Treatment outcome and relapse with short-term oral terbinafine (250 mg/day) in tinea pedis.

A total of 168 patients with tinea pedis, but without onychomycosis, were treated with 1 cycle of terbinafine (TBF) (1 cycle: defined as 250 mg/day for 1 week). KOH preparation for direct microscopy was performed 4, 8 and 12 weeks after starting therapy to determine if testing was positive for tinea. Patients with no negative results on KOH examination or no evidence of obvious clinical improvement at 8 weeks, another cycle of the therapy was prescribed. The "cure", "no cure", "dropout", and "discontinuation/unevaluable" rates were 89.3%, 4.8%, 4.8% and 1.2%, respectively. The number of cycles required for cure in the plantar type was 1 cycle in 65.9% and 2 cycles in 54.5% of cases; in the interdigital type, 1 cycle in 79.1% and 2 cycles in 20.9% of cases; and mixed type, 1 cycle in 29.1% and 2 cycles in 60.9% cases. Among patients who were followed for at least 3 years after cure, the relapse rates were about 10% each year: 1 year, 11.3%; 2 years, 8.9%; and 3 years, 11.2%. The relapse rate of about 10% each year over a 3-year period suggests that reinfection may be likely.     

One week terbinafine 1% cream (Lamisil) once daily is effective in the treatment of interdigital tinea pedis: a vehicle controlled study. LAS-INT-06 Study Group.

Duration of therapy is an important factor determining patients' compliance in dermatomycosis clinical practice. We undertook a prospective, randomised, double-blind, parallel group study to investigate the efficacy and tolerability of once daily treatment with terbinafine 1% cream for 1 week, compared to its vehicle, in adult patients with interdigital tinea pedis. Efficacy was assessed in terms of mycological cure, total clinical signs and symptoms scores, and clinical response, 1 day and 1, 5 and 7 weeks after end of treatment. Terbinafine 1% cream was significantly more effective than its vehicle in achieving and maintaining mycological cure for 7 weeks: 91.4% vs. 37.1%, P < 0.001. Terbinafine was also significantly more effective than its vehicle in reducing total clinical signs and symptoms scores, and in achieving clinical response. We conclude that terbinafine 1% cream, applied once daily for 7 days, is an effective and well-tolerated treatment for interdigital tinea pedis in nonimmunocompromised patients. The short duration of treatment needed to achieve mycological cure has important implications for patient compliance and for control of infection within the community.     

Treatment of tinea unguium with terbinafine: an open study comparing twelve weeks and twenty-four weeks of continuous terbinafine therapy, and determination of terbinafine level in the target nails]

The study protocol was approved by the Ethical Committee of Sakai Municipal Hospital. A total of 40 outpatients with tinea unguium of the toenails, fingernails or both took part after giving voluntary written informed consent. Inclusion criteria were suggestive clinical appearance, a positive KOH preparation and an opaqueness of more than 50% of the nail length. The patients received 125 mg terbinafine once a day. The medication was taken after the evening meal and treatment was continued for 12 weeks. Medication stopped in twenty patients who responded well and a follow-up study was continued for 64 weeks. In the other 20 patients, medication was continued for 24 weeks and the follow-up study continued for 64 weeks. At 4-week intervals, the patients were evaluated for their clinical and mycological statuses and adverse reactions. Clipping of distal nail samples, including any attached subungual tissue, was done using nail clippers at 4-week intervals after cessation of therapy and the level of terbinafine was measured in the laboratory. No adverse reactions were detected. Tinea unguium of fingernails (1) and the third toes (2) were cured easily in the short term in the 12 week therapy group. One case in the 24 week therapy group was excluded because systemic steroid therapy was started for bullous pemphigoid at 32 weeks. The results of treatment of big toe onychomycosis were compared between the 12 week (17) and the 24 week (19). In the former group, 9 (52.9%) showed complete cure and 8 (47.1%) showed relapse or worse after cessation of therapy was. In 24 week therapy group, complete cure was achieved in 14 (73.7%) and relapse or worse in 5 (26.3%). The cure rate between the 2 groups was statistically not significant. Terbinafine was detected in the target nails up to 24 weeks after cessation of medication in both groups. Onychomycosis or tinea pedis reappeared in a few cases 12 to 16 weeks after medication ceased in the 12 week group. Topical antimycological therapy is necessary after cessation of oral terbinafine.     

One-week application of terbinafine cream compared with four-week application in treatment of Tinea pedis]

The possibility of one-week application of terbinafine cream for tinea pedis was studied in a double-blind test at four institutes, comparing four-week application as a control. Of a total of forty-three patients studied, nineteen were randomized into a four-week application group, Group I, and twenty into a one-week application group, Group II. Group I was evaluated as moderate to extremely useful in twelve (63.2%) of the nineteen patients and Group II in twelve (60.0%) of the twenty patients. No statistical differences were observed between two groups. These findings appeared to indicate that the short term, one-week application of terbinafine cream had results equivalent to the four-week application. This short-term treatment which aids in improving patient compliance and reducing the total amount of drug applied, thus lowering drug cost, is viewed as a useful way of treating tinea pedis.     

Dermatophytosis of the external auditory meatus]

Dermatophytosis of the external auditory meatus is believed to be a fairly rare disease. In the past three and a half years we have had seven cases of dermatophytosis in the external auditory meatus. All cases except one were associated with tinea of other lesions. Case 1: A 44-year-old man had tinea of the auricle, tinea pedis and tinea unguium. Case 2: A 14-year-old boy, the son of case 1 had no tinea elsewhere on his body, including the auricle. He scratched the auditory meatus with an earpick which his father had used. Case 3: A 62-year-old man had tinea of the auricle, tinea pedis and tinea unguium. Case 4: A 50-year-old man had tinea of the auricle, tinea pedis and tinea unguium. Case 5: A 36-year-old man had tinea of the auricle, tinea pedis, tinea unguium and tinea cruris. Case 6: A 30-year-old woman had tinea of the auricle. Case 7: A 68-year-old man had tinea of the auricle, tinea pedis, tinea unguium and tinea manuum. Endoscopic examination (except for cases 4 and 7) revealed dry cerumen from cartilaginous to bony region of the external auditory meatus. Direct examination using KOH method of the cerumen in all cases demonstrated numerous fungal elements. Fungal cultures identified Trichophyton rubrum except for cases 3 and 6. All cases were successfully treated with oral itraconazole or terbinafine. We suggest that tinea of the external auditory meatus is frequently associated with that of the auricle.     

Prevalence and risk factors of tinea unguium and tinea pedis in the general population in Spain

This study prospectively evaluated the prevalence and risk factors of tinea unguium and tinea pedis in the general adult population in Madrid, Spain. One thousand subjects were clinically examined, and samples of nails and scales from the interdigital spaces of the feet were taken from those patients presenting with signs or symptoms of onychomycosis and/or tinea pedis, respectively. In addition, a sample from the fourth interdigital space of both feet was collected from all individuals with a piece of sterilized wool carpet. Tinea unguium was defined as a positive direct examination with potassium hydroxide and culture of the etiological agent from subjects with clinically abnormal nails. Patients with positive dermatophyte cultures of foot specimens were considered to have tinea pedis. The prevalence of tinea unguium was 2.8% (4.0% for men and 1.7% for women), and the prevalence of tinea pedis was 2.9% (4.2% for men and 1.7% for women). The etiological agents of tinea unguium were identified as Trichopyton rubrum (82.1%), followed by Trichopyton mentagrophytes var. interdigitale (14.3%) and Trichopyton tonsurans (3.5%). Trichophyton rubrum (44.8%) and Trichophyton mentagrophytes (44.8%), followed by Epidermophyton floccosum (7%) and T. tonsurans (3.4%), were the organisms isolated from patients with tinea pedis. The percentage of subjects who suffered simultaneously from both diseases was 1.1% (1.7% for men and 0.6% for women). In a multivariate logistic regression analysis, age (relative risk [RR], 1.03) and gender (RR, 2.50) were independent risk factors for tinea unguium, while only gender (RR, 2.65) was predictive for the occurrence of tinea pedis. In both analyses, the presence of one of the two conditions was associated with a higher risk for the appearance of the other disease (RR, >25).     

Effect of temperature, humidity and minor injury to the penetration of dermatophytes into human stratum corneum]

We evaluated the minimum period for penetration of Trichophyton mentagrophytes into human stratum corneum using an experimental model of tinea pedis. Fungal elements were applied to the surface of stratum corneum which were obtained from a healthy human heel, and samples were incubated under a designated condition of temperature and humidity. Thirty-five degrees, which is the approximate temperature of the surface of human skin, seemed more suitable for penetration than 27C. The result also indicated that humidity was a more significant factor than temperature. In the following examination using T. mentagrophytes and T. rubrum, the minimum period for penetration at 100% humidity was 1 day with the former and 1.5 days with the latter. At 95% humidity, T. mentagrophytes penetrated into human stratum corneum on day 1.5 and T. rubrum penetrated on day 4. Humidity of the 4th interdigital space in daily life was calculated to be below 95% using a hygro-thermometer. Therefore, to wash the feet daily can prevent development of tinea pedis. When we applied fungal elements to a cut side of stratum corneum, fungi penetrated within a day at 100% and 95% humidity. In addition, fungi were able to penetrate at below 85% humidity, which they were unable to do when applied them to the surface side. We stress that minor injury of stratum corneum is also a significant factor of the development of tinea pedis.     

Clinical evaluation of terbinafine on onychomycosis with a 2 year follow-up]

Over the 2 year period from October, 1997 to September, 2005, the clinical efficacy of 125 mg/day of terbinafine was evaluated in 356 patients with onychomycosis. Of these, 253 patients were followed up for 6 months after oral treatment of terbinafine, 120 for 1 year, and 56 for 2 years. The improvement ratio increased depending on follow-up period: 30.4% in 6 months, 65.0% in 1 year, and 67.9% in 2 years. However, in 25 patients who showed regression from onychomycosis at the 1 year period, 8 patients (32.0%) relapsed. The muddy rate of the first toenail was decreased from pre-treatment with terbinafine in 92.1% at 6 months, 91.7% at 1 year and 87.5% at 2 years. It is considered that efficacy of this medication is maintained within 1 year after the treatment, but the number of patients who experience a relapse is likely to increase from 1 year to 2 years.     

Effects of temperature, humidity, minor injury and washing on penetration of dermatophytes into human stratum corneum]

We evaluated the minimum time for penetration of Trichophyton mentagrophytes into human stratum corneum using an experimental model of tinea pedis. After fungal elements were applied on the surface of stratum corneum obtained from a healthy human heel, samples were incubated under designated conditions of temperature and humidity. The penetration of fungal elements was much faster at 35 degrees C than 27 degrees C despite the fact that the latter is an optimal temperature for fungal growth. At 35 degrees C and 100% humidity the minimum time required for penetration was one day. When we applied fungal elements on an abraded surface of stratum corneum, fungi penetrated within a half day under the same conditions. This suggests that minor injury of stratum corneum is a significant factor for infection. The development of tinea pedis does not occur frequently in daily life. We examined the effect of washing the surface of stratum corneum to which T. mentagrophytes had been applied. The samples were incubated under conditions simulating daily life: i.e. with 80% humidity for 8 hours, and 100% humidity for 16 hours. After washing, nearly all the fungal elements had been removed from the surface of stratum corneum within one day. The data suggests that to prevent tinea pedis, daily washing of soles and interdigital regions is effective.     

A short-term treatment of tinea corporis and tinea cruris with oral terbinafine]

We studied the effectiveness of short-term treatment of tinea corporis and tinea cruris with oral terbinafine at 250 mg/day for 2-3 days. The treatment on an open study basis consisted of two groups: the first group (n=17) was given 250 mg/day for two consecutive days, and the second group (n=24) was given the same dose for three consecutive days. No patient was treated topically. Effectiveness was evaluated at the end of the second week both clinically and mycologically (KOH examination and culture). In the two-day group, five cases showed an excellent response, three had a good response and nine had a fairly good response. Patients with good response or better comprised 47.1% of the total, while those with excellent response stood at 29.4%. The negative mycological examination ratio was 47.1%. In the three-day group, 12 cases showed an excellent response, four a good response while eight had a fairly good response. Patients with a good response or better comprised 66.7% of the group, while cases with an excellent response comprised 50.0%. The negative mycological examination ratio stood at 66.7%. The overall effectiveness evaluation showed no statistically significant difference between the two treatment groups in the Wilcoxon's rank sum test. No side effect was observed in either group. These findings showed that terbinafine therapy of tinea cruris is effective even with a short-term treatment of 2-3 days at a small dose.     

Monthly cycles of 1-week therapy with itraconazole for patients with Tinea pedis]

Monthly cycles of 1-week therapy with oral itraconazole at 200 mg daily for tinea pedis was assessed to determine its acceptability to patients. Thirty-four patients (17 men and 17 women) with intractable tinea pedis, with informed consent, took 200 mg of itraconazole once daily for one week over a month period until mycological studies showed negative results for up to 4 months. The overall mycological effectiveness was about 80% after this therapy. Information was also gathered on the influence of this therapy on the patients quality of life by questionnaires. Nineteen (70%) among the 27 patients who answered the questionnaire preferred this 1-week administration of itraconazole over a month-long period compared with continuous daily therapy. Twenty-two (81%) preferred this therapy over topical treatment. We recommend to this therapy be added for the treatment of intractable tinea pedis.     

Tinea pedis: The etiology and global epidemiology of a common fungal infection

Abstract

Tinea pedis, which is a dermatophytic infection of the feet, can involve the interdigital web spaces or the sides of the feet and may be a chronic or recurring condition. The most common etiological agents are anthropophiles, including Trichophyton rubrum sensu stricto, which is the most common, followed by Trichophyton interdigitale and Epidermophyton floccosum. There has been a change in this research arena, necessitating a re-evaluation of our knowledge on the topic from a multidisciplinary perspective. Thus, this review aimed to provide a solid overview of the current status and changing patterns of tinea pedis. The second half of the twentieth century witnessed a global increase in tinea pedis and a clonal spread of one major etiologic agent, T. rubrum. This phenomenon is likely due to increases in urbanization and the use of sports and fitness facilities, the growing prevalence of obesity and the aging population. For optimal patient care and management, the diagnosis of tinea pedis should be verified by microbiological analysis. In this review, we discuss the epidemiology, clinical forms, complications and mycological characteristics of tinea pedis and we highlight the pathogenesis, prevention and control parameters of this infection.     

Analysis of dermatophyte flora at a private clinic in Sapporo during the period 1992 to 2001]

Statistical analysis was made of a total of 5530 patients (6798 cases) of dermatophytoses presenting at our private clinic during the period 1992 to 2001. The number of patients and cases represents 8.0% and 9.8% of the entire outpatient population during that time, respectively. Sex ratio (male/female) was 1.5. Among the 6798 dermatophytoses cases, tinea pedis was most frequent (65.8%), followed by tinea unguium (20.7%), tinea cruris (7.2%), tinea corporis (3.9%), tinea manuum (2.4%) and tinea barbae (0.04%). The incidence of tinea unguium increased, whereas that of tinea pedis, tinea cruris, and tinea corporis decreased during this ten year period, and 35.8% of dermatophytoses patients had more than two clinical subtypes simultaneously. Three thousand seven hundred ninety-five dermatophytes were isolated during the survey. : Trichophyton rubrum (TR)(79.4%), Trichophyton mentagrophytes (TM)(19.5%), Microsporum canis (MC)(0.7%), Epidermophyton floccosum (EF) (0.3%), and Microsporum gypseum (MG) (0.1%). Compared with our previous analysis reported for the period 1982 to 1991, the frequency of dermatophytoses increased, especially among aged individuals. Of the clinical subtypes, tinea pedis and tinea unguium were higher, but tinea cruris and tinea corporis were lower, and tinea capitis was not seen in the current survey. Among dermatophytes, TR was increased and other types of fungi were decreased. TR was 4.08 times more common than TM; this ratio is higher than our previous report.     

Prevalence and patient's consciousness of tinea pedis and onychomycosis]

Epidemiological studies on tinea pedis and onychomycosis have been performed across Europe and East Asia. The prevalence of these conditions was 20%, respectively, and it increased with advancing age, more men than women had fungal infection of the feet. The prevalent predisposing factors were sports participation, average temperature, and family history of tinea pedis. The predisposing diseases were hypercholesterolemia, cardiovascular disease, diabetes mellitus, and osteoarticular disease. We conducted an epidemiological investigation to determine the prevalence and circumstances of untreated and unsuspected tinea pedis and onychomycosis. The results showed that the prevalence of occult athlete's foot was 25%, and that 59% of those cases were complicated by tinea unguium. The characteristics of patients with occult athlete's foot included a higher proportion of men and a tendency toward a low clinical score together with a high severity score. In the patient background, a strong correlation was observed between a positive KOH test result and characteristics such as past history of tinea pedis and/or onychomycosis, age, disposition of toes, and predisposing disease, as well as the type of shoes worn daily. We suspected that a patient's local and systemic conditions affected each other, creating good conditions for tinea pedis and onychomycosis so that the prevalence has increased. More understanding of occult athlete's foot will lead to prevention and improvement in treatment and diagnosis.     

Statistical study of dermatomycosis for 30 years (1968-1997) in sendai national hospital]

A statistical study on dermatomycoses for the 30 years from 1968 to 1997 in the dermatologic section of Sendai National Hospital was carried out with the following results. The total number of dermatomycosis patients was 14,259 and accounted for 9.59% of all new outpatients during this period. These cases of dermatomycoses were composed of the following: dermatophytoses 10,656, candidiasis 3,287, malassezia infection 566, sporothrichosis 20, aspergillosis 7, and chromomycosis 1. Annual changes in number of dermatophytoses varied in each clinical type: tinea corporis and tinea cruris had increased by the end of the 1970s, and there after decreased gradually until recent years. Tinea pedis and tinea unguium, on the contrary, increased after the 1980s. Age distribution of all clinical forms of dermatophytoses changed gradually, and its peak of the distribution curve shifted to an older site each year, while the number of younger generation patients decreased. Mycologically Trichophyton (T.) rubrum was mainly isolated from all types of dermatophytoses, and T. mentagrophytes followed. The ratio of these two species (R/M) in tinea pedis was 1.25, and the ratio of T. mentagrophytes was relatively high. Epidermophyton floccosum was continuously isolated, but its frequency in recent years has decreased. Microsporum canis infection increased from the middle period of this research, but after 1990 decreased gradually. The other dermatophytes were found sporadically. In recent years the species isolated have become more simplified. Among candidiasis, infantile candidiasis increased dramatically in the 1970s but soon decreased. Intertrigo type also increased in the same period and then decreased to an intermediate level. Paronychia, onychia and erosio interdigitale were constantly found in small numbers, while malassezia infection remained at a constant level and was found more in male patients.     

Tinea faciei in a newborn due toTrichophyton tonsurans

We report here the first case of neonatal tinea faciei caused by Trichophyton tonsurans in mainland China.The mother of the infant had tinea corpris and tinea capitis while the father had tinea incongnito.The infections in the parents were mycologically confirmed to be due to Trichophyton tonsurans.Ttinea faciei in the infant was cured after two-week topical use of amorolfine cream.The mother ceased breastfeeding and took oral terbinafine for 4 weeks.No recurrence was observed in the infant during 12 months of follow-up.     

Guidelines for clinical evaluation of topical antifungal agents]

The Japanese Society for Medical Mycology (JSMM) decided in 2002 to establish guidelines for the clinical evaluation of antifungal agents. The JSMM committee presents here guidelines for the clinical evaluation of topical antifungal agents in the dermatology field. Guidelines for the Clinical Evaluation of Antibiotic Agents established by the Japanese Society of Chemotherapy were referred to, and the diseases subjected to clinical evaluation include tinea (tinea pedis and tinea glabrosa), cutaneous candidiasis, and pityriasis versicolor. Among superficial mycoses, tinea pedis is viewed as the pivotal disease because it is intractable and is the most common. Therefore, the clinical efficacy of antifungal agents for external use in this condition should be established, and tinea pedis is subjected to phase III clinical studies. If efficacy of the antifungal agents is confirmed in the treatment of tinea pedis, a comparative study need not necessarily be performed for tinea glabrosa. If the number of patients is adequate for statistical analysis, a comparative study should be considered for both cutaneous candidiasis and pityriasis versicolor. However, if the number of patients is low, the efficacy of the agents should be evaluated based on their antifungal activity on pathogens and the results of open trials, and a comparative study is not necessarily performed for such diseases. The safety should be strictly evaluated.     

A case of chromomycosis arising in a Japanese-Brazilian patient]

A 41-year-old Japanese-Brazilian man, living in Japan since 1991, visited our hospital in August 1998 complaining of a scaly annular erythema which had been present on his right forearm since 1996. Granulomatous inflammation was revealed in the dermis upon skin biopsy. Sclerotic cells were present within the granulomatous lesions. Fonsecaea pedrosoi was isolated from tissue cultures. The restriction fragment length polymorphism pattern of mitochondrial DNA of the causative fungus was compatible with F. pedrosoi type 1, the commonest type in Japan. Since type 4 is usually found in South America, the patient was assumed to have become infected in Japan. An oral dose of terbinafine at 125 mg/day was ineffective. 125 mg/day single dose of terbinafine reaches an average plasma concentration of only 0.69 g/ml, where as 250 mg/day reaches 0.96 micro g/ml. Because the minimum inhibitory concentration (MIC) of terbinafine against the isolated fungus was found to be 0.76 micro g/ml, the terbinafine dose was increased from 125 mg/day to 250 mg/day, which slowly led to remission. Chromomycosis is caused by several species of dematiaceous fungi, and terbinafine efficacy may vary depending on the causative fungus. MIC values may differ even within the same species. It is important to isolate the pathogenic fungus in each case and measure the MIC value to determine the optimal dose of terbinafine.     

Statistical study of dermatomycosis - observations in Sendai National Hospital over a 30 year period]

A statistical 30-year study of dermatomycosis in Sendai National Hospital (1968-1997) revealed many changes in the prevalent diseases: Tinea pedis and tinea unguium constantly increased during this period, and the ratio of the former associated with nail infection finally reached 30% of all tinea pedis patients. On the contrary, tinea corporis and cruris showed a remarkable decreasing tendency. Patient age distribution of each disease also showed distinctive changes, generally increasing in the older generation and decreasing in the younger. The number of patients with tinea pedis and unguium gradually increased among the middle and older generations, with the peak of the age-distribution curve shifting upward year after year. On the other hand, cases of tinea cruris among the younger generation were few in the latest years, and middle-age patients remained at a low number. In the first stage of this study the kinds of atiologic dermatophytes consisted of multiple species, but after middle period the isolation of Epidermaphyton floccosum decreased. Microsporum canis appeared first in 1976 but in the recent several years has completely disappeared. In the last few years of the period studied Trichophyton rubrum and Trichophyton mentagrophytes were the only isolates found from among all types of dermatophytoses. Infantile candidiasis remarkably increased in 1970-1975 but thereafter decreased rapidlly. Candidial intertrigo also increased in the same period but did not decrease as much thereafter and continued at the same intermediate level. The number of other types of candidiases were not greatly changed throughout the 30-year period. Malassezia infection also showed no remarkable changes, and only 20 cases of sporothrichosis were found. One case of the deep seated form of cutaneous aspergillosis was found, and this was also true of chromomycosis caused by Fonceaea pedrosoi.     

1996 epidemiological survey of dermatophytoses in Japan. Epidemiological Investigation Committee for Human Mycoses in the Japanese Society for Medical Mycology]

An epidemiological investigation on dermatophytoses in Japan for the year 1996 was carried out with the following results. The number of dermatomycoses patients visiting the fifteen cooperating institutes that year was 8,402. New outpatients with this condition accounted for 13.1% of all new outpatients in these institutes. Dermatophytoses patients numbered 7,395 and were composed of: tinea pedis 4,764 (64.4%), tinea unguium 1,487 (20.1%), tinea corporis 558 (7.5%), tinea cruris 369 (5.0%), tinea manuum 195 (2.6%), tinea capitis 11, kerion Celsi 7, tinea barbae 1 and other forms 3. Of these, 113 were children under 15 years of age. Species and incidences of the 2,615 strains isolated from the patients with dermatophytoses were as follows: Trichophyton (T.) rubrum 1,828 (69. 9%), T. mentagrophytes 743 (28.4%) Epidermophyton floccosum 20 (0. 8%), Microsporum (M.) canis 13 (0.5%), M. gypseum 5, T. violaceum 2, and 4 undetermined strains. Candidiasis was found in 722 individuals: intertrigo 299, erosio interdigitalis 95, erythema infantum 89, oral candidiasis 63, paronychia et onychia 56, genital candidiasis 56, onychomycosis 24, chronic mucocutaneous candidiasis 1 and other atypical forms of candidiasis 39. Patients with tinea versicolor numbered 265 and those with Malassezia folliculitis 15. There were five cases of deep dermal mycoses: three of sporotrichosis, one of chromomycosis and one of aspergillosis. The results of superficial dermatophytoses for the year 1996 differed from those of 1991-92 in the following points: Tinea corporis and tinea cruris were lower in number, while tinea unguium had increased in ratio and number. M. canis infection tended to decrease gradually. In the age-distribution of tinea, in every clinical form the peak of distribution curve shifted to a more elderly age group.