EPIDEMIOLOGY, DIAGNOSIS, AND MANAGEMENT OF Trichophyton tonsurans INFECTION IN JAPAN

Abstract

In Japan, Trichophyton tonsurans infection has become an increasing problem among participants in martial arts over the last ten years. For the purpose of controlling this infection, a treatment protocol was evaluated. Method : This study involved 6,133 athletes affiliated with judo clubs in the 20 First Division universities that were registered with the University Judo Federation of Tokyo for 5 years. Results : 418 (6.0%) subjects yielded positive hairbrush culture. a. If the number of colonies as observed by the hairbrush method was 2 or fewer, the hair was washed with miconazole shampoo. b. If the number of colonies was 3 or more, 1) itraconazole : 100mg/day for 6 weeks or 400mg/day for 1week, or 2) terbinafine : 125mg/day for 6weeks or 500mg/day for 1week, was administered. 311 (87.1%) of 325 subjects treated with TBF or ITZ were negative;however, the test was not negative in individuals who discontinued the treatment. Conclusion : The pulse-dose regimen was the preferred option in this study. However, there were, in fact, some subjects who were not able to complete the treatment. The following steps are necessary to control infection : 1) determine an effective therapeutic method, 2) set guidelines for disease prevention and control of infection, and 3) establish a network among expert therapeutic institutions to optimize treatment.