Four-hundred and ninety-four schoolchildren and 200 children attending a paediatric medical out-patient clinic were screened for clinical evidence of dermatophyte onychomycosis. Only one case was found and mycological investigation showed this to be due to Trichophyton rubrum. The overall prevalence of dermatophyte onychomycosis in the prospective survey of schoolchildren was 0.2%, confirming that this type of infection is very uncommon in children. Seven further cases of nail infection occurring in children under the age of 12 years are reported. These represent all cases collected by our laboratory over a 3-year period. In six cases where culture of nail was positive, the causative organism was T. rubrum. In four cases at least one parent was also found to have dermatophyte onychomycosis; again, T. rubrum was the causative organism in all cases. Dermatophyte onychomycosis in children appears to be of low infectivity, (in contrast to viral wart infection), and a parental source should be suspected and sought.

No abstract

The prevalence of cutaneous fungal infection was studied in 72 patients who had undergone renal transplantation and compared with a group of age and sex matched controls. Samples were obtained from toe nails, toe webs, and the upper back; clinically suspicious lesions from other areas were also examined. A total of 576 sites were sampled (288 in each group). Pathogenic fungi were identified from 44 sites (15%) in the renal transplant (RT) group compared with 26 sites (9%) in the control group, (P less than 0.05). However, site-specific differences were less marked; no difference was found between the RT group and controls when the results from the toe nails and toe webs were analysed separately. Trichophyton mentagrophytes was the most common species isolated from both groups. Colonization of the back with Pityrosporum yeasts was significantly more common in the RT group, but few patients in either group had tinea versicolor. 'Mixed infections', with more than one species of fungus isolated in an individual, were only found in the RT group. We also examined the relationship between the presence of fungal infection and the presence or absence of cutaneous malignancy in the renal transplant group. No increase in the prevalence of fungal colonization was found in those patients who had developed cutaneous malignancy compared with those who had not.

In these days of rapid transit from continent to continent, and the increasing mobility of people, agents of disease are no longer geographically restricted. Disease contracted half way across the world may become manifest in a country in which the pathogen is not normally found. Thus knowledge of the geographical distribution of pathogens becomes increasingly important when a diagnosis is being made. This is as true of ringworm fungi as of any other group of micro-organisms. In the last 12 years, in the Mycological Reference Laboratory, an increasing number of exotic dermatophytes have been seen, related in part at least to the great increase in the number of non-British residents.

Two related cases of ringworm caused by contact with an infected hedgehog are reported. The causal fungus, Trichophyton erinacei, was isolated from human and animal cases. The epidemiology of hedgehog ringworm is discussed.