title: [Prevalence and clinical aspects of superficial mycosis in hospitalized diabetic patients in Tunisia].
abstract: OBJECTIVE
  The prevalence of mycotic infection seems to be higher among diabetic patients than in the non-diabetic population. The aims of this study were to determine the frequency of mycosis and to compare clinical and fungal results.
  
  
  METHODS
  This transversal study included 307 type 1 and 2 diabetic patients admitted between January 1998 and January 2000. A dermatologist examined all patients. The mean age was 44 +/- 17 years and the duration of diabetes 8 +/- 6 years. Patients with suspected lesions underwent mycological examination.
  
  
  RESULTS
  Clinical signs of presumed fungal infection were found in 61% of patients, but mycosis was confirmed only in 30%. Fungal foot infection accounted 38% of the patients, mostly due to dermatophytes (94%). The commonest localizations of dermatophytes were interdigital (60%) followed by onychomycosis (30%). The main fungal agent was Trichophyton rubrum. The main risk factors for fungal infections were the age of patients (P = 0.0003) and duration of diabetes (P < 0.05). Interdigital foot localization of dermatophytes was correlated to age (P < 0.0001) and to the male gender (P < 0.01). The frequency of dermatophytes in nails was higher in type 2 diabetic patients (P < 0.01). Vulvovaginal candidosis and interdigital dermatophytes were more frequent in obese than in non-obese patients. The accuracy and specificity of direct examination were respectively 85% and 79%.
  
  
  CONCLUSIONS
  The high frequency of mycosis in diabetic patients at hospital is demonstrated. The main risk factors were age, male gender and obesity.
authors.affiliation: Service d'endocrinologie-diabétologie, institut national de nutrition, Bab-Saadoun, Tunisie.
authors.forename: R
authors.initials: R
authors.lastname: Bouguerra
authors.forename: O
authors.initials: O
authors.lastname: Essaïs
authors.forename: N
authors.initials: N
authors.lastname: Sebaï
authors.forename: L
authors.initials: L
authors.lastname: Ben Salem
authors.forename: H
authors.initials: H
authors.lastname: Amari
authors.forename: M R
authors.initials: MR
authors.lastname: Kammoun
authors.forename: E
authors.initials: E
authors.lastname: Chaker
authors.forename: B
authors.initials: B
authors.lastname: Zidi
authors.forename: C
authors.initials: C
authors.lastname: Ben Slama
mesh_terms: D000328:Adult; D000367:Age Factors; D002179:Candidiasis, Cutaneous / Q000453:epidemiology / Q000209:etiology; D002180:Candidiasis, Oral / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D003881:Dermatomycoses / Q000453:epidemiology* / Q000209:etiology; D048909:Diabetes Complications / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004198:Disease Susceptibility; D005260:Female; D005533:Foot Dermatoses / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D014009:Onychomycosis / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D014005:Tinea / Q000453:epidemiology / Q000209:etiology; D014010:Tinea Versicolor / Q000453:epidemiology / Q000209:etiology; D014416:Tunisia / Q000453:epidemiology