mykosen 11 (9) : 651-654 (1968) Eingegangen am 11. Mai 1968

From the Institute for Health Protection of the S. R. of Serbia, Belgrad

Dermatomycoses found in a Serbian Mining and Smelting Plant

MARIJA STEFANOVI~, A. K R S T I ~ and R. ANDJELKOVI~

Along with allergic skin manifestation, fungus diseases play an important role in the increasing occupational dermatosis. The development of mycologic flora with the creation of the characteristic regional spectrum is known to be dependent on the development of individual economic and industrial plants among other factors. Thus the hygienic habit of putting on rubber boots or other footwear and nylon or similar socks, using common bath facilities, as well as the specific conditions in individual industrial establishments, are known to be playing a substantial role in regard to frequent appearances of fungus diseases affecting the skin in some mining and industrial centres. The soil as the natural stock of dermatophytes combined with atmospheric conditions exercises its influence on both the morphological properties and pathogenicity of some types of fungi. Similarly, individual factors (e. g. sensibilisation aptness, hyperfunctioning of perspiration glands, incidence of accidents thickness of the horny layer, etc.) in some groups of workers have an important role in dermatosis.

Table 1: Structure of skin diseases in Bor and Prahovo Mines in 1967 ~ _ _ _ -~

Types of diseases Bor Prahovo Total Number % Number % Number %

~ ~ ~

Tinea pedis 500 55.00 26 26.26 526 52.20 Tinea inguinalis 18 1.98 6 6.56 24 2.38 Tinea cutis trichophytica 6 0,67 2 2.02 8 0.79 Candidiasis 33 3.63 14 14.15 47 4.66

Pityriasis versicolor 54 5.94 9 9.09 63 6.25 Trichomycosis axillaris 48 5.28 19 19.19 67 6.64

Erythrasma ax. et ing. 210 23.10 5 5.05 215 21.36 ~~ ~~

Furunculosis Psoriasis vulgaris Tinea albigena (Dyschromia) Heinangioma Lipoma Dermatitis in seborrhoico

3 0.33 4 4.04 7 0.69 6 0.66 5 5.05 11 1.08

3 0.33 1 1.01 4 0.39

1 1.01 1 0.09 8 0.88 4 4.04 12 1.20

16 1.76 2 2.02 18 1.75

_ _

Eczema chron., contact dermatitis 4 0.44 1 1.01 5 0.49

T o t a l 909 100.00 99 100.00 1008 100.00

~~~ ~~ __

- ~- .- _ ~ _ _ _ ~ ~ ~~

652 MARIJA STEFANOVI~, A. K R S T I ~ and R. ANDJELKOVI~

Bearing in mind the preventive and epidemiological significance of these general and particular factors, dermatological examinations of the miners from a Serbian mining area were effectuated in 1967. On that occasion 3012 miners from the Mining and Smelting Plant Bor were examined, and the results obtained showed a considerable percentage of various skin manifestations, i. e. 33.46. These were very oRen combined with fungus diseases and the team concerned with this found a large percentage of epidermophytoses, trichomycosis axillaris, erythrasma axillaris et inguinalis, etc. Depending on the conditions of work these dermatoses were chronic in most cases lasting up to 20 years with frequent remissions.

Figure 1: Diseases caused by fungi

50

40

30

20

10

0.

5 2 . 2 0

2.38

Fig. 1 and table 1 present the structure of skin diseases in the miners employed by the Smelting and Superphosphate Plant. In 526 miners tinea pedis was found; candidiasis in 47; pityriasis in 63; trichomycosis in 67, etc.

Fig. 2 and table 2 contain the types of isolates of clinical dermatomycoses. From 526 such dermatomycoses 355 cultures were obtained and the following strains were isolated: Trichophyton rubrum 43.38 %, Trichophyton mentagrophytes 26.47, Epidermo- phyton floccosum 3.67, Candida spec. 15.79, Tr. tonsurans 1.98, Tr. verrucosum 0.25, Scopulariopsis sp. 4.50, Mucor sp. 0.84, Cephalosporium sp. 0.28, Geotrichum sp. 0.84, Rhodotorula'sp. 1.41, and unidentified fungi 0.56 percent.

mykosen 11, Heft 9 (1968)

Dermatomycoses found in a Serbian Mining and Smelting Plant 653

Figure 2: Most common strains isolated from pathologically changed skin

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30-

20-

10-

0-

2 6 , 4 7

Table 2: Types of isolates from cases diagnosed as clinical dermatomycoses in Bor and Prahovo mines in 1967

- ~~~~ -

Types of isolation from Number Structure the skin index

Trichophyton rubrum 154 43.38 Trichophyton mentagrophytes 94 26.47 Epidrrmophyton floccosum 13 3.67 Candida species 56 15.79 Trichophyton tonsurans 7 1.98 Trichophyron verrucosum 1 0.28 Scopulariopsis sp. 16 4.50 Mucor sp. 3 0.84

Cephalosporium sp. 1 0.28 Geotrichum sp. 3 0.84 Rhodotorula sp. 5 1.41

Nonidentified molds 2 0.56

Total 355 100.00

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~~~~~~ ~ ~ ~ _ _ _ ~ ~ ~ ~

mykosen 11, Heft 9 (1968)

654

Number

is situated I spczLenr Place where bath

~

MARIJA S T E F A N O V I ~ A. K R S T I ~ and R. ANDJELKOVI~

Trichophyton

N u m b E b r % ~ _ _

Table 3: Mycological findings of cultures taken from baths ~ _ _ _ _ _ ~ _ _ _ _ _ ~

I I T y p e s o f d e r m a t o p h y t e s

3 Pit Surface mining S m e 1 t e r 20 2

Superphosphate plant 20 1

~ ::' ~

45.45 27.27 18.18

9.10 __

.

2 -

1

2 -

Epidermophyton floccosum

Number 1 % _ _ ~

40.00 -

20.00 40.00

- I - - I - - I -

- I -

- I - Table 3 presents the mycologial findings of cultures taken from the bath. From each

bath 20 samples of swabs were taken, 80 altogether. Trichophyton rubrum was predo- minant over Tr. mentagrophytes mainly in those places where foreigners shared the bath facilities. This fact justifies the large percentage of Tr. rubrum infection in the workers using the same bath facilities. I t is, accordingly, easy to understand the rapid increase in these infections.

In some patients in which no fungus elements were found dermatophytides have been noticed as an allergic manifestation of primary fungus foci. In addition to dermatosis (psoriasis chron., contact dermatitis, etc.) in a small number of workers artificial changes were found on the skin, such as burns, cuts, slight chemical injuries, etc.

Summary Under systematic dermatological examinations of 3012 workers (miners) coming from

a mining area of Serbia in Bor 33.46 percent of skin affections were found. The largest percentage of the disease is related to dermatophytosis of which 35.21 percent of myco- logical cultures were positive. The infections caused by Tr. rubrum played a predominant role over Tr. mentagrophytes, which means that there is at present a reverse correlation of this fungus flora if compared with previous findings. Striking incidence was parti- cularly noticed in regard to Tr. rubrum strains isolated from the baths used by foreign workers. In addition to general and individual factors influencing the appearance of dermatomycoses, specific working conditions play here a vital role.

L i t e r a t u r

1. ALKIEWIEZ, J. u. W. S O W I ~ ~ S K I : Mykosen 10

2. GRIN, E. and OZEGOVI~, L.: Symposium of med. Mycol. 1963, Warsaw, 67-70 (1965).

3. HANTSCHKE, D.: Mykosen 9 (3) : 129-131 (1966).

4. JUMINER B., KHALFAT, A. and STEFANOVI~, M.: Arch. Inst. Pasteur de Tunis 41 (2) : 207-216 (1964).

(10) : 463-466 (1967).

5. JUMINER, B., RIOUX, A. and STEFANOVIC, M.: Arch. Inst. Pasteur de Tunis 41 (3/4) :

6. POHLER, H., BRAUN, H . und CHRISTINA SCHONBORN: Mykosen 11 (3) : 205-261 (1 968).

7. RIETH, H. : Mykosen 10 (10) : 487-488 (1967).

8. SCHWA", JADWIGA: Mykosen 10 (10) : 493 -500 (1967).

321-345 (1964).

9. SCHWA", JADWIGA: Mykosen 11 (2) : 165- 168 (1968).

Author's address: Dr. MARIJA STEFANOVIC, Beograd, 29 novembre No. 25/V, Jugoslavija

mykosen 11, Heft 9 (1968)