title: The prevalence of skin eruptions and mycoses of the buttocks and feet in aged care facility residents: a cross-sectional study.
abstract: The prevalence of skin mycoses in the elderly remains unclear. The proportion of people with skin eruptions who are positive for mycoses using direct microscopy is not known. The purpose of this study is to identify the prevalence of skin eruptions and skin mycoses (e.g. candidiasis and tinea) in the buttocks and feet, which are common sites of skin mycoses in residents of long-term care facilities. This multi-site cross-sectional study used visual inspection and direct microscopy to diagnose the type of skin eruption. Subjects were residents of facilities covered by long-term care insurance schemes in Japan. Of the 171 residents enrolled in this study, 72.5% had a skin eruption. Only 4.8% of participants had tinea in the buttocks; 2.4% had buttock candidiasis. In those with a nail abnormality, 58.3% of residents had tinea unguium. For tinea pedis, residents who had any form of interdigital or plantar region skin eruption, 22.5% and 31.4% of residents were positive, respectively. The prevalence of observed skin mycoses was: buttock candidiasis 1.8%; buttock tinea 3.5%; tinea unguium 56.2%; interdigital tinea pedis 20.5%; and plantar tinea pedis 22.5%. The very low proportion of residents with mycoses in the buttocks suggests that anti-inflammatory agents, such as steroids, should be used as first choice. Our observation that not all residents with skin eruptions on the feet had tinea, should remind clinicians to perform direct microscopy before initiating antifungal treatments.
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
authors.forename: Gojiro
authors.initials: G
authors.lastname: Nakagami
authors.affiliation: Department of Advanced Clinical Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
authors.forename: Kimie
authors.initials: K
authors.lastname: Takehara
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kanazawa
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Japan Society for the Promotion of Science, 5-3-1, Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Miura
authors.affiliation: Abe Clinic, 2-1-7, Sakuradai, Nerima-ku, Tokyo 176-0002, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Dermatology, Tokyo Women's Medical University, 8-1, Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawashima
authors.affiliation: Department of Dermatology, Tokyo Women's Medical University, 8-1, Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Tsunemi
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. Electronic address: hsanada-tky@umin.ac.jp.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sanada
mesh_terms: D000368:Aged; D002081:Buttocks; D003430:Cross-Sectional Studies; D005260:Female; D005533:Foot Dermatoses / Q000453:epidemiology*; D006801:Humans; D007353:Insurance, Long-Term Care; D007564:Japan / Q000453:epidemiology; D008134:Long-Term Care; D008297:Male; D009181:Mycoses / Q000453:epidemiology / Q000382:microbiology; D014009:Onychomycosis / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D011795:Surveys and Questionnaires; D014008:Tinea Pedis / Q000453:epidemiology* / Q000382:microbiology
keywords: Elderly; Long-term care facility; Mycoses; Prevalence; Tinea pedis; Tinea unguium