TY - JOUR
T1 - Chronic recurrent dermatophytosis in the tropics
T2 - Studies on tinea imbricata in Indonesia
AU - Bramono, Kusmarinah
PY - 2012/3
Y1 - 2012/3
N2 - Dermatophytosis is one of the major public health problems in tropical countries, especially the chronic recurrent type. Tinea imbricata (TI), a dermatophytosis caused by Trichophyton concentricum (TC), is endemic in several remote and isolated areas in Indonesia. This dermatophytosis is unique due to its predominant genetic predisposition, which leads to chronic recurrent conditions among the affected. Moreover, hot and humid climate, low socio-economic conditions, lack of hygiene, inadequate treatment due to difficult access to health care facilities, and persistent source of re-infections, are among other factors that maintain the chronic-recurrent state. Studies on TI in Indonesia have been done since the 1960s, encompassing the epidemiology, clinical features, and efficacy of antifungal treatment. Griseofulvin is still the mainstay treatment, but relapse rates are high. The latest effort in reducing relapse includes the training of healthcare providers and provision of fungal disinfectant for clothing and bedding to patients in West Papua in addition to standard treatment. Higher cure rate was achieved at the end of treatment and the four-month follow-up in comparison to previous studies. Parallel studies on the same patient populations showed that: 1. clothing and bedding were fomites and potential sources of re-infections; 2. sodium hypochlorite worked well as a fungal disinfectant, followed by anionic detergent and pine oil containing cleaner; 3. terbinafine was the most effective antifungal agent for TC in vitro, followed by griseofulvin; itraconazole, and fluconazole were less effective. In conclusion, to eradicate TI in endemic areas, appropriate and affordable antifungal treatment, concurrent with health education and efforts to identify and eradicate the source of re-infections are very important.
AB - Dermatophytosis is one of the major public health problems in tropical countries, especially the chronic recurrent type. Tinea imbricata (TI), a dermatophytosis caused by Trichophyton concentricum (TC), is endemic in several remote and isolated areas in Indonesia. This dermatophytosis is unique due to its predominant genetic predisposition, which leads to chronic recurrent conditions among the affected. Moreover, hot and humid climate, low socio-economic conditions, lack of hygiene, inadequate treatment due to difficult access to health care facilities, and persistent source of re-infections, are among other factors that maintain the chronic-recurrent state. Studies on TI in Indonesia have been done since the 1960s, encompassing the epidemiology, clinical features, and efficacy of antifungal treatment. Griseofulvin is still the mainstay treatment, but relapse rates are high. The latest effort in reducing relapse includes the training of healthcare providers and provision of fungal disinfectant for clothing and bedding to patients in West Papua in addition to standard treatment. Higher cure rate was achieved at the end of treatment and the four-month follow-up in comparison to previous studies. Parallel studies on the same patient populations showed that: 1. clothing and bedding were fomites and potential sources of re-infections; 2. sodium hypochlorite worked well as a fungal disinfectant, followed by anionic detergent and pine oil containing cleaner; 3. terbinafine was the most effective antifungal agent for TC in vitro, followed by griseofulvin; itraconazole, and fluconazole were less effective. In conclusion, to eradicate TI in endemic areas, appropriate and affordable antifungal treatment, concurrent with health education and efforts to identify and eradicate the source of re-infections are very important.
KW - Indonesia
KW - Tinea imbricata
UR - http://www.scopus.com/inward/record.url?scp=84862747185&partnerID=8YFLogxK
U2 - 10.17966/kjmm.2012.17.1.1
DO - 10.17966/kjmm.2012.17.1.1
M3 - Article
AN - SCOPUS:84862747185
SN - 1226-4709
VL - 17
SP - 1
EP - 7
JO - Korean Journal of Medical Mycology
JF - Korean Journal of Medical Mycology
IS - 1
ER -