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How often are dermatophytes present in apparently normal versus scaly feet of children?
G Becerril-Chihu1, E Bazán-Mora, R López-Martínez
1Department of Pediatric Dermatology, National Institute of Pediatrics, Mexico City, Mexico.
Insights
Not all foot scaling in children indicates a fungal infection. Pathogenic dermatophytes can be present on both scaly and seemingly healthy feet in pediatric populations.
Area of Science:
- Mycology
- Pediatric Dermatology
- Infectious Diseases
Background:
- Investigated the prevalence of pathogenic dermatophytes in children with and without foot scaling.
- Compared fungal presence in symptomatic pediatric patients (scaling, erythema, pruritus) versus healthy controls.
- Utilized direct microscopy (KOH) and mycologic culture (Mycosel) for accurate diagnosis.
Discussion:
- Foot scaling in children, whether pruritic or not, is not always caused by dermatophytes.
- Pathogenic dermatophytes were detected in both groups, suggesting potential asymptomatic carriage.
- Man-made shoe materials were more common in patients, indicating a possible environmental factor.
Key Insights:
- Pathogenic dermatophytes were found in 21 patients with scaling and 7 controls with healthy feet.
- The study highlights that dermatophyte infections can occur even in the absence of visible scaling.
- Findings challenge the assumption that foot scaling in children exclusively points to dermatophyte infection.
Outlook:
- Further research into environmental factors and footwear contributing to pediatric dermatophytosis.
- Development of diagnostic strategies that account for asymptomatic dermatophyte carriage in children.
- Improved public health awareness regarding non-dermatophyte causes of pediatric foot scaling.
Abstract:
The purpose of this investigation was to find out how often pathogenic dermatophytes are found in apparently normal versus scaly feet of children. In this prospective protocol, we studied 100 patients, 2 to 12 years of age, consulting for plantar and/or interdigital scaling with or without erythema, maceration, and pruritus, and 100 controls with apparently healthy feet. Direct microscopic examination (KOH) and mycologic culture (Mycosel) of skin scrapings were performed from the lesions of patients and from the soles and interdigital folds of controls. Mean age of patients and controls was 7 years 7 months (SD = 3 years 2 months). Scaling was present in 100% of patients with a mean time of evolution of 8.9 months (SD = 16.3 months). Shoes fashioned from man-made material were significantly more frequently used by patients than by controls (chi 2(df = 1) = 9.4; p = 0.002). Pathogenic dermatophytes were present in the soles and/or interdigital webs of 21 patients and 7 controls. Not all foot scaling in children, pruritic or not, is associated with dermatophytes. Dermatophytes may be present on the apparently healthy feet of children.