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[Etiology of pathogen-induced changes between the toes in patients working under moist conditions]
K Gründer1, A Kroker, M Heppner
1Zentrum für Dermatologie, Andrologie und Venerologie, Abt. klin. u. exp. Dermatologie, Justus-Liebig-Universität Giessen.
Abstract:
Referring to recent studies, we discuss the epidemiology of tinea pedis and its position within the range of polyetiological foot infections caused by microbial agents. 201 industrial workers used to wear rubber boots because of moist working conditions were examined with regard to their feet. 107 of them showed clinically altered toe web; in 45 cases, we found ringworm infection (22.4%), in correlation to increased daily wearing time of rubber boots. 85 workers showed colonization of pathogenic bacteria (42.4%), especially gram-negative species (25.8%). Frequently, mixed infections were found. The clinical picture not always allows definite conclusions as to the causal agents. The symptom "maceration" is seen in each of the 3 pathogenic groups of germs (fungi, gram-positive pathogenic cocci, gram-negative bacteria), frequently in bacterial foot infections, especially gram-negative infections. Marked clinical symptoms involve increased infection rates. The predisposing factors to foot infection such as interdigital maceration and the promoting role of rubber boots have been confirmed. The final diagnosis is to be reassured by cultural investigations, in order to set up a specific treatment.
Insights
This study found that industrial workers wearing rubber boots in moist conditions have a high prevalence of tinea pedis and bacterial foot infections. Increased rubber boot use correlated with higher infection rates, confirming predisposing factors.
Area of Science:
- Dermatology
- Microbiology
- Occupational Health
Context:
- Foot infections are common in industrial settings, particularly among workers exposed to moist conditions and prolonged rubber boot usage.
- Tinea pedis (athlete's foot) and bacterial infections are significant contributors to polyetiological foot conditions.
Purpose:
- To investigate the epidemiology of tinea pedis and bacterial foot infections in industrial workers.
- To determine the correlation between rubber boot usage, interdigital maceration, and the prevalence of specific microbial agents causing foot infections.
Summary:
- A study of 201 industrial workers revealed a high incidence of clinically altered toe webs (53.2%).
- Ringworm infection (tinea pedis) was diagnosed in 22.4% of cases, with a correlation to increased daily rubber boot wear.
- Bacterial colonization, particularly by gram-negative species, was found in 42.4% of workers. Mixed infections were frequent, and maceration was observed across fungal and bacterial infections.
- Clinical presentation alone was insufficient for definitive diagnosis, highlighting the need for cultural investigations.
Impact:
- Confirms the role of interdigital maceration and rubber boots as predisposing factors for foot infections in occupational settings.
- Emphasizes the need for accurate etiological diagnosis through cultural investigations for effective treatment of diverse foot infections.
- Provides insights into the prevalence and causative agents of foot infections in a specific occupational group, informing preventive strategies.