Risk factors for the development of tinea pedis and onychomycosis: Real-world evidence from a single-podiatry center, large-scale database in Japan.

Dermatomycosis, including tinea pedis and onychomycosis, is frequently encountered in routine medical care in Japan. Identifying the risk factors for tinea pedis and onychomycosis development is important to encourage hospital visits by patients who may have these diseases but who are not undergoing any treatment. This approach may lead to the prevention of disease progression and the spread of infections to others. Risk factors for onychomycosis development have been reported both in and outside of Japan. However, most of the risk factors were identified based on a multicenter, questionnaire survey study and included evidence obtained from unclear or inconsistent diagnostic criteria for tinea pedis, onychomycosis, and identified risk factors. The current study analyzed the risk factors for developing tinea pedis and onychomycosis in real-world practice in Japan using a single-center, large-scale database that included the data of patients managed with consistent diagnostic criteria at the Podiatry Center of Juntendo University Hospital. A total of 2476 patients (1012 males, 1464 females) with a mean age of 63.4 years were included. Among these patients, 337 (13.6%) had tinea pedis and 346 (14.0%) had onychomycosis. A total of 259 patients (~ 75% of each patient population) had both diseases concomitantly. Multivariate logistic regression analysis adjusted for the possible risk factors of age (per 10 years), sex, diabetes, dialysis, visual impairment, ulcer history, lower-limb ischemia (LLI), and diabetic peripheral neuropathy (DPN) revealed that advanced age, male sex, diabetes, and LLI were independent risk factors for the development of tinea pedis. In addition, DPN was an independent risk factor for developing onychomycosis. We believe that these data are useful for identifying patients who are at high risk of developing tinea pedis and onychomycosis, which may result in disease prevention and suppression in real-world clinical practice in Japan.

The prevalence of dermatophytoses in Brazil: a systematic review.

Dermatophytosis is a common cutaneous mycosis worldwide whose prevalence in Brazil is still unknown. This systematic review has estimated the burden of dermatophytoses from updated literature data reported in the general Brazilian population. We used the following databases: Web of Science, Medline/PubMed, Embase, The Cochrane Library and Scopus for studies published between 2011 and 2020. Original articles with an emphasis on prevalence data for dermatophytosis in the Brazilian population, and diagnosed by culture exam or molecular biology were eligible. We also assessed the methodological quality of the studies. A total of 24 articles met the inclusion criteria and were reviewed. The occurrence of dermatophytoses found in the studies ranged from 4-88.50 %. The pooled prevalence of dermatophytosis for the population studies was 25 % (95 % CI: 24.7-25.3 %). The size of the samples used in the studies ranged from 45 to 36 446 participants, and ages ranged up to 98 years old. The populations studied involved mostly women. The presence of tinea unguium (toenail and fingernail) and tinea pedis were the most frequent dermatophytosis, and we observed a predominance of Trichophyton rubrum, T. interdigitale and T. mentagrophytes. The studies were primarily conducted in patient groups with suspected mycoses and were not entirely representative of the general population. Yet we believe that in the future, more collaborative strategies would improve both diagnostic capacity and epidemiological methodologies, associating the prevalence of dermatophytosis with social and environmental risk factors. This review helps to better understand future epidemiological trends in Brazil and the world.

Internal environment of footwear is a risk factor for tinea pedis.

The relation between tinea pedis and the internal environment of footwear has not been scientifically proven. This study aimed to determine whether the internal environment of footwear affects the incidence of tinea pedis and tinea unguium. This cross-sectional, observatory study involved 420 outpatients who were categorized into non-tinea, tinea pedis or tinea unguium groups based on mycological analysis. External climatic conditions, and temperature, humidity and dew points inside the patients' footwear were recorded. Univariate and multivariate analyses were used to determine independent risk factors for tinea pedis and tinea unguium. A significant correlation was found between high temperature/high humidity and dew point of the internal environment of the footwear and the season. Furthermore, those who wore footwear with internal environments characterized by high temperature, high humidity, high-temperature/high-humidity and high dew point values had a significantly higher incidence of tinea pedis. The internal dew point correlated with the incidence of tinea pedis, whereas the external temperature correlated with the incidence of tinea unguium. The internal humidity and dew point of footwear as well as the frequency with which footwear with a high-temperature/high-humidity internal environment were worn was significantly higher in men than in women. In conclusion, the internal environment of footwear is a risk factor for tinea pedis, and this environment is affected by the season. Moreover, the frequency of tinea pedis among men is related to the internal environment of footwear. The dew point is an appropriate index for evaluating temperature and humidity in relation to tinea pedis.

Documento de consenso SEIP-AEPap-SEPEAP sobre la etiología, el diagnóstico y el tratamiento de las infecciones cutáneas micóticas de manejo ambulatorio / SEIP-AEPap-SEPEAP consensus document on the etiology, diagnosis, treatment and ambulatory management of fungal skin infections

Entre las infecciones por hongos, las micosis superficiales, adquiridas por contacto directo o indirecto con un animal o con una persona infectados, son las más habituales en la infancia. Los patógenos más frecuentes en el niño inmunocompetente son las levaduras (Candida y Malasezzia) y los dermatofitos. La morbilidad de las micosis superficiales es tan importante como poco considerada, pues existe la falsa impresión de que constituyen un problema menor pese a su gran incidencia en la práctica habitual. En el presente documento de consenso, elaborado por el Grupo de Trabajo de Infecciones de Manejo Ambulatorio de la Sociedad Española de Infectología Pediátrica (SEIP), la Asociación Española de Pediatría de Atención Primaria (AEPap) y la Sociedad Española de Pediatría Extrahospitalaria y Atención Primaria (SEPEAP), se abordan los aspectos esenciales de la infección micótica superficial en el niño inmunocompetente (AU)

Superficial mycoses, acquired by direct or indirect contact with an infected animal or person, are frequent in childhood. The most common pathogens in immunocompetent children are yeasts (Candida and Malasezzia) and dermatophytes. The morbidity of the superficial mycoses is as important as trivialized, which gives the false impression that it constitutes a minor problem despite its high incidence in routine practice. In this consensus document of the Spanish Society of Pediatric Infectious Diseases (SEIP), the Spanish Association of Primary Care Pediatrics (AEPap) and the Spanish Society of Pediatric Outpatient and Primary Care (SEPEAP), the essential aspects of superficial fungal infection in the immunocompetent child are addressed (AU)

Annular plaques on the back and flanks.

An 86-year-old African American woman sought care for an asymptomatic rash on her back and flanks that she'd had for 14 months. Physical examination of her trunk revealed 3 to 6 cm annular/arcuate plaques with central clearing. The lesions also had a delicate trailing scale behind a slightly raised erythematous rim. The combination of a ring-shaped rash on the patient's torso and a foot infection led us to the diagnosis.

Comorbidity of tinea pedis and onychomycosis and evaluation of risk factors in Latino immigrant poultry processing and other manual laborers.

OBJECTIVES: Latino immigrant workers experience elevated rates of skin disease that result from their working and living conditions. Working in manual occupations exposes workers to a variety of challenges, including occlusive shoes, vigorous physical activity, and wet conditions. These challenges predispose workers to fungal infection. The objectives of this article are to examine the comorbidity of tinea pedis and onychomycosis and to identify possible risk factors among Latino immigrant poultry and nonpoultry workers in western North Carolina. METHODS: Data were obtained from a cross-sectional study conducted between June 2009 and November 2010 in rural western North Carolina among 518 manual Latino immigrant workers to assess their occupational injuries. Participants completed a face-to-face interview and a dermatologic examination. RESULTS: Nearly one-third of the participants (32%) were diagnosed as having onychomycosis and more than one-third (37.8%) were diagnosed as having tinea pedis. There was a greater prevalence of tinea pedis in men than women (71.3% vs 28.7%, respectively). Of the 518 participants, 121 (23.5%) had both conditions. Participants who reported the use of occlusive shoes as "always" or "most of the time" had a higher prevalence of comorbid onychomycosis and tinea pedis than the rest of the group. CONCLUSIONS: Comorbidity of tinea pedis and onychomycosis is common among immigrant Latino men and women who perform manual labor. Further studies confirming the presence and type of dermatophyte should be conducted.

[Investigation of tinea pedis and toenail onychomycosis prevalence in patients with psoriasis]. / Psöriazisli olgularda tinea pedis ve ayak tirnagi onikomikozu prevalansinin arastirilmasi.

The data about the prevalence of onychomycosis in patients with psoriasis is contradictory. In this study, we investigated the prevalence of onychomycosis and tinea pedis in patients with psoriasis compared to control group. A total of 60 patients with psoriasis (27 male, 33 female; mean age: 40.8 +/- 17.6 years) and 60 subjects without psoriasis (27 male, 33 female; mean age: 42.8 +/- 17.3 years) who were admitted to dermatology outpatient clinics of our hospital were included to the study. Scrapings from both normal and abnormal toenails as well as toewebs were examined using microscopy and fungal culture. Foot dermatomycosis was diagnosed in 6 (5 onychomycosis and 1 tinea pedis) patients with psoriasis (10%) and in 8 (5 onychomycosis and 3 tinea pedis) control subjects (13.3%) (p > 0.05). The only dermatophyte fungi isolated in both patients with psoriasis and control group were Trichophyton rubrum (75%) and Trichophyton interdigitale (25%). Onychomycosis was more predominant in male psoriatic patients (p = 0.01). Both distero-lateral subungual onychomycosis (DLSO) and total dystrophic onychomycosis were detected in patients with psoriasis, however, DLSO, was the only clinical type in the control group. Pitting is the most typical lesions in nails in patients with psoriasis (p = 0.04). The use of common showers play a role in transmission of foot dermatomycosis (p = 0.04). In this study, psoriasis was not found as a risk factor for onychomycosis. However, onychomycosis is a major problem in psoriatic nails, and mycological methods would be useful in differential diagnosis. Since dermatomycosis is still an important public health problem, it may be controlled by education of the patient about proper foot hygiene and avoiding walking barefooted in shower areas.

Skin disorders in patients with hemiplegia and papaplegia.

OBJECTIVE: The aim of this study was to determine the incidence of skin disorders in patients with hemiplegia and paraplegia. Several skin disorders have been reported previously in these patients. METHODS: Seventy inpatients with hemiplegia, 30 with paraplegia, and 90 individuals as a control group were included in the study. RESULTS: The most common skin disorder in the patient group was tinea pedis, which was observed in 18 of the 100 patients. The other common dermatological disorders in the patient group were onychomycosis of the toenails (n = 14), xerosis of the extremities (n = 13) and reduction in hair on the lower extremities (n = 12). The incidence of tinea pedis (p = 0.004), onychomycosis of the toenails (p = 0.010), xerosis of the extremities (p = 0.017) and reduction in hair on the lower extremities (p = 0.027) in the patient group were significantly more common than in the control group. There was no significant correlation between tinea pedis, onychomycosis of the toenails, xerosis of the extremities and reduction in hair on the lower extremities and the duration of hemiplegia and paraplegia. CONCLUSION: Dermatological disorders are observed more commonly in hemiplegic and paraplegic patients than in controls, therefore routine dermatological examination should be performed in these patients.

[Interdigital and foot fungal infection in patients with onychomycosis]. / Infección micótica plantar e interdigital en pacientes con onicomicosis.

In patients with onychomycosis (OM) 71.5% of them have been reported with plantar fungal infection. The aim of this study was to study the frequency and distribution of plantar and interdigital affection in diabetic patients and in a control group without diabetes, all of them with OM. Diabetic patients with OM were more frequently diagnosed with plantar (61.2%) than interdigital (46.7%) infection. In the control group similar results were obtained; patients with OM in 76.5% had plantar mycotic infection and 67.1% interdigital involvement.

Aspectos epidemiológicos das micoses dos pés em um time chinês de futebol / Epidemiological aspects of the feet mycosis in a Chinese soccer team

As infecções fúngicas podais podem interferir no desempenho esportivo ao provocar desconforto e dor nos atletas. O objetivo deste estudo foi avaliar a prevalência das infecções fúngicas podais em um time profissional de futebol, verificando os agentes mais freqüentes e os fatores predisponentes. O delineamento da pesquisa foi transversal e descritivo. A amostra foi composta de 22 homens, com idades entre 23 e 36 anos, integrantes do time de futebol profissional chinês, quando de sua participação de jogos em Curitiba (PR). Todos foram avaliados clinicamente e submetidos a exames micológicos (direto e cultura) de escamas de pele e unha dos pés e estudo histopatológico de fragmento ungueal. Os resultados encontrados foram: 12 casos (54,5 por cento) não apresentavam micose; cinco casos (22,72 por cento) apresentavam onicomicose isolada e cinco casos (22,72 por cento) apresentavam onicomicose associada a tinea pedis, tendo como principal agente isolado o Trichophyton rubrum. Os fatores predisponentes apontados pelos atletas incluíram: banho em local público (85 por cento), prática de esporte (76 por cento), uso de calçados fechados (70 por cento), contato com animal doméstico (63 por cento) e irregularidade na higiene dos pés (50 por cento). CONCLUSÃO: A freqüência da onicomicose em atletas chineses foi maior do que na população em geral. O agente mais freqüente foi o Trichophyton rubrum. Os hábitos individuais podem contribuir para a aquisição dessas infecções fúngicas, além do trauma direto pelo calçado e bola, bem como pelo contato físico durante treinos e jogos que podem favorecer lesões cutâneas e ungueais.

Podal fungal infections can interfere in the sportive performance, since they provoke discomfort and pain in the athletes. The purpose of this study was to assess the prevalence of podal fungal infections in a professional soccer team, verifying the more frequent agents and the predisposing factors to that condition. The research had a transversal and descriptive outlining. The sampling was composed by twenty-two 23 to 36 years old male athletes from the professional Chinese soccer team on the occasion they participated in a game series in Curitiba (PR). All athletes were clinically assessed, and they were submitted to mycological examinations (direct and culture) of the skin and nail's squamas from their feet, as well as to a histopathologic study of the ungual fragment. The results found were: twelve cases (54.5 percent) did not present mycosis; 5 cases (22.72 percent) presented isolated onychomycosis, and 5 cases (22.72 percent) presented onychomycosis associated to tinea pedis, having as major isolated agent the Trichophyton rubrum. The predisposing agents pointed by athletes included: bath in a public place (85 percent), sports practice (76 percent), use of closed shoes (70 percent), contact with pets (63 percent), and irregular feet hygiene (50 percent). CONCLUSION: The frequency of the onychomycosis in Chinese athletes was higher than in the general population. The most frequent agent found it was the Trichophyton rubrum. The individual habits may contribute to the acquisition of these fungal infections added to the direct trauma provoked by the shoe and the ball, as well as to the physical contact during the trainings and games that may favor the cutaneous and ungual injuries.

Las infecciones fúngicas pueden interferir en la acción deportiva por provocar incomodidad y dolor en los atletas. El objetivo de este estudio fue evaluar el predominio de infecciones fúngicas en los pies que afectan a un equipo profesional de fútbol, mientras se verifican los agentes más frecuentes y los factores predisponentes. El delineamento de la investigación fue cruzado y descriptivo. La muestra estaba compuesta de 22 hombres, con las edades entre 23 y 36 años, íntegrantes del equipo de fútbol profesional chino, cuando participaron en juegos en Curitiba (PR). Todos fueron evaluados clínicamente y sometidos a los exámenes micológicos respectivos (directo y cultivo) de escamas de piel y uña de los pies y estudio histopatológico de fragmento ungueal. Los resultados que se encontraron fueron: 12 casos (54,5 por ciento) que no presentaron micosis; 5 casos (22,72 por ciento) que presentaron onicomicosis aislada y 5 casos (22,72 por ciento) que presentaron onicomicosis asociada a tinea pedis, que tiene como agente aislado principal el Trichophyton rubrum. Los factores predisponentes para los atletas incluidos consignados fueron: bañarse en lugares públicos (85 por ciento), la práctica deportiva (76 por ciento), el uso de zapatos cerrados (70 por ciento), tener un animal doméstico (63 por ciento) y la irregularidad en la higiene de los pies (50 por ciento). CONCLUSIONES: La frecuencia de la onicomicosis en los atletas chinos es más grande que en la población en general. El agente más frecuente fué el Trichophyton rubrum. Los hábitos individuales pueden contribuir a la adquisición de esas infecciones fúngicas, además del trauma directo por el zapato, así como el contacto físico durante los entrenamientos y juegos que pueden favorecer lesiones cutáneas y ungueales.

Species distribution and frequency of isolation of yeasts and dermatophytes from toe webs of diabetic patients.

The paper identifies fungal species, looking at the incidence of fungal isolation and risk factors influencing the development of fungal infection and colonization of interdigital spaces of the feet in 509 diabetic outpatients. Using standard mycologic diagnostic methods, fungi were detected in toe webs of 122 (24%) diabetic patients. The finding of fungi was twice as common in interdigital spaces of one (85/16.7% of the patients) than both feet (37/7.3% of the patients). Yeasts were the most common isolates (95/18.7% of the patients), followed by dermatophytic moulds (24/4.7% of the patients), whereas coexistence of yeasts and dermatophytes was the most infrequent finding (3/0.6% of the patients). From toe webs, 24 fungal species, 21 yeast species belonging to nine genera (Candida, Rhodotorula, Cryptococcus, Trichosporon, Saccharomyces, Blastoschizomyces, Geotrichum, Debaryomyces, and Ustilago) as well as three species of dermatophytes of the genera Trichophyton and Epidermophyton were isolated. The most frequently isolated fungi were Candida parapsilosis (59/11.6% of the patients) and Trichophyton mentagrophytes (16/3.1% of the patients). Although there was no correlation between the incidence of toe web space colonization with yeasts and dermatophytosis with the criteria of patient sex and age, and duration of diabetes, the difference in the incidence according to type of diabetes was statistically significant. In non insulin dependent diabetes mellitus patients, the incidence of fungal isolation from toe webs was statistically significantly higher (30.1%) than in insulin dependent diabetes mellitus patients (19.8%).

Epidemiology of tinea pedis and toenail tinea unguium in worshippers in the mosques in Adana, Turkey.

The aim of this study was to determine the prevalence of dermatomycosis and the risk factors in those who perform their prayers in the mosques in the city center of Adana Province. The diagnosis of dermatomycosis was made on the basis of direct microscopy and/or culture in addition to clinical findings. Among 461 subjects, 136 (29.5%) had tinea pedis, 23 (5.0%) had tinea unguium, and 21 (4.5%) had both infections simultaneously, with a resulting total of 180 (39.0%) cases of dermatomycosis. The causative agents by frequency were: Trichophyton rubrum (67.0%), T. mentagrophytes var. interdigitale (31.1%), and Candida albicans (1.9%). The prevalence of the foot dermatomycosis was found to be high among those who practiced ablution 3-5 times a day and did not dry their feet immediately, who used rubber shoes, and/or who shared their shoes. Pedal dermatophyte infection seems to be a major problem among the adult Muslim male population regularly attending mosques especially in 5th and 6th decades of life.

The wear and tear of 26.2: dermatological injuries reported on marathon day.

Whether it is to take on the challenge, to get in shape and lose weight, to relieve stress, or to enjoy the outdoors, people have increasingly turned to the marathon as their sporting event of choice. Although there are many health benefits, beginners should be aware that injuries are quite common in marathon runners. Among these are the wear and tear injuries to the skin. This is a review of the most commonly reported dermatological injuries on marathon day.