Eccema coxsackium en adulto: presentación de un caso / Eczema coxsackium in adults: a case report

La enfermedad de pie, mano boca es una patología frecuente de observar en niños menores de 5 años, generalmente producida por virus Coxsackies y Enterovirus. Existen presentaciones atípicas debido a serotipos recientemente descritos de estos virus, algunos de ellos se han reportado en pacientes adultos. Se presenta caso de paciente masculino de 19 años, con antecedentes de dermatitis seborreica facial en tratamiento, que desarrolla una presentación atípica del síndrome pie, mano boca en contexto de un brote de esta patología en su academia militar. Luego del análisis epidemiológico, clínico e histopatológico, se diagnostica eccema coxsackium, una patología infrecuente en este grupo etario que contiene algunas particularidades destacables en relación con su manejo y estudio.

The hand mouth foot syndrome is a common pathology observed in children under 5 years, usually caused by coxsackie virus and enterovirus. There are exuberant clinical presentations, due to infrequent and emerging serotypes of these viruses, some of them manifesting in adult patients. A case of a 19 year old patient is presented, with a history of seborrheic dermatitis of the face and scalp in treatment, who develops an atypical clinical presentation of the hand foot mouth syndrome, intensely affecting the areas of seborrheic dermatitis on the face, in the context of an outbreak of this pathology in his military academy. After the epidemiological, clinical and histopathological analysis, eczema coxsackium is diagnosed, an infrequent pathology in this age group that contains some remarkable peculiarities in relation to its management.

Dermatitis digital en novillos de feedlot: Descripción de 2 brotes en el Noroeste Argentino

La Dermatitis Digital (DD) es una afección podal de distribución mundial. Al igual que otras enfermedades que afectan al pie bovino induce evidentes cojeras, con las consecuentes pérdidas productivas y económicas. Comúnmente se la describe en el ganado lechero y raramente en ganado de carne. En este trabajo se presentan dos brotes de DD en novillos de feedlot del Noroeste Argentino. Se destacan aspectos clínicos, epidemiológicos, patológicos y de diagnóstico. La incidencia fue de 5 y 35 %. Las lesiones se identificaron típicamente en el área palmar de los miembros posteriores e histopatológicamente se observó una dermatitis necrotizante con infiltrado neutrofílico. Mediante la tinción Warthin-Starry se identificaron espiroquetas intralesionales en el 50% (4/8) de las muestras colectadas.

Digital Dermatitis (DD) is a podal condition of worldwide distribution. Like other diseases that affect the bovine foot, it induces obvious lameness, with consequent productive and economic losses. It is commonly described in dairy cattle and descriptions in beef cattle are scarce. In this paper, two DD outbreaks are described in steers from feed-lot in the Argentine Northwest. Emphasis is given to more relevant aspects of clinical, epidemiological, pathological and diagnostic findings. The incidence was 5 and 35%. Lesions are typically identified in the palmar area of the hind limbs, and a necrotizing dermatitis with neutrophil infiltrate was observed histopathologically. By Warthin-Starry staining was identified an intralesional spirochetes in 50% (4/8) of collected samples.

Onicomadesis asociada a la enfermedad de boca, mano, pie / Onychomadesis associated to mouth, hand, and foot disease

Introducción: la onicomadesis es el desprendimiento completo y espontáneo de la uña desde su extremo proximal, sin dolor o inflamación, consecutivo a la detención mitótica de la matriz ungular que conlleva a un cambio de su función. Objetivo: describir una serie de casos de onicomadesis atendidos en la consulta de Dermatología del Hospital Pediátrico Docente del Cerro, entre noviembre y diciembre del año 2017, después de presentar un cuadro clínico compatible con enfermedad boca, mano, pie, con la finalidad de contribuir al conocimiento de esta patema. Presentación de los casos: las edades estuvieron comprendidas en un rango entre 1 y 12 años, con solo 3 pacientes correspondientes al sexo masculino y solo uno con el color de la piel negra. Los días previos al padecimiento de la enfermedad boca, mano, pie se enmarcan entre 15 y 47 días de haber tenido los síntomas que indujeron al diagnóstico del citado morbo. El estudio virológico se efectuó en dos pacientes con presencia del Coxsackie A6. La evolución resultó satisfactoria en todos los casos. Conclusiones: los hallazgos, en general, coinciden con los mencionados en la literatura. Todos los pacientes presentaron semanas anteriores signos y síntomas compatibles con enfermedad boca, mano, pie. Es necesario orientar a los padres de los enfermos con este morbo, la posibilidad de la ocurrencia de onicomadesis como complicación, cuyo tratamiento es sintomático, seguido de buen pronóstico, para evitar la ansiedad familiar y los gastos de recursos innecesarios(AU)

Introduction: onychomadesis is the total and spontaneous detachment of the nail from its proximal end, without pain or inflammation, and following the mitotic halting of the nail matrix that leads to a change in its function. Objective: to describe a series of cases of onychomadesis attended in the Dermatology clinic of the Pediatric Teaching Hospital of Cerro, in the period of November to December of 2017, after presenting clinical manifestations compatible with mouth, hand, and foot disease, and in order to contribute to the knowledge of this pathology. Presentation of cases: ages were among 1 and 12 years old, with only 3 patients corresponding to the male sex and only one with black skin. The days before presenting symptoms of mouth, hand, and foot disease were between 15 and 47 days after having the symptoms that led to the diagnosis of the aforementioned disease. The virological study was carried out in two patients with the presence of Coxsackie A6. The evolution was satisfactory in all cases. Conclusions: in general the findings coincide with those mentioned in the literature. All patients presented previous signs and symptoms compatible with mouth, hand, and foot disease in the previous weeks. It is necessary to guide the parents of patients with this disease on the possibility of the onychomadesis occurrence as a complication, whose treatment is symptomatic, followed by a good prognosis to avoid family anxiety and the expense of unnecessary resources(AU)

Características clínico epidemiológicas de pacientes pediátricos con enfermedad boca, mano, pie / Clinical epidemiological characteristics of pediatric patients with mouth, hand and foot disease

Introducción: la enfermedad boca, mano, pie es una enfermedad febril eruptiva provocada por la infección por los virus Coxsackie, consistente en fiebre, exantema pápulo-vesicular en las manos, los pies y un enantema ulceroso en la boca. Objetivos: indagar la etiología viral y describir las características clínico epidemiológicas de la entidad. Métodos: estudio descriptivo prospectivo en 54 pacientes menores de 18 años, diagnosticados con la enfermedad boca, mano, pie, atendidos en el Hospital Pediátrico Docente del Cerro, de septiembre a noviembre de 2017. Se incluyeron aquellos con lesiones vesiculares o pápulas vesiculares, distribuidas en la piel y úlceras en la mucosa oral; y se excluyeron los pacientes con otras entidades exantemáticas o vesiculares. Las variables investigadas resultaron: la edad, el sexo, los signos, los síntomas clínicos de infección, el leucograma y el estudio virológico. La selección de la muestra fue de manera no probabilística consecutiva. Los datos se procesaron por el paquete estadístico XLSTAT con análisis univariado. Resultados: el grupo entre 1-3 años obtuvo 53,7 por ciento, y el sexo masculino el 68,5 por ciento. Las lesiones cutáneas fueron más frecuentes en la cara, las extremidades, los glúteos y el tronco (68,6 por ciento), seguido de la zonas de la cara, las extremidades y el tronco (29,6 por ciento). El enantema fue apreciado en el 48,1 por ciento, la fiebre en el 61,1 por ciento, la fiebre más secreción nasal en el 44,4 por ciento y el prurito en el 70,3 por ciento. El conteo leucocitario alcanzó 11,1 x 109 células. Los polimorfonucleares obtuvieron promedio de 37,9 y los linfocitos 70,3. En 49 de los 54 pacientes se aisló el virus Coxsackie A6. Conclusiones: se describe la enfermedad boca, mano, pie en forma atípica, cuyo cuadro clínico coincide con lo aparecido en la literatura(AU)

Introduction: mouth, hand and foot disease is an eruptive febrile illness caused by the infection of Coxsackie viruses, and it consists in fever, papulo-vesicular exanthema in the hands, feet and an ulcer enanthema in the mouth. Objectives: to investigate the viral etiology and describe the clinical epidemiological characteristics of the entity. Methods: prospective descriptive study in 54 patients under 18 years old diagnosed with mouth, hand and foot disease, and whom were attended at the Pediatric Teaching Hospital of Cerro from September to November 2017. Those with vesicular lesions or vesicular papules distributed in the skin, and ulcers in the oral mucosa were included in the research; and patients with other exanthematic or vesicular entities were excluded. The variables investigated were: age, sex, signs, clinical symptoms of infection, leukogram and virological study. The selection of the sample was consecutive non-probabilistic. The data was processed by the XLSTAT statistical package with univariate analysis. Results: the group from 1 to 3 years old represented the 53.7 percent, and the male sex the 68.5 percent y. Skin lesions were more frequent on the face, extremities, buttocks and trunk (68.6 percent), followed by facial, limbs and trunk areas (29.6 percent). Enanthem was visible in 48.1 percent, and fever appeared in 61.1 percent, fever plus nasal discharge in 44.4 percent and itching in 70.3 percent y The leukocyte count reached 11.1 x 109 cells. Polymorphonuclear cells obtained an average of 37.9 and lymphocytes of 70.3. In 49 of the 54 patients the Coxsackie A6 virus was isolated. Conclusions: mouth, hand, and foot disease is described in an atypical form, whose clinical manifestations coincide with what appeared in the literature(AU)

Análisis biomecánico a través de simulación numérica de la ruptura del tendón del tibial posterior en el pie plano valgo: estudio en cadáver / Biomechanical analysis through numerical simulation of rupture of the tibial posterior tendon in valgus flat foot: a cadeveric study

Resumen: La insuficiencia del tendón del tibial posterior es la causa adquirida de dolor más común relacionada con la deformidad de pie plano valgo en adultos. El pie plano adquirido por el adulto es una deformidad sintomática muy dolorosa que resulta de un estiramiento gradual (atenuación) del tendón del tibial posterior, así como de los ligamentos que sostienen el arco de la planta del pie. El dolor progresivo en el pie plano adquirido por el adulto afecta cuatro veces más a las mujeres que a los hombres. Algunos factores que contribuyen a incrementar el riesgo del pie plano adquirido en el adulto son la diabetes, la hipertensión y la obesidad. Se piensa que la combinación de los eventos siguientes es la causa del pie plano adquirido por el adulto. La clasificación de Johnson Strom modificada por Mayerson lo evalúa en cuatro estadios. Este estudio se dividió en tres etapas: etapa 1: disección y análisis tridimensional del tendón, etapa 2: aplicación de herramientas de bioingeniería para determinar las causas de ruptura del tendón del tibial posterior y etapa 3: evaluación de 24 pacientes con enfermedad de pie plano valgo para describir la deformidad.

Abstract: The insufficiency of the posterior tibial tendon is the most common acquired cause of pain related to valgus flatfoot deformity in adults. The acquired flatfoot adult is a very painful symptomatic deformity resulting from a gradual stretching (attenuation) of the posterior tibial tendon and ligaments that support the arch of the foot. The progressive pain acquired flatfoot adult affects four times more women than men. Some factors that contribute to increased risk of acquired flatfoot in adults, are diabetes, hypertension and obesity. It is thought that the combination of the following events is the cause of acquired flatfoot adult. Johnson Strom classification modified by Mayerson evaluates in 4 stages. This study was divided into 3 stages: Stage 1: Dissection and three-dimensional analysis of the tendon, Step 2: Application of tools bioengineering to determine the causes of rupture of the tibial tendon: Stage 3: Evaluation of 24 patients with flatfoot disease valgus for describe the deformity.

Acquired Change and Pain of Foot in Elderly People

As the aging of the foot progresses, the stiffness of the soft tissues, the reduction of the range of motion, the decrease of the muscle strength, and the flattening of foot are manifested. These changes increase the risk of foot pain, the problem of weight distribution and transmission, and the risk of falls, resulting in secondary complications and lowering quality of life. The most common deformities and diseases of the elderly foot are hallux valgus, hammertoes, hallux rigidus, Achilles tendinitis, plantar fasciitis, metatarsalgia, hyperkeratosis, and other deformities of the feet caused by chronic conditions. Systemic diseases that promote these foot problems include diabetes, peripheral nerve damage, repetitive ankle ligament injuries, deformities due to fractures, and obesity. Understanding the mechanisms of aging and the processing of biomechanics in the elderly will enable them to reach a healthy life through appropriate rehabilitation, exercise and educations during aging. In addition, it is necessary to promote the healthy life in elderly by customized exercise, training, and shoes.

Avaliação de rotina do pé diabético em pacientes internados: prevalência de neuropatia e vasculopatia / Routine evaluation of diabetic foot in hospitalized patients: neuropathy and vasculopathy prevalence

O diabetes mellitus (DM) está associado ao desenvolvimento de complicações macroangiopáticas e microangiopáticas. Sugere-se que o pé diabético seja responsável por até 70% das amputações não traumáticas em membros inferiores. O objetivo foi identificar a frequência de alterações vasculares e neurológicas dos pés em pacientes diabéticos internados. Foi realizado um estudo descritivo transversal em hospital universitário de agosto/2015 a agosto/2016. Os pacientes foram submetidos a exame físico detalhado dos pés com avaliação das sensibilidades protetora plantar, vibratória e dolorosa e pesquisa do reflexo aquileu. Também foram colhidos dados socio-demográficos e de presença de comorbidades. Considerou-se portador de neuropatia quem apresentou perda de dois tipos de sensibilidade, e de vasculopatia quem teve claudicação intermitente ou pulsos com diminuição de amplitude. Dos 76 pacientes examinados, 61,8% do sexo feminino, a média de idade foi 60,7 ± 13,5 anos. Destes, 64,4% apresentavam sobrepeso/obesidade (IMC 28,6 ± 6,3). O tempo de diagnóstico do DM foi de 9,5 anos ± 7,6. Associação com tabagismo estava presente em 47,3% dos pacientes, e com etilismo em 38,1% . A comorbidade mais prevalente foi hipertensão arterial sistêmica, em 80,2%. Alteração na avaliação dos pés mais comum foi diminuição de sensibilidade, presente em 69,7% dos pacientes. Redução de pulsos foi encontrada em 34,2%, e 6,5% dos pacientes eram amputados. 13,2% dos indivíduos estudados apresentavam sinais de vasculopatia e neuropatia associadamente ao exame físico. Não houve diferença entre grupos com vasculopatia e neuropatia em relação ao tempo e controle de DM, e frequencia de complicações crônicas. Alta frequência de alterações neurovasculares foi evidenciada, o que reforçou a importância da avaliação periódica dos pés, visando evitar complicações, piora da qualidade de vida e aumento do custo para saúde pública.

Diabetes mellitus (DM) is associated with the development of macroangiopathic and microangiopathic complications. It is suggested the diabetic foot is responsible for up to 70% of the non-traumatic amputations in the lower limbs. We aimed to identify the frequency of vascular and neurological alterations of the feet in hospitalized diabetic patients. A descriptive cross-sectional study was carried out in a university hospital from August/2015 to August/2016. Patients underwent a detailed physical examination of the feet with evaluation of plantar, vibratory and painful protective sensitivities and aquileu reflex. Socio-demographic data and the presence of comorbidities were also collected. It was considered neuropathy loss of two types of sensitivities, and vasculopathy intermittent claudication and nonpalpable pulses. From 76 patients examined (61.8% female), mean age was 60.7 ± 13.5 years. 49 patients (64.4%) were overweight / obese (BMI 28.6 ± 6.3). The time of DM diagnosis was 9.5 years ± 7.6. 47,3% subjects presented the association with smoking and 38,1% with alcoholism. The most prevalent comorbidity was systemic arterial hypertension(80.2%). The most common change in the assessment of foot was sensitivity reduction, present in 69.7% of patients. Reduction of pulses was found in 34.2%, and 6.5% of the patients had undergone before amputation. 13,2% os the subjects had simultaneous signs of vasculopathy and neuropathy. There was no difference between groups with and without physical examination changes in relation to the time and control of DM, and the frequency of chronic complications. We showed a high frequency of neurovascular changes, which reinforced the importance periodic assessment of feet, aim at avoiding complications which worsen quality of life and increasing public health costs.

The impact of foot arch height on quality of life in 6-12 year olds / Impacto de la altura del arco del pie en la calidad de vida, de escolares entre 6-12 años

Objective: To determine whether arch height has an effect on the health-related quality of life of schoolchildren. Methods: One hundred and thirteen schoolchildren attended an out-patient centre where self-reported data were recorded, their feet were classified into one of three groups according to their arch index (high, normal or low) and the scores obtained from the Foot Health Status Questionnaire (FHSQ - Spanish version) were compared. Results: The groups with high, low and normal arch recorded lower scores in Section One for the general foot health and footwear domains and higher scores in foot pain and foot function. In Section Two they obtained lower scores in general health and higher scores in physical activity, social capacity and vigor. Conclusions: Comparison of the scores obtained reveals that arch height has a negative impact on quality of life. Given the limited extent of available evidence in respect of the aetiology and treatment of foot diseases and deformities, these findings reveal the need to implement programmes to promote foot health and carry out further research into this commonly occurring disabling condition.

Objetivo: Conocer si la altura del arco del pie tiene impacto en la calidad de vida relacionada con la salud en la etapa escolar. Métodos: Ciento trece escolares acudieron a un centro ambulatorio donde se registraron datos autoinformados, se clasificaron los pies en función de los valores del índice del arco en tres grupos (aumentado, disminuido y normal) y se compararon las puntuaciones obtenidas según el Foot Health Status Questionnaire (FHSQ) versión española. Resultados: Los grupos con arco del pie aumentado, disminuido y normal muestran puntuaciones más bajas en la primera sección en las dimensiones salud del pie y calzado y puntuaciones altas en dolor y función del pie. En la segunda sección obtuvieron menos puntuación en la dimensión salud general y puntuaciones altas en función física, función social y vitalidad. Conclusiones: La comparación de las puntuaciones obtenidas muestra que la altura del arco tiene un impacto negativo en la calidad de vida. Dado que la evidencia actual sobre la etiología y el tratamiento de las enfermedades y deformidades es limitada, estos resultados ponen de manifiesto la necesidad de implementar programas para promover la salud de los pies y seguir investigando en esta condición común e incapacitante.

Ultrasonographic Evaluation of Flexor Hallucis Longus Tenosynovitis in Sports Players / 대한스포츠의학회지

The purpose of this study was to investigate the ultrasonographic features of flexor hallucis longus (FHL) tenosynovitis in sports players. High-resoluted ultrasound was used to measure the thickness and echogenicity of the flexor hallucis longus at the posteromedial ankle, especially the fibro-osseous tunnel, for 60 sports players (120 feet). They were compared with their asymptomatic feet. There were two group; group 1 was symptomatic feet, 2 was asymptomatic. The 36 males (72 feet) and 24 females (48 feet) had an average age of 21.3 years (range, 18.23 years). Thickness, echogenicity of the tendon on each group were evaluated by the ultrasonography and the results were statistically analyzed. The mean thickness of the FHL on group 1 was 3.4+/-1.2 mm, 2.1+/-1.3 mm on group 2. There was significant difference between two groups (p=0.002). The thickness of FHL based on gender and location was not significant different (p>0.05). For group 1, increased thickness of the FHL and reduced echogenicity, peritendious fluid collection were observed in ultrasonographic findings.Increased thickness (>3 mm) and hypoechoic lesion, peritendinous fluid collection of the tendon were sonographic findings at the posteromedial ankle in the FHL tenosynovitis. The authors suggested that Ultrasonography is a valuable and alternative tool for the evaluation of FHL tenosynovitis.

Approach to the patients of diabetic foot disease with refractory ulcers - Report of 4 typical cases with therapeutic experiences / 中华内分泌代谢杂志

The professional care by multi-disciplinary team and priority of prevention should be carried out in the treatment of diabetic foot disease to reduce diabetic amputation.This article describes the professional experience in the treatment of four complicated cases with diabetic foot disease and emphasizes the importance of the co-operation among different specialists,including diabetologists and wound,vascular,orthopedic surgeons,etc.as well as of varied therapies applied in staged management of the diabetic foot care,by treating these patients with diabetic foot disease as early as possible.

Surgical Treatment of Diabetic Foot Disease / 임상당뇨병

Diabetic foot diseases which require surgical treatment consists of diabetic foot ulcer, infection and neuropathic arthropathy. Surgical procedures for diabetic foot ulcers and infections such as drainage, debridement, partial foot amputation and major limb amputation are most common procedures and arthodesis with or without deformity correction can be performed for specific diabetic neuropathic arthropathies. Underlying pathomechanism of diabetic foot disease includes diabetic peripheral neuropathy and vasculopathy. Treating physicians should be aware that concomitant complications of long-standing diabetic status such as cardiovascular and renal dysfunction should be addressed to treat intractable diabetic foot diseases successfully. However, with advent of adjuvant treatment which increases vascular supply on ischemic limb disease, proper surgical treatment on diabetic foot disease can prevent or delay major limb amputations, sustaining functional capability of diabetic patients.

Effect of Chronic Foot Disease to Bone Mineral Density of the Affected Lower Limb / 대한족부족관절학회지

PURPOSE: Pain or discomfort caused by foot diseases may lead to abnormal gait, resulting in decreased bone mineral density (BMD) of the affected lower limb. We analyzed the effect of foot affection to BMD and its clinical significance. MATERIALS AND METHODS: Bilateral hip BMD was evaluated in 93 patients with unilateral chronic foot disease. To minimize statistical errors, we excluded patients with medical histories that had influence on BMD. Analysis was based on the results of BMD tests at the first visit. All patients denied past medical intervention for osteoporosis. The difference in density between bilateral limbs was determined by comparing BMDs of the neck, upper neck, trochanter and total area of hip. RESULTS: Test results revealed the decrease of BMD in the lower limb with the affected foot, compared to the unaffected side. This decrease was significant in the area of the trochanter (p<0.05). There was no marked difference of BMD in relation with duration of affection, underlying disease or age. Pertaining the location of foot affection, the hindfoot group showed significant decrease in BMD compared to the forefoot group. The group with affection in bone and joint also showed a marked decrease in BMD compared to the soft tissue group (p<0.05). CONCLUSION: Pain and discomfort caused by chronic foot diseases can lead to a decrease in the BMD of the affected lower limb. This may increase the risk of complications such as osteoporotic fracture and muscular atrophy.

Common Foot and Ankle Disease

Participation of the population in sports activity is increasing. The life expectancy is also on the rise. In addition, the average initial age of women who wear heels is decreasing. For this reason, the incidence of foot disease such as ankle instability, foot deformity, and degenerative joint disease is becoming increasingly common. There is a wide spectrum of foot disease. Common foot disease that can be treated from outpatient base will be discussed in this review.

Diagnosis and Conservative Treatment of Common Foot Diseases

The foot is an essential organ in the locomotion and activity of our daily living, however, its importance has always been underestimated, and foot diseases have not received much attention either from patients ormedical doctors. Recently with the advancement of technology and sophistication of modern life, one can witness a growing interest in various foot diseases in conjunction with an increased trend of many medial centers opening special foot clinics. Unlike in other muscu-Ioskeletal parts, the diagnosis of a foot disease is easy through simple history taking and physical examination, and also the treatment is relatively easy. One important thing to keep in mind is that many foot diseases result from wearing inappropriate shoes therefore the diagnosis of a foot disease should always involve an examination of the patient's shoes, and in some cases patients may require a therapeutic prescription of special shoes. It is the objective of this paper to discuss diagnostic approachesand conservative treatment modalities in common foot diseases.

Treatment of Painful Heels with Acupuncture in 32 Cases / 针灸推拿医学（英文版）

Points Fengfu(GV 16), Fengchi(GB 20) and Anmian were selected as main acupoints to treat painful heels and the total effective rate of 96.9% was got. The technique of lifting needle was the key to the therapy.

Achilles Project: An Epidemiology Survey to Assess the Seasonal Incidence of Foot Diseases and Patient Compliance / 대한의진균학회지

BACKGROUND: Dermatological diseases affecting the feet, e.g. fungal infections and nail infections, are often not fully perceived as real medical problems even when they experience great discomfort, including pain. These misperception often prevents from seeking timely treatment, which can result in very severe conditions. This survey, so called "ACILLES PROJECT" was a "foot screening" project that would be focused on all parts of the body below the Achilles heel: foot, toe and toenails. OBJECTIVE: This study was undertaken for both medical doctors and patients to raise the awareness of foot diseases and additional insights into disease that could affect foot. And also, in seasonal variation, we tried to compare the epidemiological data and to look over the relationship of dermatophytosis in other parts with fungal infections in foot and to analyze the compliance and efficacy of antifungal agents in the treatment of patients who were diagnosed as dermatophytosis in their feet in the treatment of antifungal agents. METHODS: Achilles survey was conducted for one week from 7th July to 13th July, 1997 and 16th March to 17th April, 1998 co-worked by the Korean Society for Medical Mycology and Janssen Korea. In 1997, 19,298 patients, who visited dermatology and urology, and 353 investigators participated in this survey. And Achilles 98, in 1998, was composed of two parts, Unit I and Unit II. Unit I survey was a foot disease consult program and Unit II was a patient compliance survey 29,922 patients, 391 investigators and 16,383 patients, 350 investigators were involved in Unit I and Unit II respectively. RESULTS: Among total 29,922 patients who responded to the survey, 57.7% of them had more than one foot disease. There was no big difference comparing with the number (67%) in the survey of last summer. And it was observed that fungal infection was the most dominant disease (79.8%) regardless of seasons (83.7% in July, 1997). Furthermore, there were no significant differences in the prevalence of other foot diseases for each season (eczema 11.1%, corns 5.1%, warts 2.7%, psoriasis 2.1%). Oral antifungal agents were prescribed to the patients who were diagnosed as having fungal infections in their feet in order to survey drug compliance by filling out the patients diary. In compliance, only 24% of patients in itraconazole pulse therapy for 28 days and 16% of patients in itraconazole continuous therapy for 28 days compiled with their dosage guideline exactly. It is observed that the longer the duration of drug therapy is, the worse the patients compliance is. CONCLUSION: According to the epidemiological survey in 1997 and 1998, the prevalence of foot disease was not significantly different seasonally, and it was reported that the awareness of and the intention for the treatment of foot diseases were not high enough based on the compliance data of patients.