title: Superficial fungal infections: clinical and epidemiological study in adolescents from marginal districts of Lima and Callao, Peru.
abstract: BACKGROUND
  Since limited data on superficial fungal infections in teenagers exist in our setting, this study provides the first description of the clinical and epidemiological characteristics of these infections among teenagers in Lima and Callao, Peru.
  
  
  METHODS
  The study involved 1,387 adolescents in five public schools from June to November 2006. Participants were examined for superficial fungal lesions. Samples of skin scrapings for microbiological investigations were obtained from suspicious lesions.
  
  
  RESULTS
  A total of 257 subjects were identified with suspected superficial fungal infections. Microbiological assessment was positive for 166 of 257 (64.59%). The average prevalence was 12.61% with variation between different districts. Males were more affected (64%) than females (36%) (p = 0.001). Pet ownership, use of public baths, and wearing sneakers were identified as important risk factors. The majority (61.5%) of the subjects presented with itching although 38.5% were asymptomatic. Tinea pedis was observed in 62.6%, onychomycosis in 24% and pityriasis versicolor in 10.8%. Dermatophytes were isolated in 105 cases with T. rubrum being identified in 86 cases (59.7%), T. mentagrophytes in 14 (9.7%) and yeast in 39 (23.4%). Malassezia spp. was found by direct examination in 18 cases (12.5%), C. kruseii in 8 cases (5.6%), and C. albicans in 2 cases (1.4%). Mixed infections were found in 22 cases.
  
  
  CONCLUSIONS
  Superficial fungal infection manifesting as tinea pedis, onychomycosysis and tinea versicolor is prevalent in our setting. As many infections remain asymptomatic, regular examination of this population is advocated. The associated risk factors for these infections also need to be addressed.
authors.affiliation: Children's Health National Institute, Department of Pediatrics, Lima, Peru. jpmfha@yahoo.com
authors.forename: Juan Medina
authors.initials: JM
authors.lastname: Flores
authors.forename: Vilma Bejar
authors.initials: VB
authors.lastname: Castillo
authors.forename: Florencio Cortez
authors.initials: FC
authors.lastname: Franco
authors.forename: Armando Betanzos
authors.initials: AB
authors.lastname: Huata
mesh_terms: D000293:Adolescent; D003883:Arthrodermataceae / Q000145:classification / Q000302:isolation & purification; D002648:Child; D003881:Dermatomycoses / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D014009:Onychomycosis / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D010915:Pityriasis / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D014008:Tinea Pedis / Q000453:epidemiology