당뇨족 궤양에서 진균감염의 유병률

Prevalence of Fungal Infection in Diabetic Foot Ulcer

  • 유연식 (고려대학교 의과대학 성형외과학교실) ;
  • 한승규 (고려대학교 의과대학 성형외과학교실) ;
  • 김우경 (고려대학교 의과대학 성형외과학교실)
  • Yoo, Yeon Sik (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Han, Seung-Kyu (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Kim, Woo Kyung (Department of Plastic Surgery, Korea University College of Medicine)
  • 투고 : 2008.01.24
  • 발행 : 2008.03.10

초록

Purpose: In a diabetic foot ulcer, superficial fungal infection of the foot may disrupt the skin integrity and provide an avenue for bacterial infection. The prevalence of fungal infection in diabetic foot ulcer has been reported as 12-30% in Caucasian patients. However, no data are available for Korean patients. The purpose of the study was to examine the prevalence of fungal infection in diabetic foot patients admitted in our clinic. Methods: This study included consecutive 30 diabetic foot ulcer patients(24 males and 6 females) admitted from May 2007 to July 2007. The mean age was 60.5 years. All patients underwent mycological examination including direct microscopic examination in KOH and culturing on slants and tubes with Sabouraud's glucose agar. Results: Clinical signs of presumed fungal infection, which were examined by dermatologists, were found in all patients included in this study. Direct microscopic examination was positive for the specimens of the skin and the toenails in 28(93.3%) and 25(83.3%) patients, respectively. In addition, culture result was positive for the specimens of the skin and the toenails in 5(16.73%) and 7(23.3%) patients, respectively. Conclusion: The prevalence of fungal infection in diabetic foot ulcer patients admitted in our clinic is much higher than that in Caucasian patients(83.3-93.3% vs 12-30%).

키워드

참고문헌

  1. Lavery LA, Armstrong DG, Wunderlich RP, Tredwell J, Boulton AJ: Diabetic foot syndrome: evaluating the prevalence and incidence of foot pathology in Mexican Americans and non-Hispanic whites from a diabetes disease management cohort. Diabetes Care 26: 1435, 2003 https://doi.org/10.2337/diacare.26.5.1435
  2. Buxton PK, Milne LJ, Prescott RJ, Proudfoot MC, Stuart FM: The prevalence of dermatophyte infection in well-controlled diabetics and the response to Trichophyton antigen. Br J Dermatol 134: 900, 1996 https://doi.org/10.1111/j.1365-2133.1996.tb06322.x
  3. Gupta AK, Konnikov N, MacDonald P, Rich P, Rodger NW, Edmonds MW, McManus R, Summerbell RC: Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey. Br J Dermatol 139: 665, 1998 https://doi.org/10.1046/j.1365-2133.1998.02464.x
  4. Lugo-Somolinos A, Sánchez JL: Prevalence of dermatophytosis in patients with diabetes. J Am Acad Dermatol 26: 408, 1992 https://doi.org/10.1016/0190-9622(92)70063-L
  5. Boyko EJ, Ahroni JH, Cohen V, Nelson KM, Heagerty PJ: Prediction of diabetic foot ulcer occurrence using commonly available clinical information: the Seattle Diabetic Foot Study. Diabetes Care 29: 1202, 2006 https://doi.org/10.2337/dc05-2031
  6. Alteras I, Saryt E: Prevalence of pathogenic fungi in toe webs and toe nails of diabetic patients. Mycopathologia 67: 157, 1979 https://doi.org/10.1007/BF00470749
  7. Eckhard M, Lengler A, Liersch J, Bretzel RG, Mayser P: Fungal foot infections in patients with diabetes mellitus-results of two independent investigations. Mycoses 50: 14, 2007 https://doi.org/10.1111/j.1439-0507.2007.01425.x
  8. Clayton YM: Clinical and mycological diagnostic aspects of onychomycoses and dermatomycoses. Clin Exp Dermatol 17: 37, 1992 https://doi.org/10.1111/j.1365-2230.1992.tb00276.x
  9. Ecemis T, Deqerli K, Aktas E, Teker A, Ozbakkaloqlu B: The necessity of culture for the diagnosis of tinea pedis. Am J Med Sci 331: 88, 2006 https://doi.org/10.1097/00000441-200602000-00015
  10. Rich P: Onychomycosis and tinea pedis in patients with diabetes. J Am Acad Dermatol 43: 130, 2000 https://doi.org/10.1067/mjd.2000.110376