title: Dermatomycosis in lower limbs of diabetic patients followed by podiatry consultation.
abstract: BACKGROUND
  Diabetic patients are particularly susceptible to fungal infections due to modifications that occur in their immunological system. These modifications compromise natural defences, such as skin and nails, especially from lower limbs.
  
  
  OBJECTIVE
  Assessing the presence of dermatomycosis in lower limbs of Portuguese diabetic patients followed on Podiatry consultation. Determination of possible predisposing factors and the most frequent fungal species associated with the cases are included in the study.
  
  
  METHODS
  A six-month prospective study was carried out in 163 diabetic patients with signs and symptoms of dermatomycosis followed by Podiatry at the Portuguese Diabetes Association in Lisbon. Samples from the skin and/or nails of the lower limbs were collected and demographic and clinical data of those patients were recorded.
  
  
  RESULTS
  Trichophyton rubrum was the most frequently isolated dermatophyte (12.1%), followed by Trichophyton mentagrophytes (7.7%) and Trichophyton tonsurans (4.4%). Our study showed positive associations between type 2 diabetes and the presence of dermatomycosis in the studied population (p=0.013); this association was also shown between the occurrence of dermatomycosis and the localization of the body lesion (p=0.000). No other predisposing factor tested was positively associated with infection (p>0.05).
  
  
  CONCLUSIONS
  Data on superficial fungal infections in diabetic patients are scarce in Portugal. This study provides information on the characterization of dermatomycosis in lower limbs of diabetic patients.
authors.affiliation: URSZ - Infectious Diseases Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Parada
authors.forename: Cristina
authors.initials: C
authors.lastname: Veríssimo
authors.forename: João
authors.initials: J
authors.lastname: Brandão
authors.forename: Baltazar
authors.initials: B
authors.lastname: Nunes
authors.forename: José
authors.initials: J
authors.lastname: Boavida
authors.forename: Rui
authors.initials: R
authors.lastname: Duarte
authors.forename: Zulmira
authors.initials: Z
authors.lastname: Peerally
authors.forename: Rui
authors.initials: R
authors.lastname: Oliveira
authors.forename: Laura
authors.initials: L
authors.lastname: Rosado
authors.forename: Raquel
authors.initials: R
authors.lastname: Sabino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002179:Candidiasis, Cutaneous / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003881:Dermatomycoses / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D017719:Diabetic Foot / Q000453:epidemiology / Q000382:microbiology; D004198:Disease Susceptibility; D005260:Female; D005533:Foot Dermatoses / Q000453:epidemiology / Q000382:microbiology; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D007866:Leg / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D009790:Occupations; D014009:Onychomycosis / Q000453:epidemiology / Q000382:microbiology; D011032:Podiatry; D011174:Portugal / Q000453:epidemiology; D012017:Referral and Consultation; D014008:Tinea Pedis / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D014249:Trichophyton / Q000302:isolation & purification*; D055815:Young Adult