Commonly affected body sites in 92 Japanese combat sports participants with Trichophyton tonsurans infection

Abstract

Outbreaks of Trichophyton tonsurans infection constitute one of the serious problems among combat sports practitioners in Japan. To facilitate the diagnosis of individuals at risk, we undertook a study to determine which body sites are most commonly infected. We reviewed medical data, hairbrush culture results and questionnaire information from patients with T. tonsurans infection who were admitted to the dermatology clinic of Juntendo University hospital from 2000 to 2004. The study included 92 patients (87 males), aged 6-38 years (mean age: 18.4 years old). Eighty-nine patients were judo practitioners and three were wrestlers. Twenty-eight patients (30.4%) were asymptomatic carriers. In 64 patients, 51 patients (55.4%) with tinea corporis, 27 patients (29.3%) with tinea capitis, and/or one patient (1.1%) with tinea manuum were seen. Tinea corporis was observed on the forehead, auricles, nape of the neck, bilateral shoulders, left side of the upper chest, both elbows, back of the left hand to the wrist and both knees. Tinea capitis was most common in the occipitonuchal region at the hairline and in the temporal and frontal regions, at both auricles. Initial screening of these sites might facilitate the identification of the infection especially in judo practitioners.

Infectious Disease Outbreaks in Competitive Sports, 2005–2010

“…Of these, 19 were solitary reports of an outbreak in a single sport [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] ; 3 (including 2 from Juntendo University 24,25 ) addressed a tinea epidemic due to Tricophyton tonsurans among combat-sport (mainly judo, although one also included wrestlers 26 ) competitors in Japan [24][25][26] ; 1 reported on a single measles virus outbreak involving competitors in 2 sports;hairsp 27 ; and 1 discussed the importance of sentinel surveillance sites in high school athletic departments to monitor outbreaks of CA-MRSA across a variety of sports. 28 When we excluded this latter study from analysis (because its main focus was not a specific outbreak) and counted the 3 articles on the tinea outbreak among combatsport competitors in Japan as a single outbreak, a total of 21 outbreaks or clusters were reported in the time period.…”

Trichophyton tonsurans infection in Japan: Epidemiology, clinical features, diagnosis and infection control

“…We analyzed a total of 92 patients with T. tonsurans infection who visited a dermatology clinic of a university hospital during a 5‐year period from 2000 to 2004. For judo practitioners, we found that the commonly affected body sites are the hairline in the occipitotemporal region and sites that rub against the judo uniform during judo practice …”

Epidemiology of dermatophytosis in junior combat and non‐combat sports participants

“…Contact sports involve close skin‐to‐skin contact, facilitating the transmission of dermatophytes between competitors and team members 2–11 . Recent studies have revealed that, although it is not spreading rapidly, T .…”

“…On the other hand, the incidence of tinea cruris and tinea pedis does not differ across combat and non‐combat sports 1 . The anthropophilic dermatophyte Trichophyton tonsurans is an emerging pathogen that is responsible for several tinea gladiatorum outbreaks in North America, 2,3 as well as Europe, 4–7 the Middle‐East 8–10 and Japan 11 . These worldwide outbreaks reflect the potential spread of this fungus across contact sports players.…”

“…Therefore, clinicians and mycologists have focused on the spread of T . tonsurans , particularly in sports participants worldwide 2–12 and in primary school children in endemic foci, such as the USA 13,14 . Typically, the prevalence of asymptomatic carriers related to T .…”