Chronic Dermatomycoses of the Foot as Risk Factors for Acute Bacterial Cellulitis of the Leg: A Case-Control Study

• Published in: Dermatology (Basel) Vol. 209; no. 4; pp. 301 - 307
• Main Authors: Roujeau, Jean-Claude, Sigurgeirsson, Bardur, Korting, Hans-Christian, Kerl, Helmut, Paul, Carle
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2004; S. Karger AG
• Subjects: Acute Disease; Age Distribution; Aged; Analysis of Variance; Bacteria; Biological and medical sciences; Case-Control Studies; Cellulitis - epidemiology; Cellulitis - microbiology; Chronic Disease; Clinical and Laboratory Investigations; Comorbidity; Confidence Intervals; Dermatology; Disease Susceptibility - epidemiology; Feet; Female; Human mycoses; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Mycoses; Mycoses of the skin; Odds Ratio; Onychomycosis - diagnosis; Onychomycosis - epidemiology; Prevalence; Prognosis; Risk Factors; Severity of Illness Index; Sex Distribution; Skin Diseases, Bacterial - epidemiology; Skin Diseases, Bacterial - microbiology; Skin involvement in other diseases. Miscellaneous. General aspects; Tinea Pedis - diagnosis; Tinea Pedis - epidemiology; Foot dermatomycosis; Bacterial cellulitis; Onychomycosis; Risk factors; Tinea pedis; Skin disease; Mycosis; Dermatology; Acute; Case control study; Cellulitis; Leg; Foot; Infection; Chronic; Risk factor; Bacteriosis; Nail disease; Adipose tissue disorders; Dermatophyte
• ISSN: 1018-8665; 1421-9832
• DOI: 10.1159/000080853

Objective: To assess the role of foot dermatomycosis (tinea pedis and onychomycosis) and other candidate risk factors in the development of acute bacterial cellulitis of the leg. Methods: A case-control study, including 243 patients (cases) with acute bacterial cellulitis of the leg and 467 controls, 2 per case, individually matched for gender, age (±5 years), hospital and admission date (±2 months). Results: Overall, mycology-proven foot dermatomycosis was a significant risk factor for acute bacterial cellulitis (odds ratio, OR: 2.4; p < 0.001), as were tinea pedis interdigitalis (OR: 3.2; p < 0.001), tinea pedis plantaris (OR: 1.7; p = 0.005) and onychomycosis (OR: 2.2; p < 0.001) individually. Other risk factors included: disruption of the cutaneous barrier, history of bacterial cellulitis, chronic venous insufficiency and leg oedema. Conclusions: Tinea pedis and onychomycosis were found to be significant risk factors for acute bacterial cellulitis of the leg that are readily amenable to treatment with effective pharmacological therapy.