We conducted a study on clinical and mycological features of tinea pedis and tinea unguium in patients with dementia. There are few studies internationally regarding clinical and mycological features of tinea pedis and tinea unguium in patients with dementia.
. (Methods)
We studied patients with dementia who attended department of neurological medicine of Juntendo University Koshigaya Hospital during 2017. The patients who agreed to participate in this study signed the entry sheets. The Ethics Committee of Juntendo University Koshigaya Hospital approved this study.
We examined specimens from sites of possible dermatophyte infection in feet and toenails of patients by direct microscopy in potassium hydroxide (KOH). When fungus elements were possible(KOH-positive), causative species were identified by culturing the funji on Sabraud’s glucose agar. And we also recorded clinical features and estimated severity of tinea pedis.
(Results)
We studied 64 patients (25 men, 39 women, a mean age 79.3 years). 56 patients had Alzheimer’s disease, 3 had dementia with Lewy bodies, 3 had frontal temporal lobar degeneration and others.  Of these 64 patients, 39 patients (60.9%, 15 men, 24 women) presented positive signs by direct microscopy. 20 patients with tinea pedis (51.3%, 9 men, 11 women) also had tinea unguium.14 patients (35.9%, 6 men, 8 women) had only tinea pedis, and 5 female patients (12.8%) had only tinea unguium., The most common clinical type of tinea pedis was the interdigital type and those of tinea unguim was the distal-lateral subungal onychomycosis (DLSO). The mean severity score of tinea pedis was 4.7. Positive cultures were observed in 20 patients (51.3%).  Trichophyton rubrum was isolated in 16 (80%), T. mentagrophytes in 4 (20%). 
 (Conclusion), 
The incidence rates of tinea pedis and tinea unguium of the patients with dementia tended to be higher than those of healthy people of same ages. Patients with dementia might not to be able to perform daily foot care and maintain the proper hygiene for reasons of apathy or lack of interest. Those are the reasons why the patients with dementia could worsen their foot condition and get to have tinea pedis and tinea unguium. Our study suggests that dementia diseases, like diabetes mellitus and HIV infections, should be regarded as a risk factor for tinea pedis and tinea unguium.

A Study of Tinea pedis and Tinea unguium in Patients with Dementia