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Prevalence and Clinical Correlation of Superficial Fungal Foot Infection in Thai Naval Rating Cadets.

Abstract：

BACKGROUND:Superficial fungal foot infection is one of the most important dermatological diseases currently affecting military personnel. Many Thai naval rating cadets are found to suffer from superficial fungal foot infections and their sequels. OBJECTIVE:To investigate prevalence, potent risk factors, responding pathogens and clinical correlation of superficial fungal foot infection in Thai naval rating cadets training in Naval rating school, Sattahip, Thailand. MATERIALS AND METHODS:This cross-sectional study was performed in August 2015. Validated structured questionnaire was used regarding information about behaviors and clinical symptoms. Quality of life was assessed by Dermatology Quality of Life Index (DLQI) questionnaire and clinical presentation demonstrated by Athlete's foot severity score (AFSS). Laboratory investigations including direct microscopic examination and fungal culture were performed and recorded. All of the participants were informed and asked for their consent. RESULTS:A total of 788 Thai naval rating cadets with a mean age of 19 yr were enrolled. There were 406 (51.5%) participants suspected of fungal skin infection from questionnaire screening. After clinical examination, 303 participants (38.5%) were found to have foot lesions (AFSS ≥1). Superficial fungal foot infection was diagnosed with microscopic examination and fungal culture in 57 participants, giving a point prevalence of 7.2%. Tinea pedis was diagnosed in 54 participants with the leading causative organism being Trichophyton mentagrophytes (52.8%). Other 3 participants were diagnosed as cutaneous candidiasis. Wearing combat shoes more than 8 h was found to be a predisposing factor (p = 0.029), taking a shower less than two times a day (p = 0.008), and wearing sandals during shower (p = 0.055) was found to be protective against infection. Most fungal feet infection cases noticed their feet abnormalities (p < 0.001) including scales (p < 0.001), vesicles (p = 0.003) and maceration at interdigital web spaces (p < 0.001). Mean DLQI in superficial fungal foot infection cases was 3.35. Participants who had foot lesions (AFSS ≥1) were concerned of their foots unpleasant odor demonstrated significantly higher mean DLQI than those without odor (4.2 vs. 2.28; p < 0.001). CONCLUSION:Superficial fungal foot infection is found as 7.2% of naval rating cadets. Wearing combat shoes more than 8 h was found to be a predisposing factor. In addition to skin manifestations including scales, vesicles, and maceration, superficial fungal foot infection also exhibited an unpleasant foot odor which affected quality of life. Self-foot-examination and life style modification should be promoted to prevent fungal infection.

journal_name

Mil Med

journal_title

Military medicine

authors

Ongsri P,Bunyaratavej S,Leeyaphan C,Pattanaprichakul P,Ongmahutmongkol P,Komoltri C,Kulthanan K

doi

10.1093/milmed/usx187

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

e633-e637

issue

9-10

eissn

0026-4075

issn

1930-613X

pii

4852798

journal_volume

183

pub_type

杂志文章

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Prevalence and Clinical Correlation of Superficial Fungal Foot Infection in Thai Naval Rating Cadets.