Onychomycosis is widespread in the adult population, but considered to be rare in children. A number of studies in recent years show a rise in the prevalence of toenail onychomycosis in children. Of these, only a few were population-based. Here, we present a comprehensive cross-sectional population-based survey of toenail onychomycosis in primary school children in Israel. The survey included 1148 children, 598 boys, and 550 girls aged 5 to 14 from primary schools in the Jerusalem vicinity. Each child underwent a physical examination and completed a personal questionnaire, which provided background information of predisposing factors. The survey shows a prevalence of 0.87% of toenail onychomycosis. Although this figure is too small for statistical analysis, some important conclusions could be drawn: prevalence increased with age: boy/girl ratio was 2.2; the dominant etiologic agent was Trichophyton rubrum followed by Trichophyton mentagrophytes and Candida albicans. Infections were probably transferred from adults via the environment to children. Infected children came from different socio-economic backgrounds. This condition should be considered in the differential diagnosis of nail diseases in children.

Fungal infections of the skin are caused by dermatophyte fungi. Infections can be acute and inflammatory or chronic and non-inflammatory; it is believed that cell-mediated immunity is the cornerstone of host defence and is instrumental in the eradication of the infection. We describe here parameters of the immune response of a group of patients who although not immunocompromised, suffered from widespread and chronic infections. All patients lacked a specific delayed-type hypersensitivity (DTH) response; however, their in vitro lymphocyte proliferation in response to Trichophyton rubrum extract and to other fungal antigens was normal. The patients were not atopic by clinical history, and yet had high levels of non-specific IgE and of T. rubrum-specific IgG4. Taken together, the results of this study suggest that the group of patients studied suffered from an immune imbalance which has characteristics of a Th2-type response.

An antimycotic agent was isolated from roots of alfalfa and further purified to yield a nonhemolytic, homogeneous compound (G2). This compound contained considerable activity against 10 medically important yeasts. MICs obtained by both agar and broth dilution methods ranged from 3 to 15 micrograms/ml. Compound G2 was fungicidal at a relatively low concentration for nine different species of yeasts tested (minimum fungicidal concentrations ranged between 6 and 24 micrograms/ml). The considerable stability of compound G2 and its strong inhibitory and fungicidal activity against a broad range of yeasts suggest that after further development it might be useful as an active agent in the treatment of mycotic infections.

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Data for dermatophyte infections analysed for five 3-year periods between 1954 to 1981 led to the following conclusions: Tinea pedis, tinea cruris and tinea manuum showed an increase in the 50's and 60's and declined in the 70's; Tinea unguium and tinea corporis showed an increase during the whole period; At all these sites, the percentage of Trichophyton rubrum, the main etiologic agent, increased steadily over the periods while the percentage of Trichophyton mentagrophytes, the secondary etiological agent, decreased. Epidermophyton floccosum, the third etiological agent in these sites, showed no sharp fluctuations; These three dermatophytes which show similar microclimatic requirements and favour the same microecological niches, were called 'glabrohydrophilic'. In tinea corporis they form a definite subset, their percentage being similar to that at other glabrous sites; Tinea capitis was at its peak in the 50's, decreased sharply until the second half of the 70's, its main etiological agent being Trichophyton violaceum. Since 1979, an increase of tinea capitis occurred due to the newly introduced Microsporum canis; Dermatophytes favouring scalp hair were called 'trichophilic'. In tinea corporis they form a definite subset, their percentage being similar to that of tinea capitis; A comparison with other studies from this country shows that macroclimate (i.e. humid warm coastal climate compared with dry cooler inland-mountain climate) is not an important factor in the etiology of tinea.