Enterococcus faecalis and Staphylococcus
aureus were usually found to be associated with
Pseudomonas aeruginosa or other gram-negative
bacteria. Systemic antibiotic treatment based on the
antibiogram also appeared to be successful.
Ten patients had both tinea pedis and onychomycosis
of the toes. Two patients had tinea pedis
without toenail infection. Potassium hydroxide
preparations (KOH) and fungal cultures were performed
in the eight patients who did not have complete
improvement after systemic antibiotic therapy.
Five patients had both KOH and fungus culture. Two
patients had fungus culture alone and the other one
had KOH alone. One of the six KOH studies
revealed positive results, and six of the seven cultures
grew fungus. The types of fungi isolated were
Candida albicans in two patients, Candida parapsilosis
in two, Trichophyton terrestre in one, and
Trichosporon sp. in one. These ten patients accepted
antifungal treatment.
In addition to foot intertrigo, some patients had
itchy red papules, papulovesicles and plaques on
their extremities and/or the trunk, so- called autosesitization
dermatitis. (Fig. 3) Itchy lesions developed
in 16 of the 32 recorded disease episodes (50%).