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      Chronic Dermatomycoses of the Foot as Risk Factors for Acute Bacterial Cellulitis of the Leg: A Case-Control Study

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          Abstract

          Objective: To assess the role of foot dermatomycosis (tinea pedis and onychomycosis) and other candidate risk factors in the development of acute bacterial cellulitis of the leg. Methods: A case-control study, including 243 patients (cases) with acute bacterial cellulitis of the leg and 467 controls, 2 per case, individually matched for gender, age (±5 years), hospital and admission date (±2 months). Results: Overall, mycology-proven foot dermatomycosis was a significant risk factor for acute bacterial cellulitis (odds ratio, OR: 2.4; p < 0.001), as were tinea pedis interdigitalis (OR: 3.2; p < 0.001), tinea pedis plantaris (OR: 1.7; p = 0.005) and onychomycosis (OR: 2.2; p < 0.001) individually. Other risk factors included: disruption of the cutaneous barrier, history of bacterial cellulitis, chronic venous insufficiency and leg oedema. Conclusions: Tinea pedis and onychomycosis were found to be significant risk factors for acute bacterial cellulitis of the leg that are readily amenable to treatment with effective pharmacological therapy.

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          Prevalence of dermatophyte onychomycosis in the United Kingdom: results of an omnibus survey.

          Lynne Roberts (1992)
          A computer omnibus survey to determine the prevalence of onychomycosis in the United Kingdom was carried out in the early part of 1990. A total population of 9332 adults, aged 16 years and over, was interviewed face-to-face, and a questionnaire completed, which consisted of questions and photographs of various nail dystrophies, including onychomycosis. The results in the population surveyed revealed a prevalence of dermatophyte nail infection of 2.8% in men and 2.6% in women. In the group aged 16-34 years, the prevalence rate was 1.3%; this increased to 2.4% in the group aged 35-50 years, and to 4.7% in those aged 55 years or over. Of those found to have onychomycosis, 27% had sought advice from a chiropodist and less than 12% had consulted a specialist. These results suggest that nearly 1.2 million people in the UK have a fungal nail infection and the majority had not sought medical advice, although over 80% stated that they would do so if they were aware that their nail disorder was of fungal origin. A similar proportion would wish to be treated if an effective treatment was available.
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            Interdigital athlete's foot. The interaction of dermatophytes and resident bacteria.

            J Leyden, A M Kligman (1978)
            Quantitative cultures in 140 cases of interdigital "athlete's foot" established the following clinical-microbiological correlations. In 39 cases of mild, scaling, relatively asymptomatic variety, fungi were recovered in 84% of cases. As the disease progressed to maceration, hyperkeratosis, and increased symptoms, recovery of fungi fell to 55% in moderately symptomatic and to 36% in severe cases. Symptomatic cases had increasing numbers of resident aerobic organisms, particularly large colony diphtheroids. Experimental manipulations of the interspace microflora in volunteers, monitored with quantitative cultures, demonstrated that symptomatic, macerated, hyperkeratotic process results from an overgrowth of resident organisms if the stratum corneum barrier is damaged by preexisting fungi, while overgrowth of the same organisms in normal, fungus-free interspaces does not produce lesions. These experiments support the conclusion that athlete's foot represents a continuum from a relatively asymptomatic, scaling eruption produced by fungi to a symptomatic, macerated, hyperkeratotic variety that is caused by an overgrowth of bacteria.
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              Prevalence of dermatophyte onychomycosis in Spain: a cross-sectional study

              G Sais, A. JUGGLÁG, J. PEYRI … (2006)
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                Author and article information

                Journal
                Journal ID (publisher-id): DRM
                Journal ID (nlm-ta): Dermatology
                Journal ID (doi): 10.1159/issn.1018-8665
                Title: Dermatology
                Publisher: S. Karger AG
                ISSN (Print): 1018-8665
                ISSN (Electronic): 1421-9832
                Publication date Subscription-year: 2004
                Publication date (Print): November 2004
                Publication date (Electronic): 04 December 2004
                Volume: 209
                Issue: 4
                Pages: 301-307
                Affiliations
                aService de Dermatologie, Hôpital Henri-Mondor, Créteil, et bService de Dermatologie, Hôpital E.-Mueller, Mulhouse, France; cLandspitali University Hospital, Reykjavik, Iceland; dDermatological Clinic and Outpatients’ Clinic, University of Munich, Munich, Germany; eDepartment of Dermatology and Venereology, University Clinic, Graz, Austria; fClinical Research, Novartis Pharma AG, Basel, Switzerland
                Article
                Publisher ID: 80853 Other ID: Dermatology 2004;209:301–307
                DOI: 10.1159/000080853
                PubMed ID: 15539893
                SO-VID: a7e1aa95-dbd2-442f-9f0e-7d089650eaf8
                Copyright © © 2004 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 06 May 2004
                Date accepted : 05 August 2004
                Page count
                Figures: 3, Tables: 3, References: 13, Pages: 7
                Categories
                Subject: Clinical and Laboratory Investigations

                ScienceOpen disciplines: Oncology & Radiotherapy,Pathology,Surgery,Dermatology,Pharmacology & Pharmaceutical medicine
                Keywords: Onychomycosis,Bacterial cellulitis,Foot dermatomycosis,Risk factors,Tinea pedis
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy, Pathology, Surgery, Dermatology, Pharmacology & Pharmaceutical medicine
                Keywords: Onychomycosis, Bacterial cellulitis, Foot dermatomycosis, Risk factors, Tinea pedis

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