title: [Dermatophytosis with concurrent lesions in distant locations. Prognostic and therapeutic significance].
abstract: BACKGROUND
  Recurrence and a lack of treatment response are common in dermatophytosis. In patients with cutaneous and concurrent toenail lesions, often only the former are investigated, which may result in inappropriate treatment due to misdiagnosis.
  
  
  METHODS
  Between January 2000 and April 2004, we prospectively studied the presence of dermatophytic fungi in lesions other than those prompting the consultation to further investigate the diagnosis.
  
  
  RESULTS
  We prospectively identified 61 patients with dermatophytosis and concurrent lesions caused by the same fungus at sites distant from the primary lesion. Concurrent lesions occurred in 15.9% of culture-confirmed dermatophyte infections. Thirty-six patients (59%) consulted for skin lesions located at sites other than that of the primary lesion in the foot. The most frequently identified species was Trichophyton rubrum (50/61, 82%).
  
  
  CONCLUSIONS
  Localization of all the lesions, as well as isolation and identification of the causative fungus, are essential to establish the prognosis and choose the most appropriate antifungal agent, route of administration, and duration of treatment in dermatophytosis.
authors.affiliation: Servicio de Microbiología, Hospital Donostia, San Sebastián, Guipúzcoa, España.
authors.forename: Julián
authors.initials: J
authors.lastname: Larruskain
authors.forename: Luis
authors.initials: L
authors.lastname: Piñeiro
authors.forename: Pedro
authors.initials: P
authors.lastname: Idigoras
authors.forename: Emilio
authors.initials: E
authors.lastname: Pérez-Trallero
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004821:Epidermophyton / Q000302:isolation & purification; D005148:Facial Dermatoses / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014009:Onychomycosis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D009928:Organ Specificity; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D014005:Tinea / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D014006:Tinea Capitis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D014008:Tinea Pedis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D014249:Trichophyton / Q000302:isolation & purification
chemical_list: D000935:Antifungal Agents