Skin diseases are associated with environmental factors and a public health approach is particularly important. We determined the prevalence of skin conditions and associated socioeconomic factors in primary school children in Turkey. A questionnaire for determining the socioeconomic level and a complete dermatologic examination were performed in 785 children in two primary schools in different socioeconomic areas of suburban and central Manisa, Turkey. The study included 345 (43.9%) girls and 440 (56.1%) boys with a mean age of 9.25 +/- 1.55 (range 6-14 years). Infectious skin diseases were frequently observed: pediculosis capitis in 74 children (9.4%), scabies in 17 (2.2%), viral skin diseases in 30 (3.8%), and fungal infections in 6 (0.7%). The other common conditions were melanocytic nevi (14.4%), keratosis pilaris (12.5%), pityriasis alba (12%), xerosis (11.8%), and atopic dermatitis (6.8%). Pediculosis capitis, acne, and dandruff were more common in girls. The rate of infections, atopic dermatitis, xerosis, and pityriasis alba were significantly higher in the school children with poor socioeconomic conditions. Improvement in socioeconomic conditions along with education may be needed to decrease the prevalence of some of these skin disorders in order to decrease costs related to treatment.

A cross-sectional study was performed in two primary schools with different socioeconomic status in the suburban and central areas of Manisa, Turkey, in order to determine the prevalence of tinea pedis and onychomycosis. A full dermatological examination and a questionnaire on socioeconomic conditions were performed in a group of 785 randomly selected children aged 6-14. Of 9 clinically suspected tinea pedis and 4 onychomycoses cases, KOH examination (direct microscopy) and/or mycological cultures were positive in six boys, in whom Candida glabrata and C. tropicalis grew. Older age and higher number of siblings were found to be significant factors for fungal infection.

A 29-year-old woman with swelling, multiple nodules and discharging sinuses of her right foot is presented. A single nodule on the sole was excised 15 years ago and since then she has had recurrent attacks of swelling and discharging sinuses that improved partially with antibiotics. Magnetic resonance images (MRI) revealed an ill-defined mass predominantly with low signal intensity on T2W images. Within the granulomata, multiple unenhancing foci, with low T1W and T2W signal most likely representing the fungal balls or grains were detected. Histopathological examination revealed large clusters of microorganisms resembling fungal hyphae and bacteria, which were surrounded by mixed inflammatory infiltrate cells and stained positively by PAS and Gomori's methenamine silver stain. As minimal regression was seen on MRI with 4 months' itraconazole (200 mg day(-1)) treatment, co-trimoxazole (160 TMP/800 SMX b.i.d.) was added to treatment. Complete remission was established by MRI examination after 10 months with this combination therapy.