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The Prevalence of Mycotic Infections and the Immunologic Response in Patients with Housewives' Eczema
Author(s) -
Feuerman E.,
Alteras I.
Publication year - 1976
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/j.1439-0507.1976.tb01407.x
Subject(s) - epidermophyton floccosum , trichophyton rubrum , trichophyton , medicine , candida albicans , dermatology , dermatophyte , paronychia , microbiology and biotechnology , antifungal , biology
Summary Mycological investigations performed in 100 patients with housewives' eczema revealed the presence of a fungal infection in 77 %. Candida albicans was found to be the causative agent in 53 patients, who presented with either onychia and paronychia or erosio interdigitalis or both of the hands and feet. Dermatophytes were found to be the causative agent in the other 24 patients, who presented with tinea pedis and onychomycosis. Trichophyton rubrum was the main agent (17 cases), followed by T. mentagrophytes (5 cases) and Epidermophyton floccosum (2 cases). A positive candidin reaction was observed in 62 % of the cases most of whom had onychia and paronychia. The trichophytin skin test was positive in 41 %. In the 23 patients free of mycotic lesions, the trichophytin and candidin tests gave a positive response in 8 and 7 patients respectively. The implications and importance of these findings are briefly discussed. Zusammenfassung Bei 100 Patientinnen mit Hausfrauenekzem wurden Pilze mikroskopisch und kulturell in 77 % der Fälle nachgewiesen. Am häufigsten handelte es sich um eine durch Candida albicans hervorgerufene Onyhie oder Paronychie. Bei 32 % der Patientinnen fand sich eine Tinea pedis. Trichophyton rubrum war am häufigsten unter den Dermatophyten anzutreffen, gefolgt von T. mentagrophytes und dann Epidermophyton floccosum. In allen Fällen einer Onychie und Paronychie durch Candida albicans war der Candidin‐Test positiv. Bei den durch Dermatophyten verursachten Fällen einer Tinea pedis wurde ein stark positiver Trichophytin‐Test nur in 13 Fällen beobachtet. Die Reaktion auf die intrakutane Injektion von Pilzantigen scheint von Bedeutung zu sein: 62 % positive Candidin‐und 41 % positive Trichophytin‐Reaktionen. Es wird zur Diskussion gestellt, ob man eine Hyposensibilisierung mit Trichophytin und Candidin als Zusatz zur komplkierten Therapie des Hausfrauenekzems versuchen sollte. There have been a number of reports concerning the presence of chrome and nickel in household detergents and the possibility of their inducing an allergic contact dermatitis in housewives (3‐7, 9, 10). One of us, in a series of laboratory and clinical investigations (3, 4, 5), recently confirmed the role which chromates may play in this widely‐prevalent skin disorder and proved that the chromates contained in such detergents are by far the most important factor in causing contact dermatitis in housewives in Israel. As yet, there have been no reports on the relationship between this type of contact dermatitis and cutaneous niycotic infections, although several authors have pointed at the possible role played by fungal senzitization in some allergic dermatoses: nodular vasculitis (1, 8), dyshidrosis and eczema, neurodermatitis (2), and prurigo (8, 11, 12). Since superficial cutaneous fungal infections, mainly caused by dermatophytes and Candida albicans, are very common in Israel, it was though to be of interest to determine whether such long‐standing mycotic foci might be a factor in the senzitization of patients with housewives' eczema in whom contact dermatitis was found to be caused by chromates. The following is a preliminary report on that study.