Newer Studies on the Epidemiology of Fungous Infections of the Feet

Abstract

Experimental evidence was presented that pathogenic fungi are readily shed from the feet of many individuals with and without clinically active fungus disease of the feet. Persons clinically free from fungus disease of the feet frequently harbor the fungi, even though not demonstrable in repeated clinical and mycologic examinations. Attempts to induce acute attacks[long dash]or at least some evidence of clinical fungus disease of the feet in 45 subjects, mycologically free from disease, by deliberate exposure to masses of pathogenic fungi in foot baths were entirely unsuccessful. No fungus disease occurred within 6 weeks after exposure, although during this period fungi were found 1 or more times on the feet of 60% of the exposed subjects. Ready transmission of fungi from exposed feet to unexposed "control" feet was demonstrated. These studies add convincing support to existing clinical data that exogenous exposure to fungi in swimming pools, shower stalls bathrooms, etc., plays a minor or negligible role in eliciting acute attacks of fungus infections of the feet. As previously stressed by certain dermatologists it is the decreased resistance of the human skin with resultant activation of pathogenic fungi, previously lying dormant as opportunists on the patients'' own feet, which is usually responsible for such attacks. Certain hitherto commonly used, but ineffective and potentially harmful measures for the prevention of fungus infection of the feet which should be discarded are discussed. Similarly, suggestions are resubmitted for a few simple procedures designed to maintain and increase resistance of the feet and thus to prevent acute attacks of tinea pedis.