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9.6.1 Is there a link between fungal foot infection and recurrent cellulitis? (206)

Carol Collins, PhD student, School of Nursing and Midwifery, University of Southampton, Southampton, United Kingdom Co authors: Kathryn Getliffe & David Voegeli csc@soton.ac.uk

Abstract:

Celluitis is an infective/inflammatory skin condition accounting for around 70,000 hospital referrals/year. The legs are most frequently affected and patients experience extreme pain often for many weeks. In addition 18-20% of patients suffer from chronic infection or recurrent attacks. Choice of treatment is empirical. A combination of intravenous and oral antibiotic therapy is offered together with skin care. Recent studies have cited athlete’s foot (dermatophytosis) as a risk factor for cellulitis. Relationships with the immune response, skin vulnerability and stressors have also been reported. This project is designed to investigate these relationships and aims to provide an evidence base for a prophylactic skin care intervention particularly for use by those suffering from recurrent disease. The presence of dermatophytes is established using an agar culture medium. Immune responses are determined from blood samples and categorised by reference to white cell types and numbers, assessment of T-cell status (cytokine analysis) and by markers specific to dermatophyte infection. Physiological measurements of skin blood flow, venous insufficiency, transepidermal water loss, skin hydration, acidity, erythema and skin structure, provide numerical data to assess skin function. A simple questionnaire adds quantitative information on psychological stress. So far nine patients and matched controls have completed data collection.

Preliminary results suggest that:

  • Disrupted transepidermal water loss and venous incompetence are more common in cellulitic legs
  • The prevalence of potential foot pathogens (dermatophytes, moulds, yeasts and bacteria) within the general population may be higher than is currently accepted

These findings may have implications for skin care interventions in patients suffering recurrent attacks of cellulitis. Recruitment is ongoing and data collection should be complete by December 2007.

Source of Funding: UK - Higher Education Institution

Amount in Funding: N/A

Recommended reading list:

  • Day, M.R., Day, R.D., Harkless, L.B. (1996) Cellulitis secondary to webspace dermatophytosis, Clinics in Podiatric Medicine and Surgery, 13 (4) pp 759-766
  • Roujeau, J., Sigurgeirsson, B., Korting, H., Kerl, H., Paul, C. (2004) Chronic dermatomycoses of the foot as risk factors for acute bacterial cellulitis of the leg: a case-control study, Dermatology, 209 pp 301-307