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Trichophyton tonsurans scalp carriage among wrestlers in a national competition in Turkey

Abstract

Trichophyton tonsurans tinea gladiatorum is an emerging epidemic among combat-sport athletes across the globe. In the present study, we investigated the prevalence of symptomatic and asymptomatic dermatophytic infections among wrestlers in the National Greco-Roman Championship in Turkey. In total, 194 wrestlers from 32 provinces and 72 clubs were examined for scalp, trunk, groin, and toe web dermatophytic infections. We also administered a questionnaire to obtain information on the participants’ lifestyles, wrestling characteristics, and risk factors for dermatophytic infections. The hairbrush method was used for scalp and trunk sampling, whereas a cotton swab was used for groin, toe web, and mat sampling. Three wrestling mats in the gymnasium were surveyed for dermatophytes using the touch preparation method. A total of 17 (8.8%) wrestlers harbored dermatophytes, and 22 strains were isolated: 13 (59.1%) T. tonsurans and 9 (40.9%) T. rubrum. These isolates were found on the scalp (8), trunk (2), forearm (1), hand (1), groin (3), and feet (7). In addition, we recovered 8 dermatophyte strains from the 150 mat samples (5.3%): T. rubrum in 6 samples (75%) and T. tonsurans in two samples (25%). T. tonsurans was only recovered from 11 out of 194 (5.7%) wrestlers. Scalp carriage represents the predominant (72.7%) clinical picture of a T. tonsurans infection in these Greco-Roman wrestlers in Turkey.

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References

  1. Adams BB. Tinea corporis gladiatorum. J Am Acad Dermatol. 2002;47:286–90.

    PubMed  Article  Google Scholar 

  2. Shiraki Y, Hiruma M, Hirose N, Sugita T, Ikeda S. A nationwide survey of Trichophyton tonsurans infection among combat sport club members in Japan using a questionnaire form and the hairbrush method. J Am Acad Dermatol. 2006;54:622–6.

    PubMed  Article  Google Scholar 

  3. Ilkit M, Saraclı MA, Kurdak H, et al. Clonal outbreak of Trichophyton tonsurans tinea capitis gladiatorum among wrestlers in Adana, Turkey. Med Mycol. 2010;48:480–5.

    PubMed  Article  Google Scholar 

  4. Aghamirian MR, Ghiasian SA. A clinico-epidemiological study on tinea gladiatorum in Iranian wrestlers and mat contamination by dermatophytes. Mycoses. doi: 10.1111/j.1439-0507.2009.01809.x.

  5. Mulic R, Kraljevic-Sisko K, Tolic T, et al. Endemo-epidemic occurrence of Trichophyton tonsurans in martial art athletes in Split-Croatia. HealthMED. 2009;4:405–11.

    Google Scholar 

  6. Abdel-Rahman SM. Trichophyton tonsurans: the need for enhanced infection control measures in the pediatric population. Pediatric Health. 2010;4:367–9.

    Article  Google Scholar 

  7. Stiller MJ, Klein WP, Dorman RI, Rosenthal S. Tinea corporis gladiatorum: an epidemic of Trichophyton tonsurans in student wrestlers. J Am Acad Dermatol. 1992;27:632–3.

    PubMed  Article  CAS  Google Scholar 

  8. Hradil E, Hersle K, Nordin P, Faergemann J. An epidemic of tinea corporis caused by Trichophyton tonsurans among wrestlers in Sweden. Acta Derm Venereol. 1995;75:305–6.

    PubMed  CAS  Google Scholar 

  9. Piqué E, Copado R, Cabrera A, et al. An outbreak of tinea gladiatorum in Lanzarote. Clin Exp Dermatol. 1999;24:7–9.

    Google Scholar 

  10. El Fari M, Gräser Y, Presber W, Tietz HJ. An epidemic of tinea corporis caused by Trichophyton tonsurans among children (wrestlers) in Germany. Mycoses. 2000;43:191–6.

    PubMed  Article  CAS  Google Scholar 

  11. Ergin S, Ergin C, Erdogan BS, Kaleli I, Evliyaoglu D. An experience from an outbreak of tinea capitis gladiatorum due to Trichophyton tonsurans. Clin Exp Dermatol. 2006;31:212–4.

    PubMed  Article  CAS  Google Scholar 

  12. Ilkit M, Demirhindi H. Asymptomatic dermatophyte scalp carriage: laboratory diagnosis, epidemiology and management. Mycopathologia. 2008;165:61–71.

    PubMed  Article  Google Scholar 

  13. Ates A, Ozcan K, Ilkit M. Diagnostic value of morphological, physiological and biochemical tests in distinguishing Trichophyton rubrum from T. mentagrophytes complex. Med Mycol. 2008;46:811–22.

    PubMed  Article  CAS  Google Scholar 

  14. Abdel-Rahman SM, Talib N, Solidar A, Nopper AJ, Wyckoff GJ. Examining Trichophyton tonsurans genotype and biochemical phenotype as determinants of disease severity in tinea capitis. Med Mycol. 2008;46:217–23.

    PubMed  Article  CAS  Google Scholar 

  15. Abdel-Rahman SM, Sugita T, González G, et al. Divergence among an international population of Trichophyton tonsurans isolates. Mycopathologia. 2010;169:1–13.

    PubMed  Article  Google Scholar 

  16. Hirose N, Suganami M, Shiraki Y, Hiruma M, Ogawa H. Management and follow-up survey of Trichophyton tonsurans infection in a university judo club. Mycoses. 2008;51:243–7.

    PubMed  Article  Google Scholar 

  17. Hirose N, Suganami M, Ogawa YS, Hiruma M, Ogawa H. Screening examination and treatment of Trichophyton tonsurans infection in judo athletes affiliated with the University Judo Federation of Tokyo. Mycoses. doi:10.1111/j. 1439-0507.2009.01823.x.

  18. Hedayati M, Afshar P, Shokohi T, Aghili R. A study on tinea gladiatorum in young wrestlers and dermatophyte contamination of wrestling mats from Sari, Iran. Br J Sport Med. 2007;41:332–4.

    Article  Google Scholar 

  19. Bassiri-Jahromi S, Khaksar AA. Outbreak of tinea gladiatorum in wrestlers in Tehran (Iran). Indian J Dermatol. 2008;53:132–6.

    PubMed  Article  Google Scholar 

  20. Beller M, Gessner BD. An outbreak of tinea corporis gladiatorum on a high school wrestling team. J Am Acad Dermatol. 1994;31:197–201.

    PubMed  Article  CAS  Google Scholar 

  21. Shiraki Y, Hiruma M, Hirose N, Ikeda S. Commonly affected body sites in 92 Japanese combat sports participants with Trichophyton tonsurans infection. Mycoses. 2009;52:339–42.

    Article  Google Scholar 

  22. Frisk A, Heilborn H, Melen B. Epidemic occurrence of trichophytosis among wrestlers. Acta Derm Venereol. 1966;46:453–6.

    PubMed  CAS  Google Scholar 

  23. Erös N, Kárloyi ZS, Molnár E. Trichophyton equinum infections among young wrestlers in Hungary. Acta Derm Venereol. 1999;8:63–6.

    Google Scholar 

  24. Adams BB. Skin infection in athletes. Expert Rev Dermatol. 2010;5:567–77.

    Article  Google Scholar 

  25. Adams BB. Tinea corporis gladiatorum: a cross-sectional study. J Am Acad Dermatol. 2000;43:1039–41.

    PubMed  Article  CAS  Google Scholar 

  26. Abdel-Rahman SM, Simon S, Wright KJ, Ndjountche L, Gaedigk A. Tracking Trichophyton tonsurans through a large urban child care center: defining infection prevalence and transmission patterns by molecular strain typing. Pediatrics. 2006;118:2365–73.

    PubMed  Article  Google Scholar 

  27. Ginter-Hanselmayer G, Weger W, Ilkit M, Smolle J. Epidemiology of tinea capitis in Europe: current state and changing patterns. Mycoses. 2007;50(Suppl 2):6–13.

    PubMed  Article  Google Scholar 

  28. Kawachi Y, Ikegami M, Takase T, Otsuka F. Chronically recurrent and disseminated tinea faciei/corporis-autoinoculation from asymptomatic tinea capitis carriage. Pediatr Dermatol. 2010;27:527–8.

    PubMed  Article  Google Scholar 

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Acknowledgments

The present study was partly supported by the Turkish Wrestling Federation. We gratefully acknowledge Mr. Önder Yakşi, the General Coordinator of the Turkish Wrestling Federation, who kindly helped in the organization of this study, making the present study possible. In addition, we appreciate and give our sincere thanks to two anonymous reviewers for their critical comments on earlier drafts of this paper.

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and the writing of the paper.

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Correspondence to Macit Ilkit.

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Ilkit, M., Gümral, R., Saraçlı, M.A. et al. Trichophyton tonsurans scalp carriage among wrestlers in a national competition in Turkey. Mycopathologia 172, 215–222 (2011). https://doi.org/10.1007/s11046-011-9421-y

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  • DOI: https://doi.org/10.1007/s11046-011-9421-y

Keywords

  • Anthropophilic
  • Asymptomatic carrier
  • Dermatophyte
  • Trichophyton tonsurans
  • Wrestling