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Occult tinea pedis in an Israeli population and predisposing factors for the acquisition of the disease

Authors

  • Nicole Sakka MD,

    Corresponding author
    1. Department of Dermatology and Dermatomycology, Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Hashomer, Israel
    • Correspondence

      Nicole Sakka, md

      Department of Dermatology

      Chaim Sheba Medical Center

      Tel Hashomer 52621

      Israel

      E-mail: nicsakka@hotmail.com

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    • These authors contributed equally to this work.

  • Avner Shemer MD,

    1. Department of Dermatology and Dermatomycology, Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Hashomer, Israel
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    • These authors contributed equally to this work.

  • Aviv Barzilai MD,

    1. Department of Dermatology and Dermatomycology, Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Hashomer, Israel
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  • Renata Farhi MD,

    1. Faculdade Técnico Educacional Souza Marques (Souza Marques Technical Education Foundation), Santa Casa da Misericordia, Rio de Janeiro, Brazil
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  • Ralph Daniel MD

    1. Department of Dermatology, Faculty of Medicine, University of Mississippi, Jackson, MS, USA
    2. Department of Dermatology, Faculty of Medicine, University of Alabama, Birmingham, AL, USA
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  • Funding sources: None.

  • Conflicts of interest: None.

Abstract

Background

Tinea pedis is a commonly encountered dermatophytic infection with a clinical prevalence of 15–25%. Limited studies have evaluated the prevalence of occult tinea pedis.

Objectives

The aims of this study were to evaluate the prevalence of occult tinea pedis in asymptomatic subjects with feet that appeared healthy and to identify possible related risk factors.

Methods

A prospective study of 221 asymptomatic subjects with apparently normal feet was conducted. All subjects completed a questionnaire covering anamnestic details (personal and family histories of tinea pedis, preferred footwear) and were examined for foot odor and the clinical presence of tinea pedis and onychomycosis. Samples were taken from the foot for direct microscopic examination and culture.

Results

Among the 221 patients, 31 (14.0%) were positive for occult tinea pedis. Positive cultures from both the anterior and posterior aspects of the foot were obtained in 22 patients. The most common pathogen isolated was Trichophyton rubrum. Strong correlations emerged between occult tinea pedis and characteristics such as male gender, foot odor, previous personal and family histories of tinea pedis, and clinical and mycological evidence of onychomycosis. No significant associations were found between occult tinea pedis and age or preferred footwear.

Conclusions

The prevalence of occult tinea pedis is similar to that of clinical tinea pedis. This may imply that patients with subclinical infection carry a risk for transmitting disease similar to that of clinical carriers. This is of great importance in the prevention and management of the disease as high-risk asymptomatic carriers can be identified.

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