ABSTRACT
In this essay, we analyze the case study of mass ringworm irradiation conducted in Israel during its first years of existence and its consequences. We analyzed the case study of ringworm irradiation in the framework of racial construction of illness and its treatment, showing the elasticity of race and ethnicity as medical and social categories.
Subject(s)
Ethnicity/history , Jews/history , Public Health/history , Tinea/history , Head and Neck Neoplasms/etiology , History, 20th Century , Humans , Israel , Jews/ethnology , Neoplasms, Radiation-Induced/ethnology , Neoplasms, Radiation-Induced/history , Prejudice , Tinea/ethnology , Tinea/radiotherapyABSTRACT
Tinea of the skin and nails is a common problem in remote Aboriginal communities of the Top End of Australia. A retrospective study was performed on data collected from 104 patients from several indigenous communities. Worksheets were filled in by district medical officers and rural general practitioners, detailing the extent of the tinea. Patients were prescribed between 4 and 12 weeks of 250 mg daily oral terbinafine. Fifty-two patients were followed up, with 45 having a good response to treatment (87%) and with 22 of these patients having full clearance of tinea (42%). A prospective study with 44 subjects was performed. The extent of the tinea was documented and fungal scrapings/clippings were taken. Forty subjects were recruited and given oral terbinafine (2-12 weeks depending on skin/nail involvement) or topical terbinafine if oral treatment was contraindicated. Twenty-five of the 40 (63%) subjects were reviewed. Twenty-three (92%) subjects that were followed up improved clinically, with 8/25 (32%) clearing completely. Twenty (80%) of followed-up patients complied fully with treatment. Terbinafine was found to be a well-tolerated and effective treatment of tinea of the skin and nails.
Subject(s)
Antifungal Agents/administration & dosage , Naphthalenes/administration & dosage , Native Hawaiian or Other Pacific Islander , Tinea/drug therapy , Tinea/ethnology , Administration, Oral , Adolescent , Adult , Aged , Australia , Child , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Male , Middle Aged , Prospective Studies , Retrospective Studies , Severity of Illness Index , Terbinafine , Tinea/diagnosis , Treatment OutcomeABSTRACT
HISTORY AND FINDINGS: Several weeks before coming to Germany the two daughters (aged 3 and 6 years) of a family from Togo had developed desquamating skin changes over the hairy scalp. These had then spread to the trunk and limbs. The 8-weeks-old son also had discrete lesions on the hairy scalp and neck. In all of them these lesions had then spread and begun to itch markedly. When first seen as out-patients the father was free of symptoms, but the other members of the family had multiple, sharply circumscribed, partly confluent, dry and desquamating lesions, about 2-4 cm in diameter, with areas of alopecia and hair breaking off at skin level. In addition there were dry, desquamating, sharply circumscribed, partly hyperpigmented, partly infiltrated plaques, 1-3 cm in diameter, disseminated over the entire body surface, but especially the neck and limbs. INVESTIGATIONS: Typical micromorphological characteristics for T. soudanese were demonstrated in the outer zones of a primary culture and the organism was also demonstrated in culture on Sabouraud-glucose-agar. Typical colonies on Löwenstein-Jensen medium allowed differentiation from Microsporum ferrugineum. TREATMENT AND COURSE: The patients were treated systemically with griseofulvin and locally with ciclopiroxolamine. Marked clinical improvement occurred within 2 months and cultures became negative. But as fungal elements were still demonstrated in native preparations from two of the patients, treatment was continued. CONCLUSION: Efficacious treatment of tinea needs reliable diagnosis of the pathogen. Human infection with T. soudanese usually results from contact with other humans. If this infection occurs in persons not from Africa there is usually the history of indirect or direct contact with Africans. Increased international migration and tourism is likely to result in more cases of this kind: this pathogen should be considered in the differential diagnosis of tinea of scalp and body.
Subject(s)
Tinea Capitis/microbiology , Tinea/microbiology , Trichophyton/isolation & purification , Adult , Antifungal Agents/therapeutic use , Child , Child, Preschool , Ciclopirox , Diagnosis, Differential , Drug Therapy, Combination , Family , Female , Germany , Griseofulvin/therapeutic use , Humans , Infant , Male , Pyridones/therapeutic use , Tinea/drug therapy , Tinea/ethnology , Tinea Capitis/drug therapy , Tinea Capitis/ethnology , Togo/ethnology , Transients and Migrants , Trichophyton/classificationABSTRACT
In the period between April 1984 and April 1988 a total of 4294 clinically suspected cases of dermatomycoses were examined for causative fungi. Of these cases 680 were suspected as tinea pedis and tinea manuum. These cases belonged to 21 different nationalities. Both sexes were represented and 649 cases (95.4%) were adults while 31 (4.6%) were prepubertals. Clinical diagnosis was confirmed by direct microscopy in 505 cases or 74.4% (485 adults and 20 prepubertal children). Out of these, 504 cases were positive on culture and yielded 516 isolates. Candida species and other yeasts were responsible for 88.9% and dermatophytes for 11.1% of these infections. The interdigital type of lesions was the most common type (91.9% of all infections) followed by the hyperkeratotic scaling type (6.9%) while the acute inflammatory type was only 1.2% of infections. Treatment showed satisfactory results in most of the cases.
