados de severidad de las tiñas pedis escamosas de los pacientes en leves, moderados y severos; además permite relacionarlos con variables definidas de edad, sexo y color de la piel.

INTRODUCTION: tinea pedis is a dermatophyte infection that affects feet and areas between toes, it often invades edges, sides and plants, it has a high incidence, tendency to relapse and rebellious to treatment. OBJECTIVE: assess the severity of flaky tinea pedis through the rate of severity and impairment of tinea pedis (ISATP). METHODS: an assessment study was conducted in 347 patients who were diagnosed with flaky tinea pedis. They were assisted in Dermatology services at Military Central Hospital, from September 2010 to September 2012. The ISATP algorithm was applied. It was developed from psoriasis area and severity rate (PASI). RESULTS: moderate ISATP prevailed (46.6 %). It was most frequently found in the age group of 46-55 years (55.9 %), and in males (73.1 %). Depending on the color of skin, white patients (40.0 %) had the highest frequency. Severe ISATP prevailed in the age group of 56-65 years (50.0 %) in males (93.5 %) and in patients with black skin color (65.7 %). CONCLUSIONS: the algorithm used, ISATP, is useful to define the degree of severity of squamous tinea pedis in patients as mild, moderate and severe; also, it allows defining variables relate to age, sex and skin color.

Clinical Features of Dermatology-Consulted Inpatients: Focus on the Differences between Individual Departments / 대한피부과학회지

BACKGROUND: A variety of dermatological disorders develop in hospitalized patients and the need for dermatological consultations is on the rise. OBJECTIVE: We analyzed 2 years of dermatological consultation data from a tertiary medical center in Korea and compared dermatological problems among individual departments. METHODS: We reviewed 3,102 dermatological inpatient consultations by performing a retrospective chart review. RESULTS: Contact dermatitis (11.4%), drug eruption (9.6%), tinea pedis (5.5%), xerotic eczema (5.3%), and seborrheic dermatitis (5.2%) were the 5 dermatological disorders that were most commonly referred to dermatologists. Patients in the allergy and pulmonology departments had higher rates of drug eruptions. Endocrinology-admitted patients, especially diabetic patients, frequently complained of foot dermatitis. The cardiology, gastroenterology, and hemato-oncology departments referred many patients with purpuric dermatosis to dermatologists. Patients from the surgical departments consulted more frequently consulted contact dermatitis and drug eruptions. The neurology and rehabilitation medicine departments referred more seborrheic dermatitis patients than other departments. Pediatric patients commonly consulted for atopic dermatitis, viral exanthemata, and seborrheic dermatitis. Regardless of department, patients who suffered from severe illness and underwent major surgery developed herpes zoster and cutaneous fungal infections more frequently than other patients. Personal hygiene was closely related to the development of follicular disorders. CONCLUSION: Dermatologists should be familiar with the diverse dermatological complaints of patients admitted to various departments and be actively involved in the diagnosis, treatment, and education of doctors and patients to improve the quality of inpatient care.

Comparison of 1-week terbinafime hydrochloride cream, 1- and 4-week miconazole nitrate cream in the treatment of interdigital tinea pedis: a multi-center, randomized and double-blind study / 中华皮肤科杂志

ObjectiveTo compare the efficacy and tolerability of 1-week 1％ terbinafine hydrochloride cream, 1- and 4-week 2％ miconazole nitrate cream in the treatment of interdigital tinea pedis, and to observe the relapse in patients treated with these regimens. MethodsA multi-center, randomized, double-blind and parallel group study was conducted. By using a stratified randomization protocol, patients were divided into 3 groups to apply terbinafine cream twice daily for 1 week and inert cream(placebo) for the next 3 weeks (1week terbinafine group), miconazole cream twice daily for 1 week and inert cream(placebo) for the next 3 weeks (1-week miconazole group), and miconazole cream twice daily for 4 weeks (4-week miconazole group),respectively. Clinical and mycological assessment was made on week 1, 3, 4, 6, 9 and 12 after the initiation of treatment. ResultsA total of 152 patients with positive baseline mycological culture were eligible for the efficacy analysis. After 4-week treatment, the mycological cure rates were 94.7％, 87.8％ and 82.6％, global effective rates 89.5％, 81.6％ and 63.0％, respectively for the 1-week terbinafine group, 4-week miconazole group and 1-week miconazole group. On week 12, the mycological relapse rates in 1-week terbinafine, 4-week miconazole and 1-week miconazole group were 13％, 14％ and 21％ respectively, and the incidence of adverse reaction was 2.38％, 2.38％ and 3.57％, respectively. ConclusionsAs far as the efficacy and recurrence in patients are concerned, the 1-week terbinafine cream regimen is similar to the 4-week miconazole cream regimen for the treatment of interdigital tinea pedis.

Skin Hydration, Transepidermal Water Loss and Relation with Tinea Pedis in Patients with Primary Hyperhidrosis / 대한의진균학회지

BACKGROUND: Primary hyperhidrosis (PHH) is the disease of production of excessive sweat mainly localized in palm, sole, and craniofacial area. The characteristics of the lesional skin and the relationship with fungal infection in patients with PHH are still not known in Korean literature. OBJECTIVE: The aim of the present study was to compare the skin hydration and transepidermal water loss (TEWL) in patients with PHH with those in control group and to determine the relation of PPH to tinea pedis. METHODS: A prospective case-control study of patients with PHH was conducted. We have measured the skin hydration and TEWL on the skin of palm, sole and forehead in patients with PPH and those in control group. A total of 67 patients with PHH and 50 volunteers of control group were examined for the presence of tinea pedis. Information on the treatment history of tinea pedis were provided by means of reviewing the medical records. RESULTS: Of 67 patients with PHH included, mean age was 28.1 years. Distributional patterns of PHH were palmoplantar (50.7%), isolated palmar (19.4%), isolated plantar (7.5%), and craniofacial (22.4%). Age at onset for palmoplantar HH (12.9+/-7.5 years) was significantly younger than that of craniofacial HH (26.8+/-10.5 years) (p < 0.05). Compared with the skin of those in control group, the values of the skin hydration and TEWL were significantly higher in the skin of patients with PHH. The risk of tinea pedis were increased in patients with primary palmoplantar hyperhidrosis compared with controls (Odds ratio: 2.44). CONCLUSION: Skin physiological parameters of patients with PHH and normal subjects were evaluated by non-invasive skin bioengineering methods which show quantitative modifications in physiological conditions. On the basis of current data, we can expect great advances in the curative value for treatment in patients with PHH.

The Effect of Full Spectrum Light Phototherapy for Patients with Tinea pedis / 대한의진균학회지

BACKGROUND: Tinea pedis is the most common dermatophytosis which is usually treated by antifungal agent. Recently, there has been a resurgence of interest in potential phototherapy for the local treatment of bacterial and fungal infection. OBJECTIVE: The aim of this study is to evaluate the therapeutic effect of full spectrum light (F.S.L) phototherapy for patients with tinea pedis. METHODS: Lesions were irradiated for 20 minutes, 2 times a week for 4 consecutive weeks with F.S.L. emitting wavelengths from 320 nm to 5000 nm. Clinical symptoms were observed and KOH direct smear and fungal culture were done. RESULTS: Global assessment score was improved after the application of eight sessions of F.S.L phototherapy. 18% of total patient were cleared, 45.4% a marked improvement, 27.3% a mild improvement and 9.1% of patients had no effect. And the fungal exams, KOH direct smear and culture, were conversion to negative in 7 out of 11 patients. Significant adverse effects were not observed. CONCLUSION: F.S.L phototherapy might be another treatment option for the tinea pedis patients.

Dermatofitoses podais em futebolistas / Feet dermatophytosis in soccer players

Atletas apresentam risco para micoses cutâneas. Estudados 23 jogadores de futebol, através de exames clínico, micológicos (direto e cultura) e clipping ungueal, dezoito (78,26 por cento) não apresentavam micoses; dois (8,70 por cento) apresentavam tinea pedis e três (13,04 por cento) onicomicose, associada à tinea pedis, principalmente por Trichophyton mentagrophytes. Tinea pedis infectada produziu celulite em um atleta. É necessário um programa educativo de cuidados com a pele no esporte.

Athletes present risk of cutaneous mycosis. A study was carried out with 23 soccer players using clinical and mycological examination (direct microscopic examination and culture) and nail clipping. Eighteen (78.26 percent) did not present mycosis; two (8.70 percent) presented tinea pedis, and three (13.04 percent) presented onychomycosis associated to tinea pedis, mainly for Trichophyton mentagrophytes. Infected tinea pedis has produced cellulitis in one of the athletes. It is necessary to create an educative program of skin care during sports practice.

Caso para diagnóstico / Case for diagnosis

Paciente do sexo masculino, branco, 43 anos, apresentava há dois anos lesão única, localizada no joelho direito, além de descamação nas regiões plantares. O exame micológico direto das lesões plantares mostrava filamentos de dermatófitos, mas foi negativo na lesão do joelho. Porém o exame histopatológico dessa área demonstrou presença de granuloma de corpo estranho com hifas de dermatófitos, confirmando o diagnóstico de granuloma de Majocchi.

Caucasian male patient, 43 years old, presented two years ago with one single lesion in the right knee, in addition to desquamation in the plantar region. Direct mycological exam of the plantar damage showed filaments of dermatophytes, but it was negative for the knee injury. However, histopathology of the area showed presence of foreign body granuloma with hyphae of dermatophytes, confirming the diagnosis of Majocchi's granuloma.

A Clinical and Mycological Studies on Tinea Pedis / 대한의진균학회지

BACKGROUND: Tinea pedis is the most common dermatophytosis in Korea. It has been increased gradually with time and the proportion of that in the aged has been significantly increased. OBJECTIVE: The aim of this study is to evaluate the clinical characteristics of tinea pedis according to the clinical types and their mycologic findings. METHODS: A clinical and mycological study was performed with 212 cases of tinea pedis among outpatients examined for 9 months from March 2005 to November 2005 at Department of Dermatology of the 11 University Hospitals in Korea. RESULTS 1. The age distribution showed patients in their 50s and 60s to be the most common. The ratio of male to female was 1.33:1 2. The most frequent clinical type was interdigital only type (55.2%), interdigital hyperkeratotic type (39.8%), vesicular type (2.8%) and interdigital vesicular type (2.2%), in descending order. There are no hyperkeratotic only type and hyperkeratotic vesicular type. 3. The duration of tinea pedis was longer than 5 years in 73.1%. The proportion of interdigital hyperkeratotic type was the highest in longer than 10 years of duration group than in other duration groups. 4. The rate of coexistent dermatophytosis with tinea pedis was 19.3%, and tinea cruris was the most common (10.3%). 5. The positive culture rate was 73.1%, and Trichophyton(T.) rubrum was the most common isolates (93.5%) followed by T. mentagrophytes var. mentagrophytes (3.9%) and T. mentagrophytes var. interdigitale (2.6%). CONCLUSIONS: All these findings suggest that the prevalence of tinea pedis in the aged was high, longer duration of the disease was more common and the rate of coexistent dermatophytosis increased. Further studies about tinea pedis and other dermatophytosis in the aged person will be necessary.

The Frequency of Tinea Pedis in Patients with Tinea Cruris / 대한의진균학회지

BACKGROUND: There have been many studies about concurrent infection with tinea cruris and tinea pedis as a part of dermatophytosis in Korea. However, few studies have been reported about actual percentage regarding the frequency of tinea pedis in patients with tinea cruris and comparison of the causative organisms in the groin and foot. OBJECTIVE: The purpose of this study was to investigate the frequency of tinea pedis in patients with tinea cruris and the causative organisms in the groin and foot. METHODS: We examined clinical characteristics, frequency of tinea cruris, and causative organism on one hundred and eight nine cases with tinea cruris at the department of dermatology, Dongguk University Hospital from September 2000 to August 2005. RESULTS: The ratio of male to female patients was 10.8:1. Besides most of them were between the twenties and forties. Most (74.6%) of them involved both sites of the groin. Duration of tinea cruris was the most common within one year. The frequency of tinea pedis in patients with tinea cruris was 85.7%. Most of them (69.1%), duration of tinea pedis was longer than that of tinea cruris. One hundred and thirty nine dermatophytes were isolated from 189 patients with tinea cruris. They were Trichophyton(T.) rubrum (89.2%), T. mentagrophytes (7.2%), and Epidermophyton floccosum (3.6%). Of one hundred and sixty two patients with both tinea cruris and tinea pedis, 52 patients (32.1%) had same species and only four patients (2.5%) had different species in the groin and foot. CONCLUSION: Because of the high incidence of concurrent infection with tinea cruris and tinea pedis, we suggest the need of a careful mycological examination for foot in patients with tinea cruris.

Pesquisa de fungos como agentes das dermatoses plantares em pacientes do ambulatório de dermatologia do HU-UFJF / Searching for fungal infections in plantar dermatoses in outpatients from the dermatology division of the University Hospital of the Federal University of Juiz de Fora

A tinha dos pés é a forma mais comum das dermatofitoses, pode simular outras doenças de pele e tende a se tornar crônica. Apresentamos um estudo das manifestações clínicas, dos agentes etiológicos e da freqüência da tinha dos pés em pacientes do Ambulatório de Dermatologia do HU-UFJF durante o período de agosto de 2005 a junho de 2006. Foram avaliados 59 pacientes com suspeita clínica de tinha dos pés, sendo colhidas amostras de escamas de lesões plantares, a fim de serem submetidas à pesquisa laboratorial mediante exame micológico direto após clareamento com potassa a 20%. A seguir, procedeu-se ao cultivo em meio Sabouroud dextrose com gentamicina e cloranfenicol. Dos 59 pacientes avaliados, a tinha dos pés compreendeu 30 (50,85%) casos. T.rubrum foi o agente etiológico mais freqüente (65,4%). A manifestação clínica mais observada foi a variedade descamativa plantar bilateral (50%). Dentre os diagnósticos diferenciais da tinha dos pés, a psoríase plantar foi a mais freqüente (60%). Constata-se que é de inegável importância o estudo das dermatofitoses que acometem os pés, tendo em vista a numerosa incidência de casos clínicos e seu amplo diagnóstico diferencial.

Tinea pedis, the most common dermatophytosis, may mimic other skin diseases besides tending to chronicity. We studied the clinical manifestations, etiologic agents, and frequency of tinea pedis in outpatients seen at the Dermatology Division of the University Hospital ofthe Federal University of Juiz de Fora, Brazil, from August 2005 to June 2006. 59 patients suspect of having tinea pedis underwent mycologic examination of plantar scales with 20% potassium hydroxide. Samples were cultured in dextrose and gentamicin-added Sabouroud`s medium. Tinea pedis was diagnosed in 30 (50.85%) of the 59 patients examined. T.rubrum was the most frequent agent (65.4%). Bilateral plantar desquamation was the most frequent clinical presentation (50%). Plantar psoriasis was the most frequent differential diagnosis (60%). The great incidence and wide differential diagnosis make tinea pedis an important foot condition.

A Clinical and Mycological Study of Tinea Pedis / 대한의진균학회지

BACKGROUND: Tinea pedis is the most common dermatophytosis in Korea. It has been increased gradually with time. Its characteristics may change with social environments. OBJECTIVE: The purpose of this study is to evaluate the clinical characteristics of tinea pedis according to clinical type and its mycologic findings. METHODS: We performed clinical and mycological studies on 74 patients with tinea pedis among outpatients clinic of Department of Dermatology in Yeungnam University Hospital and Catholic Skin Clinic for 3 months, from January 2005 to March 2005. RESULTS AND CONCLUSIONS: 1. The age distribution showed patients in their 60s and older than 60s to be most common. The ratio of male to female was 1.32:1 2. According to clinical types, the ratio of interdigital type was the highest (50%), followed by interdigital combined hyperkeratotic type (44.6%), interdigital combined with vesicular type (4%) and vesicular type (1.4%). There are no hyperkeratotic type and hyperkeratotic combined vesicular type. 3. The duration of longer than 5 years of tinea pedis was 73%. The proportion of interdigital combined with vesicular type was more common in its duration of longer than 10 years than its duration of less than 10 years. The durations of vesicular type and interdigital combined vesicular type were more than 5 years. 4. The rate of family history of tinea pedis was 52.7%. The broader area of involved site in the patients was, the higher the positivity in family history. 5. The rate of coexistent dermatophytosis with tinea pedis was 82.5%, and tinea unguium was the most common (79.7%). 6. The positive rate of culture was 68.9%, and Trichophyton(T.) rubrum was the most common isolates (96%) followed by T. mentagrophytes (4%). Compared with previous studies, age of patients with tinea pedis was older and duration was longer, the rate of coexistent dermatophytosis was increased, especially in tinea unguium.

Prevalence of Tinea Pedis and Onychomycosis in the Aged / 대한의진균학회지

BACKGROUND: Tinea pedis and onychomycosis is a common disease and the proportion of that in the aged has been significantly increased. Although there have been many reports about tinea pedis and onychomycosis, very few studies about that in the aged have yet been conducted. OBJECTIVE: The purpose of this study is to evaluate the prevalence and clinical features of tinea pedis and onychomycosis in the aged. METHODS: One hundred twenty-six persons over 65 years old who visited the Daegu public aged welfare center (57 persons), Seongju public health center (38 persons) and hospitalized Yeungnam University Yeongcheon hospital (31 persons) from September 20, 2005 to October 7, 2005 were examined clinically and evaluated tinea pedis and onychomycosis. Their clinical lesions were confirmed by KOH preparation and fungal culture. RESULT: Among 126 examined, 62 persons (49.2%) had tinea pedis and/or onychomycosis. Prevalence of the tinea pedis and/or onychomycosis of male (53.2%) was higher than that of female (38.2%). There was no difference in the prevalence between the living area or age. Most common clinical type of tinea pedis was hyperkeratotic type (n=21/66.7%). All patients with onychomycosis were distal subungual onychomycosis. In this study common underlying disease was hypertension (22.6%), diabetes mellitus (8.1%) and cerebrovascular accident (8.1%), however, there was no correlation between underlying diseases and the prevalence of tinea pedis and/or onychomycosis. Among 87 persons, 21 strains of dermatophytes were isolated. They were 19 strains of Trichophyton(T.) rubrum, 2 strains of T. mentagrophytes. The rate of previous treatment for this problem was 32.6%. CONCLUSIONS: All this finding suggest that the prevalence of tinea pedis and/or onychomycosis in the aged was high and they did not know about the disease. Tinea pedis and/or onychomycosis in the aged could become a source of infection and complication. Therefore, it is necessary to educate them and support to treat the disease effectively. Future studies including a large number of examinee and correlation of other diseases will be needed.

Isolation of Dermatophytes from Patients with Tinea Pedis Using the Foot-press Method / 대한피부과학회지

BACKGROUND: Although tinea pedis is one of the most prevalent diseases caused by dermatophytes, there have been few studies about distribution of dermatophytes on infected soles for this disease in Korea. OBJECTIVE: The purpose of the study was to investigate the distribution of dermatophytes on infected sole using the new direct culture method (Foot-press method). METHODS: The infected soles of 39 patients were directly pressed onto Sabouraud's dextrose agar with cycloheximide prepared in a large culture dish for a few seconds. The culture media were then incubated at 25degrees C for 1-4 weeks. RESULTS AND CONDLUSION: 1. Dermatophyte colonies were isolated from twenty-eight patients (71.8%). 2. Twenty-four of the isolated dermatophytes were Trichophyton (T.) rubrum (85.7%), and the rest were T. mentagraphytes (14.3%). 3. The number of isolated colonies from each patient range from 1 to 102 (Mean+/-SD, 12.8+/-20.7). Three isolated colonies were most common. 4. The isolation frequencies were higher in the patients of keratotic type and in those with tinea unguium (p<0.05). 5. Positive rate was highest in patients with widely-spread lesion (p<0.05).

Effect of Rapid Dehydration by Vacuum Drying on Fungal Viability / 대한의진균학회지

BACKGROUND: Tinea pedis and candidiasis of the feet is the most common type of dermatomycosis. Contaminated shoes may play an important role in spread and relapse of tinea pedis and candidiasis of the feet. However there is no effective method to sterilize contaminated shoes. Since vacuum drying can evaporate water in relatively low temperature, it is thought to be able to dehydrate rapidly and to sterilize shoes without damaging them. OBJECTIVE: This study was designed to evaluate the fungicidal effect of rapid dehydration by vacuum drying. METHODS: The suspension of Trichophyton (T.) rubrum, T. mentagrophytes and Candida (C.) albicans was made with distilled water. Vacuum drying or wet heating of the suspension was conducted in the vacuum dryer at various temperature and time. The treated fungi were rehydrated and were cultured on Sabouraud dextrose agar petri dish. The viability was determined as colony forming unit (CFU) of experimental group divided by that of control group. RESULTS: When C. albicans was dried for one hour by vacuum drying, the viability decreased as temperature increased, but no sterilization was noted even at 80degrees C. Under vacuum drying at 50degrees C for one hour, viability decreased below 3% and there was no difference in the viability between one hour of the treatment and more than one hour. In T. rubrum, T. mentagrophytes, C. albicans, the number of fungi was reduced by 90% under the condition of one hour vacuum drying at 50degrees C. Wet heating was more effective than vacuum drying in reducing and sterilizing C. albicans. Sterilization was done under the condition of wet heating of one hour at 50degrees C or wet heating over 30 minutes at 60degrees C. The higher concentration of C. albicans was, the stronger resistance against the heat and dehydration was observed. Combined teatment with wet heating for one hour followed by vacuum drying for one hour at 50degrees C was effective way to sterilize C. albicans. CONCLUSION: These results suggest combined treatment with wet heating and vacuum drying can effectively sterilize shoes without damage and prevent the feet from spread and relapse of tinea pedia and candidiasis of the feet.

Trichosporon Species in Onychomycosis and Tinea Pedis / 대한피부과학회지

BACKGROUND: Onychomycosis and tinea pedis are common superficial fungal infections. Causative organism in onychomycosis and tinea pedis have been extensively studied, but the pathogenic role of non-dermatophyte is still controversial. Trichosporon species are soil and water-inhabiting yeasts, and occasionally found in the normal flora of human skin, mouth, and nails. Trichosporon spp. have been reported to be one of the pathogens in onychomycosis and tinea pedis. OBJECTIVE: We performed mycologic studies to investigate the prevalence and significance of trichosporon spp. in skin and nail lesions, which were clinically suspected of onychomycosis and tinea pedis. METHOD: We performed a survey of the mycologic laboratory records of patients clinically suspected of onychomycosis and tinea pedis from August 2001 to July 2002, and tried to identify trichosporon to species level by using API 20C kit systems. RESULTS: Out of total 1509 nail and skin samples examined, 663(43.9%) were culture positive. Trichosporon spp. were recovered from 11.2%(74/663) of the samples. In onychomycosis considered alone, the prevalence of solitary isolated Trichosporon spp. was 7.7%. In species level, T. asahii(62.1%), T. mucoides(20.3%), and T. inkin(14.9%) were isolated in decreasing frequency. The positive rate for KOH examination in trichosporon spp. was 52.9%. Among the isolated trichosporon spp., mixed cultures with other organisms were 13(17.6%) and solitary isolates were 61(82.4%). 31(41.9%) were not only positive for KOH examination but also founded in pure culture in relatively large colony counts. In pure culture isolations, high colony counts predominated over mixed cultures. CONCLUSION: Trichosporon spp. is a relatively common isolates from fungal cultures of skin and nail, and it may be pathogenic in some cases of skin or nail infection.