Tinea Pedis: An Opportunistic Infection of The Skin

Nishimoto, Katsutaro 대한의진균학회 2001 대한의진균학회지 Vol.6 No.4

In Japan, the average incidence of tinea pedis among dermatology out-patients is around 10%. Obviously this does not reflect the true invasion of dermatophytes on human skin. Several attempts to elucidate the incidence of tinea pedis among the population revealed nearly 40% of randomly chosen patients at dermatology clinics suffered from tinea pedis with an increasing incidence by age group. Furthermore, results obtained from regular medical checks of healthy adults at Nagasaki Municipal Hospital revealed more than 30% of the recruits had only a slight scaling of mild hyperkeratosis which could not be differentiated clinically from other pathological or even age-related changes. Nearly two-thirds of these tinea penis lesions are left untreated, or even unnoticed as a disease. Several experiments to prove the presence of dermatophytes from healthy-looking skin revealed the possibility of the presence of subclinical lesions or carriers of dermatophytes accumulating around these tinea pedis patients. Uncontrolled tinea pedis lesions are a major cause of tinea unguium, which is expensive and time-consuming to cure especially in the aged. There are no standardized treatment modalities for tinea pedis patients focusing on the complete cure. But the difficulties to eradicate the pathogens from their host are common among opportunistic infections. Also the dissociation of the number of patients and the population having the pathogens without apparent lesions, i.e. healthy carrier, is a characteristic of opportunistic infection. Undetected tinea penis patients are problematic since they are source of infection for others. Discovering and treating the hidden patients is becoming a public health problem, as well as a private hazard. Prevalence of pathogens in the host tissue and low mobility rate are a feature of opportunistic infections. The control of methods for tinea penis as an opportunistic infection should also be taken under consideration. [Kor J Med Mycol 6(4): 207-212] Key Words: Tinea pedis, Prevalence, Anthropophilic dermatophytes, Opportunistic infection, Healthy carrier

조선업 근로자의 족부백선 유병률 및 관련 요인

서호석,유철인,이충렬,이지호,김양호,이원신,최지호,성경제,고재경,문기찬 大韓産業醫學會 2002 대한직업환경의학회지 Vol.14 No.4

목적: 울산지역에 소재한 대규모 조선업종 근로자 1,419명을 대상으로 족부백선의 유병률을 조사하고 족부백선의 유병률에 미치는 요인을 조사하여 족부백선의 작업관련성을 알고자 본 연구를 실시하였다. 방법: 근로자 건강진단시 족부백선의 유뮤를 확인하고, 현재 족부백선의 위험인자로 알려져 있는 여러 요인들과 작업, 환경적인 요인들에 대하여 설문조사를 실시하고, 족부백선의 임상적인 양상을 관찰하였다. 결과: 조사결과 족부백선의 유병률은 54.8%로 높게 나타났으며, 직종과 공동목욕탕 이용 유무, 안전화 착용유무, 작업형태, 가족력 유무가 족부백선이 유병률에 영향을 미치는 위험인자로 나타났으나, 다변량 분석결과 가족력과 공동목욕탕 이용만이 통계적으로 유의한 위험인자로 나타났으며(P<0.05), 안전화 착용은 통계적으로 유의하지 않았다. 결론: 이상의 결과에서 사업장내 근로자들의 족부백선의 높은 유병률과 관련된 직접적인 요인은 사업장내의 공동 목욕탕의 이용 여부와 족부백선의 가족력임을 확인할 수 있었으며, 많은 근로자들이 원인으로 지목한 안전화의 착용은 통계적인 유의성은 없었다. 따라서 족부백선이 작업과 직접적으로 관련되었다는 근거는 적은 것으로 보인다. 하지만 일반인보다 높은 유병률을 보이는 것으로 확인된 사업장내 족부백선의 유병률을 감소시키기 위해서는 위험인자로 최종 확인된 작업장 내의 공동 목욕탕의 철저한 위생관리와 함께 가족간의 감염을 예방히기 위한 개인위생관리가 필요하면, 비록 통계적인 유의성은 없었으나 여러 근로자들이 원인으로 지목한 안전화의 개선에도 노력해야 할 것으로 생각한다. Objectives: Recently, tinea pedis has been reprted to be a type of occupational dermatoses because of its high prevalence in specific working conditions. Although there is no doubt that the environment surrounding work places, the usual habits of workers erc ate intimately related to this skin conditions, there is some controversu as to whether or not this condition is a real occupational illness and what is the exact cause of the high prevalence of this illness is. In this study, the prevalence of tinea pedis in workers from the shipbuilding industry was investigated andthe risk factors of this disease were evaluated. This study also aimed to verify whether or not tinea pedis is one of the occupational diseases. Methods: The result of interviews, questionnaires and clinical findings from 1,419 workers who visited the occupational health center for an annual routine check for their health state were analyzed. Results: Among the 1,419 workers, 778 workers (54.8%)had tinea pedis. By simple logistic regression analysis, the prevalence of tinea pedis was found to e affected by some variables, including the jov category, the types of work, the kinds of footwear, whether or not they were using communal baths in the work places, and a family history of tinea pedis. In contrast, by multiple logistic regression analysis, only utilization of the communal baths in the work places and a family history of tinea pedis turned out to be statistically significant risk facrors. Conclusions: In this study, the major factors contributing to the high prevalence of tinea pedis are the use of communal baths in the workplace and a positive family history. However, the wearing of safety shoes was not statistically significant. Therefore, tinea pedis could not be confirmed to be an occupational disease. On the basis of these results, a solution to the environmental hygiene of communal bats and the personal hugiene of individuals needs to be improved in order to prevent tinea pedis.

족부백선의 임상상과 진균학적 연관성

이수경 ( Soo Keoung Lee ),최종수 ( Jong Soo Choi ),김기홍 ( Ki Hong Kim ) 대한피부과학회 1995 大韓皮膚科學會誌 Vol.33 No.6

Backgrdund : In tinea pedis, the response of treatment and prognosis are different according to clinical types. Positivity in KOH mount and causative agent in culture are also different. Objective : Our purpose was to evaluate the clinical characteristics and mycologic findings of tinea pedis according to the clinical type. Methods : A clinical and mycological study was conducted with 97 cases of tinea pedis among out patients examined for 7 months from June 1994 to December 1994 at Yeungnam University Hospital and Catholic Skin Clizic, Taegu, Korea. Results : 1. Age distribution showed patients in their fourth decade to be most common. The ratio of male to female was 1.2: 1. The distribution of patients by clinical type was interdigital type, interdigital combined with hyperkeratotic type, interdigital combined with vesicular type, hyperkeratotic type, and hyperkeratotic combined with vesicular type, in descending order. One to five years was the most comrrion duration of tinea pedis. Duration of tinea pedis was the shortest in the vesicular type, otherwis was longer in hyperkeratotic type. Rate of family history of tinea pedis was 54.6%. The larger the size of family was, the higher the positivity in family history. The rate of coexistent dermatiophytosis with tinea pedis was 39.1%, and tinea unguium was the most common one. 2. The isolated dermatophytis were T. rubrum, 90.7%, T. mentagrophytes, 7.2%, and T. rubrum rnixed with T. mentagrophytes, 2.1%. T. rubrum showed an even distribution in all clinical types of tinea pedis whereas T. mentanophytes was isolated only in the interdigital type, vesicular type, and interdigital combined with vesicular type. T. rubrum mixed with T. mentagrophytes was isolated in the interdigital combine with vesicular type. Distribution of dermatophytes was relatively even arnong the age groups. T. rubrum showed a relatively even distribution in duration of tinea pedis, but T. mentagrophytes was isolated in tinea pedis with shorter duration. (Kor J Dermatol 1995;33(6): 102S-1037)

소아 족부 및 수부백선에 관한 고찰

서무규(Moo Kyu Suh),성열오(Yeol Oh Sung),오수희(Soo Hee Oh),김성화(Sung Hwa Kim),최성관(Sung Kwan Choi),서순봉(Soon Bong Suh) 대한피부과학회 1993 大韓皮膚科學會誌 Vol.31 No.5

Background : Because of concern about the infrequent occurre icc of tinea pedis & tinea manus, we studied the incidence of them. Objective : The purpose of the study was to investigate clinical and mycological features of tinea pedis & tinea manus. Methods . We reviewed outpatients with tinea pedis & tinea minus at the Catholic Skin Disease Clinic from 1976 to 1991. Results : The incidence was 0.08% out of 1,106,246 outpatients in tinea pedis, 0.02% in tinea manus. Interdigital lesions were the most common in tinea pedis. The ratio of male to female patients was 1.46: 1 in tinea pedis, 1.34:1 in tinea manus. The seasonaI pevalance was highest in summer. The species isolated were, in order of decreasing frequency, Trihohyton(T.) rubrum(89.9%), T. mentagrophytes(8.5%), Microgorum(M.) canis (1.6%) in tinea pedis, T. rubrum(77.8%), T. mentagrophytes(18.2%), M. Canis(2.0%), Epidermophyton(E.) floccosam(2.0% in tinea manus. Conclusion : We find that, the incidence of tinea pedis has been inc easing in recent years. (Kor J Dermatol 1993;31(5):713-720)

대구지역 대학생 가족에서 족부 백선의 유병율

김기홍,조해욱,신동훈,최종수,방용준,서순봉 ( Ki Hong Kim,Hae Ook Cho,Dong Hoon Shin,Jong Soo Choi,Young Jun Bang,Soon Bong Suh ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.1

Background: Tinea pedis is one of the most comrnon dermatoses in the general population. But its prevalence in the general populat,ion was not yet reported in Korea. Objective : Prevalence of tinea pedis and associated tinea unguium were checked in the general population. Methods : Six hundred fifty eight persons from 179 families of the college students were evaluated. Clinical examinatior. for tinea pedis and onychomycosis and collecting scales from the suspicious lesions of the family members were perforrned by educated college students. Then dermatologists exarnined those specimens mycologically by KOH ~tnount and fungal culture. Results . The results were as follows 1. The prevalence of tinea pedis was 41.2% in the studied 658 persons. 2. Among all 271 patients with tinea pedis, 201 strains of dermatophytes were isolated. They were 143 strains of Trichophyton(T) rubrum, 49 strains of T. mentagrophytes and 9 mixed infections of T. rubrum and T. mentagrophytes. In the co existence of i,inea pedis and tinea unguiurn, isolated species were corresponding. 3. Among 179 families, 143 families (79.9%) had at least one patient with tinea pedis. The isolated species of derrnatophytes in a farnily were one organism, 71.4% and two or more organisms, 28.6% of 77 familiys with more than one patient. Conclusion : In our study, the prevalence rate of tinea pedis was 41.2%. That suggests that tinea pedis is a wide spr .ad disease in healthy adult in Korea. (Kor J Dermatol 1997;35(1): 114-120)

족부백선 환자의 신체 각 부위와 의복에서의 백선균 오염정도

박진우,최종수,김기홍 대한의진균학회 2001 대한의진균학회지 Vol.6 No.1

Background: Dermatophytes are spreading through the scales shed from the skin lesions. Because other coexistent dermatophytoses such as tinea unguium of the toe nails and tines cruris are common in the patients with tinea pedis, the skin lesion of tinea penis might act as a reservoir of other dermatophytoses. Objective: The aim of this study is to verify the route of the infection through the identification of dermatophytes in the common sites of coexistent dermatophytoses and clothes. Methods: Mycological study was conducted in the finger, the hyponychium of the finger, the groin, the socks and the underpants which were predicted as common spreading sites of dermatophytes in 50 patients with tinea pedis. Results: Dermatophytes were cultured from the feet of 37 patients (74.0%) among 50 patients with tinea penis. Thirty seven (74.0%) patients were contaminated at least 1 site of clothes and body other than feet. Average 1.48 sites were contaminated among 5 sites (finger, hyponychium of the finger, groin, socks, underpants) where fungal culture was conducted in patients with tinea penis. The isolation rate of dermatophytes in the finger after scratching the lesion was 48.0%, and that of the socks was 46.0%. The patients with coexistent dermatophytoses showed relatively wide distribution of the contaminated sites, but isolation rate of dermatophytes from the body sites and the clothes had no correlation with the involved area of the feet, the clinical types of tinea pedis and the number of coexistent infection sites. Conclusion: Several other sites of the body and the clothes were contaminated by dermatophytes in the patients with tinea penis, and could predict not only the scales shed from the lesion of tinea and the environment containing dermatophytes but also dermatophytes from the contaminated body and the clothes can

한약 성분 함유 기능성 비누 가이아 1400의 족부 백선 개선에 대한 임상 연구

정달림,홍승욱,Jung, Dal-Lim,Hong, Seung-Ug 대한한방안이비인후피부과학회 2009 한방안이비인후피부과학회지 Vol.22 No.1

Objectives : This clinical research was conducted to test Patients with Tinea Pedis by using functional soap Gaia 1400, containing medicinal herbs Methods : Total 24 patients who visited Oriental Medical Ophthalmology & Otolaryngology & Dermatology of Dongguk Ilsan Hospital from June 17th, 2008 to November 11th, 2008. They used functional soap daily during 8 weeks. We Observed change of erythema, scaling, vesicle, pustule, exudate, crust and pruritus after 4weeks and 8 weeks. Also Clinical evaluation I, II were used to evaluate the effects of Gaia 1400. Results : 1. There were no significant differences on sex, age and onset. 2. Statistically. After treatment(4,8weekes) Tinea Pedis symptoms score showed significant effect on Tinea Pedis. And the score of using Gala 1400 after 8 weeks is lower than 4 weeks. 3. After 8weeks of treatment, Gaia 1400 showed meaningful effect on Clinical global evaluation I, II. 4. Tinea Pedis Exacerbated in a case after using Gaia 1400 and in the 4 cases Skin dryness Incerased. Conclusion : Considering the above results, we can speculate that functional soap Gaia 1400, containing medicinal herb has some therapeutical effects in mitigating the symptoms of Tenia Pedis.

소아의 손,발톱 및 족부백선증에 관한 역학적 조사

방용준 ( Young Jun Bang ),김쌍용 ( Ssang Young Kim ) 대한임상검사과학회 2007 대한임상검사과학회지(KJCLS) Vol.39 No.2

The number of children patients with tinea pedis and onychomycosis diagnosed on clinical findings and culture at the Catholic Dermatological Clinic in Daegu City were 144,446 for 2 years from January 2005 to December 2006. 120 children were suspected of having clinical onychomycosis or tinea pedis. KOH smears and cultures on the Potato corn meal dextrose agars (PDCA) were done for the suspected toe webs, nails and uninvolved neighbor toe webs. Socks were dusted and cultured to check contamination of clothes. Family infections were checked by questionnaire. The incidence was 92 (0.06%) out of 144,446 outpatients in tinea pedis, 28 (0.02%) in onychomycosis. Trichophyton(T.) rubrums were isolated from all of the 7 cases of onychomycosis. T. mentagrophytes was isolated from 5 cases of the tinea pedis patients and T. rubrum was isolated from 50 (92.5%) cases of the tinea pedis. The right side was predominant for onychomycosis of both toe nails (23 of 25) and finger nails (3 of 3). No fungal elements were detected from normal looking neighbor toe webs by KOH examinations. However, culture on PDCA agars showed T. rubrum isolates from 3 toe webs. 7 showed positive cultures from the socks. From the questionnaire, 94 had family infections.

조갑 및 족부 백선에서 Trichosporon종의 역학 및 균학적 연구

김은성 ( Eun Sung Kim ),김덕희 ( Duck Hee Kim ),장성은 ( Sung Eun Chang ),이미우 ( Mi Woo Lee ),최지호 ( Jee Ho Choi ),성경제 ( Kyung Jeh Sung ),문기찬 ( Kee Chan Moon ),고재경 ( Jai Kyoung Koh ) 대한피부과학회 2003 대한피부과학회지 Vol.41 No.6

N/A 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 : 1. Out of total 1509 nail and skin samples examined, 663(43.9%) were culture positive. 2. 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%. 3. In species level, T. asahii(62.1%), T. mucoides(20.3%), and T. inkin(14.9%) were isolated in decreasing frequency. 4. The positive rate for KOH examination in trichosporon spp. was 52.9%. 5. 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. 6. 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. (Korean J Dermatol 2003;41(6) : 702~707)

원발성 다한증 환자에서 피부수분함유량, 경표피수분손실량 수치 및 족부 백선과의 관계

손인평,김범준,석장미,박귀영,이갑석,서성준,김명남,홍창권 대한의진균학회 2011 대한의진균학회지 Vol.16 No.4

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.